Journal Article Annotations
2024, 2nd Quarter
Annotations by Christian Bjerre Real, MD, MMCI, Deepti Chopra, MBBS, MPH, Daniel McFarland, MD and Marie Tobin, MD
July, 2024
Strengths and weaknesses:
This is the first study to measure the safety, tolerability, and feasibility of psilocybin-assisted therapy in reducing depressive symptoms at weeks one and eight in cancer patients. This study highlights the need for effective and safe treatments. Additional strengths include the administration of psilocybin in group cohorts possibly conferring therapeutic benefit and the use of both individual and group psychotherapies. The study demonstrated the feasibility of this therapeutic regimen in the community setting which facilitates access and potential future scalability. Weaknesses included that this is an open-label study without a control arm. The study is small with a total of thirty participants who were primarily Caucasian (80%) and 70% identifying as female. It is unclear from the study, whether psilocybin, therapy, or the combination resulted in the demonstrated clinical outcomes. Comparison with placebo and other pharmacotherapies for depression is necessary. Additionally, it is necessary to separate the discrete effects of individual versus group psychotherapy.
Relevance:
This study is important because it shows that the novel therapeutic approach of psilocybin-assisted treatment of depression in cancer patients is safe and effective. Additionally, it demonstrates the feasibility of delivering this novel treatment, safely in a community setting. The study also elucidates important factors to be addressed in future studies of psilocybin-assisted treatment of major depression in cancer.
The finding:
Yang et al., found the education about liver resection via virtual reality (VR) helped improve patient’s understanding about the procedure and reduced their anxiety.
Strength and weaknesses:
Strengths include randomized controlled study, decent sample size, and changes in anxiety scores. Limitations include technological difficulties that may restrict use for participants or their inability to tolerate “immersive” experience. Other limitations include lack of comparison to other technology related educational tools, lack of information on participant’s engagement level and overall clinical utility of such a tool e.g., time required to set up or time required for education during actual clinical encounter.
Relevance:
In the world of advancing information technology, VR can be used as an adjunct to patient care in many ways. Use of VR in pre-operative anxiety management seems to be interesting but additional studies in various countries will be needed prior to considering generalizability of above intervention.
The finding:
Alimolk et al found that a five session Acceptance and Commitment Therapy (ACT) dedicated to Fear of Progression (FOP) significantly reduced FOP and Anxiety Sensitivity in addition to its acceptability as an intervention modality in this setting.
Strength and weaknesses:
This was a prospective longitudinal study powered to detect relatively large effect sizes. Therefore, the significant effect size was large indicating a particularly efficacious intervention. ACT is a well-established therapeutic modality that apparently has not been well studied specifically in the setting of FOP. ACT is easily adaptable and scalable. The study only examined one disease group (breast cancer) and could have had longer follow up (i.e., longer than three months post treatment).
Relevance:
This is a practical intervention for patients suffering from FOP that should be highly applicable and adaptable to various clinical settings. The paper emphasizes key areas of the adapted version of ACT.