Abstract
RationaleDepressed patients robustly exhibit affective biases in emotional processing which are altered by SSRIs and predict clinical outcome.ObjectivesThe objective of this study is to investigate whether psilocybin, recently shown to rapidly improve mood in treatment-resistant depression (TRD), alters patients’ emotional processing biases.MethodsSeventeen patients with treatment-resistant depression completed a dynamic emotional face recognition task at baseline and 1 month later after two doses of psilocybin with psychological support. Sixteen controls completed the emotional recognition task over the same time frame but did not receive psilocybin.ResultsWe found evidence for a group × time interaction on speed of emotion recognition (p = .035). At baseline, patients were slower at recognising facial emotions compared with controls (p < .001). After psilocybin, this difference was remediated (p = .208). Emotion recognition was faster at follow-up compared with baseline in patients (p = .004, d = .876) but not controls (p = .263, d = .302). In patients, this change was significantly correlated with a reduction in anhedonia over the same time period (r = .640, p = .010).ConclusionsPsilocybin with psychological support appears to improve processing of emotional faces in treatment-resistant depression, and this correlates with reduced anhedonia. Placebo-controlled studies are warranted to follow up these preliminary findings.
Highlights
Depressed patients exhibit negative affective biases in processing static emotional face stimuli, and these are thought to contribute to their low mood (Harmer et al 2009)
Psilocybin with psychological support appears to improve processing of emotional faces in treatmentresistant depression, and this correlates with reduced anhedonia
All patients had previously used at least two antidepressant medications, seven were currently using psychiatric medication and withdrew or reduced these prior to dosing, all but two patients had received some form of counselling or psychotherapy with six receiving CBT and five patients had a previous diagnosis of another psychiatric condition
Summary
Depressed patients exhibit negative affective biases in processing static emotional face stimuli, and these are thought to contribute to their low mood (Harmer et al 2009). In healthy volunteers these drugs produce a bias towards happy faces, both acutely and after 7 days’ administration (Harmer et al 2003b; Norbury et al 2009). These neuropsychological changes are thought to underlie the clinical effects of SSRIs and SNRIs (Warren et al 2015) and are predictive of clinical outcome (Tranter et al 2009; Shiroma et al 2014). In an effort to increase the ecological validity of emotional face recognition, some researchers have developed dynamically changing
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