Public Health, Prevention & Behaviour Change

Does psychedelic therapy have a transdiagnostic action and prophylactic potential?

The paper argues that psychedelic therapy’s core transdiagnostic and prophylactic action is its capacity to enhance neuronal and psychological plasticity, thereby increasing adaptability and resilience when combined with an appropriate psychotherapeutic context. The authors propose candidate neural and psychological markers and situate this plasticity model within a predictive processing framework to explain its broad therapeutic potential.

Authors

  • Robin Carhart-Harris
  • Jiří Horacek

Published

Frontiers in Psychiatry
meta Study

Abstract

Addressing global mental health is a major 21st-century challenge. Current treatments have recognized limitations; in this context, new ones that are prophylactic and effective across diagnostic boundaries would represent a major advance. The view that there exists a core of transdiagnostic overlap between psychiatric disorders has re-emerged in recent years, and evidence that psychedelic therapy holds promise for a range of psychiatric disorders supports the position that it may be transdiagnostically effective. Here, we propose that psychedelic therapy's core, transdiagnostically relevant action lies in its ability to increase neuronal and mental plasticity, thus enhancing the potential for change, which we consider to be a key to its therapeutic benefits. Moreover, we suggest that enhanced plasticityviapsychedelics, combined with a psychotherapeutic approach, can aid healthy adaptability and resilience, which are protective factors for long-term well-being. We present candidate neurological and psychological markers of this plasticity and link them with a predictive processing model of the action of psychedelics. We propose that a model of psychedelic-induced plasticity combined with an adequate therapeutic context has prophylactic and transdiagnostic potential, implying that it could have a broad, positive impact on public health.

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Research Summary of 'Does psychedelic therapy have a transdiagnostic action and prophylactic potential?'

Introduction

Ko and colleagues frame the paper around two interrelated problems in contemporary mental healthcare: the large, growing burden of mental illness worldwide and the limited efficacy and prophylactic reach of current treatments. They note widespread comorbidity across diagnostic categories and a renewed interest in transdiagnostic treatment targets—mechanisms or processes that traverse conventional diagnoses—and argue that interventions able to strengthen resilience and adaptability could shift care from reactive symptom management toward prevention and long-term wellness. The paper sets out to synthesise evidence that psychedelic therapy may act on such a transdiagnostic target by acutely increasing brain and psychological plasticity—defined here as an enhanced capacity for change—and, when combined with an appropriately supportive therapeutic context, enabling recalibration of maladaptive habits of mind and behaviour. Ko and colleagues present candidate psychological and neurobiological markers of this plasticity, link these to a predictive processing (Bayesian brain) account of psychedelic action, and propose a multilevel ‘‘process-of-change’’ model that implies both transdiagnostic therapeutic effects and potential prophylactic benefit for mental health. The extracted text does not report a formal, systematic review protocol; the paper is a narrative interdisciplinary synthesis integrating clinical, epidemiological, psychological and basic neuroscience evidence.

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Study Details

References (105)

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