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  Adolescent Psychedelic Use and Psychotic or Manic Symptoms

Simonsson, O., Mosing, M. A., Osika, W., Ullén, F., Larsson, H., Lu, Y., et al. (2024). Adolescent Psychedelic Use and Psychotic or Manic Symptoms. JAMA Psychiatry. doi:10.1001/jamapsychiatry.2024.0047.

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This is an open access article distributed under the terms of the CC-BY License. © 2024 Simonsson O et al. JAMA Psychiatry.




Simonsson, Otto1, Author
Mosing, Miriam A.2, 3, 4, 5, Author                 
Osika, Walter1, 6, Author
Ullén, Fredrik2, 3, Author                 
Larsson, Henrik5, 7, Author
Lu, Yi5, Author
Wesseldijk, Laura Wendelmoet2, 3, 8, Author                 
1Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden, ou_persistent22              
2Department of Cognitive Neuropsychology, Max Planck Institute for Empirical Aesthetics, Max Planck Society, ou_3351901              
3Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden, ou_persistent22              
4Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia, ou_persistent22              
5Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden, ou_persistent22              
6Stockholm Health Care Services, Southern Stockholm Psychiatric District, Region Stockholm, Stockholm, Sweden, ou_persistent22              
7School of Medical Sciences, Örebro University, Örebro, Sweden, ou_persistent22              
8Department of Psychiatry, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands, ou_persistent22              


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 Abstract: Importance While psychedelic-assisted therapy has shown promise in the treatment of certain psychiatric disorders, little is known about the potential risk of psychotic or manic symptoms following naturalistic psychedelic use, especially among adolescents.

Objective To investigate associations between naturalistic psychedelic use and self-reported psychotic or manic symptoms in adolescents using a genetically informative design.

Design, Setting, and Participants This study included a large sample of adolescent twins (assessed at age 15, 18, and 24 years) born between July 1992 and December 2005 from the Swedish Twin Registry and cross-sectionally evaluated the associations between past psychedelic use and psychotic or manic symptoms at age 15 years. Individuals were included if they answered questions related to past use of psychedelics. Data were analyzed from October 2022 to November 2023.

Main Outcomes and Measures Primary outcome measures were self-reported psychotic and manic symptoms at age 15 years. Lifetime use of psychedelics and other drugs was also assessed at the same time point.

Results Among the 16 255 participants included in the analyses, 8889 were female and 7366 were male. Among them, 541 participants reported past use of psychedelics, most of whom (535 of 541 [99%]) also reported past use of other drugs (ie, cannabis, stimulants, sedatives, opioids, inhalants, or performance enhancers). When adjusting for substance-specific and substance-aggregated drug use, psychedelic use was associated with reduced psychotic symptoms in both linear regression analyses (β, −0.79; 95% CI, −1.18 to −0.41 and β, −0.39; 95% CI, −0.50 to −0.27, respectively) and co-twin control analyses (β, −0.89; 95% CI, −1.61 to −0.16 and β, −0.24; 95% CI, −0.48 to −0.01, respectively). In relation to manic symptoms, likewise adjusting for substance-specific and substance-aggregated drug use, statistically significant interactions were found between psychedelic use and genetic vulnerability to schizophrenia (β, 0.17; 95% CI, 0.01 to 0.32 and β, 0.17; 95% CI, 0.02 to 0.32, respectively) or bipolar I disorder (β, 0.20; 95% CI, 0.04 to 0.36 and β, 0.17; 95% CI, 0.01 to 0.33, respectively).

Conclusions and Relevance The findings in this study suggest that, after adjusting for other drug use, naturalistic use of psychedelic may be associated with lower rates of psychotic symptoms among adolescents. At the same time, the association between psychedelic use and manic symptoms seems to be associated with genetic vulnerability to schizophrenia or bipolar I disorder. These findings should be considered in light of the study’s limitations and should therefore be interpreted with caution.


Language(s): eng - English
 Dates: 2024-03-13
 Publication Status: Published online
 Pages: -
 Publishing info: -
 Table of Contents: -
 Rev. Type: Peer
 Identifiers: DOI: 10.1001/jamapsychiatry.2024.0047
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Title: JAMA Psychiatry
Source Genre: Journal
Publ. Info: Chicago, Ill. : American Medical Association
Pages: - Volume / Issue: - Sequence Number: - Start / End Page: - Identifier: Other: 2168-6238
CoNE: https://pure.mpg.de/cone/journals/resource/2168-6238