Department of Translational Epidemiology, New York State Psychiatric Institute, New York.
Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
JAMA Psychiatry. 2024 Jan 1;81(1):89-96. doi: 10.1001/jamapsychiatry.2023.3867.
Renewed interest in the clinical potential of hallucinogens may lead people with depression to a generally more positive view of the use of lysergic acid diethylamide (LSD). Therefore, past-year LSD use among people with depression may be increasing in prevalence.
To assess time trends in the prevalence of past-year nonmedical LSD use by past-year major depression status and the variation in this association by sociodemographic characteristics.
DESIGN, SETTING, AND PARTICIPANTS: This survey study used pooled publicly available data from 478 492 adults aged 18 years or older who were administered the National Survey on Drug Use and Health from 2008 through 2019. Statistical analysis was conducted from December 2022 to June 2023.
Past-year major depression diagnoses per criteria from the DSM-IV were analyzed. Logistic regression models examined whether time trends in past-year nonmedical LSD use differed between adults with vs without past-year depression, adjusting for sociodemographic characteristics. Secondary analyses examined whether the trends in LSD use by depression status differed between sociodemographic subgroups.
The analytic sample included 478 492 adults, of whom 51.8% were female, 56.1% were younger than 50 years, 11.7% were Black, 15.1% were Hispanic, 65.8% were White, and 7.5% were another race. Weighted interview response rates ranged from 64.9% to 75.6% during the study time frame. From 2008 to 2019, past-year use of LSD increased significantly more among adults with major depression (2008 prevalence, 0.5%; 2019 prevalence, 1.8%; prevalence difference [PD], 1.3% [95% CI, 1.0%-1.6%]) compared with adults without major depression (2008 prevalence, 0.2%; 2019 prevalence, 0.8%; PD, 0.6% [95% CI, 0.5%-0.7%]) (difference in difference, 0.8% [95% CI, 0.5%-1.1%]). This difference was particularly pronounced among young adults aged 34 years or younger (PD among those aged 18-25 years with depression, 3.3% [95% CI, 2.5%-4.2%]; PD among those aged 26-34 years with depression, 2.7% [95% CI, 1.6%-3.8%]) and individuals with incomes less than $75 000 per year (PD among those with income <$20 000, 1.9% [95% CI, 1.3%-2.6%]; PD among those with income $20 000-$49 999, 1.5% [95% CI, 1.0%-2.1%]; PD among those with income $50 000-$74 999, 1.3% [95% CI, 0.7%-2.0%]).
This study suggests that, from 2008 to 2019, there was a disproportionate increase in the prevalence of past-year LSD use among US adults with past-year depression. Among those with depression, this increase was particularly strong among younger adults and those with lower household incomes. Among individuals with depression who also report LSD use, clinicians should discuss potential strategies for mitigating harm and maximizing benefits in medically unsupervised settings.
对迷幻剂临床潜力的重新关注可能会使抑郁症患者对使用麦角酸二乙酰胺（LSD）持更普遍的积极态度。因此，过去一年抑郁症患者中 LSD 的使用可能正在增加。
评估过去一年非医学 LSD 使用的流行率在过去一年的重度抑郁症患者中的时间趋势，以及这种关联在社会人口统计学特征方面的变化。
设计、地点和参与者：这项调查研究使用了来自 478492 名年龄在 18 岁或以上的成年人的公共可用数据，他们在 2008 年至 2019 年期间接受了国家药物使用和健康调查。统计分析于 2023 年 6 月进行。
根据 DSM-IV 的标准分析过去一年的重度抑郁症诊断。逻辑回归模型检验了过去一年非医学 LSD 使用的时间趋势在有与无过去一年抑郁症的成年人之间是否存在差异，同时调整了社会人口统计学特征。次要分析检验了抑郁状态对 LSD 使用趋势的影响在社会人口统计学亚组之间是否存在差异。
分析样本包括 478492 名成年人，其中 51.8%为女性，56.1%年龄小于 50 岁，11.7%为黑人，15.1%为西班牙裔，65.8%为白人，7.5%为其他种族。在研究期间，加权访谈回复率从 64.9%到 75.6%不等。从 2008 年到 2019 年，过去一年使用 LSD 的成年人中，有重度抑郁症的患者（2008 年的流行率为 0.5%；2019 年的流行率为 1.8%；流行率差异为 1.3%[95%置信区间，1.0%-1.6%]）显著高于没有重度抑郁症的成年人（2008 年的流行率为 0.2%；2019 年的流行率为 0.8%；流行率差异为 0.6%[95%置信区间，0.5%-0.7%]）（差异为 0.8%[95%置信区间，0.5%-1.1%]）。这种差异在年龄在 34 岁或以下的年轻成年人中尤为明显（患有抑郁症的 18-25 岁患者的流行率为 3.3%[95%置信区间，2.5%-4.2%]；患有抑郁症的 26-34 岁患者的流行率为 2.7%[95%置信区间，1.6%-3.8%]）和收入低于 75000 美元的个人（收入低于 20000 美元的患者的流行率为 1.9%[95%置信区间，1.3%-2.6%]；收入在 20000-49999 美元的患者的流行率为 1.5%[95%置信区间，1.0%-2.1%]；收入在 50000-74999 美元的患者的流行率为 1.3%[95%置信区间，0.7%-2.0%]）。
这项研究表明，从 2008 年到 2019 年，过去一年有抑郁症的美国成年人中 LSD 的使用流行率呈不成比例的上升。在那些有抑郁症的人中，这种增加在年轻成年人和那些收入较低的人中尤其强烈。在报告 LSD 使用的抑郁症患者中，临床医生应该讨论在非医疗监督环境中减轻伤害和最大限度地提高效益的潜在策略。
