Dourron Haley Maria, Bradley Melissa, Simonsson Otto, Copes Heith, Grossman Daniel, Shallcross Ryan Andrew, Hendricks Peter S
Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
University of Alaska Anchorage, Anchorage, AK, USA.
Psychedelic Med (New Rochelle). 2025 May 26;3(2):93-102. doi: 10.1089/psymed.2024.0036. eCollection 2025 Jun.
Prior research examining the associations between psychedelic use and general psychotic symptoms has yielded mixed findings. However, no studies have investigated the relationships between psychedelic use and specific psychotic symptoms, and whether these relationships might differ among those with liability to psychosis, namely those with a history of psychotic or bipolar disorders.
Using cross-sectional survey data from a purposive sample ( = 548), we first regressed estimated lifetime psychedelic use occasions and personal and family history of psychotic or bipolar disorders on the Magical Ideation Scale, Referential Thinking Scale, Self-Evaluation of Negative Symptoms, and Continuum of Auditory Hallucinations-State Assessment, unadjusted and adjusted for a range of covariates. We then tested the interactions of estimated lifetime psychedelic use occasions with personal and family history of psychotic or bipolar disorders on these same measures, unadjusted and adjusted for the same set of covariates.
In unadjusted models, the estimated number of lifetime psychedelic use occasions was robustly associated with less referential thinking, whereas personal and family histories of psychotic and bipolar disorders were each associated with moderately or slightly greater scores on all measures. Covariate-adjusted regression models revealed that the estimated number of lifetime psychedelic use occasions was not associated with any of the measured psychotic symptoms. A personal history of psychotic disorders was associated with moderately greater magical ideation, referential thinking, and auditory hallucinations, whereas a family history of psychotic disorders was associated with slightly greater negative symptoms. Neither personal nor family history of bipolar disorder was associated with any psychotic symptoms. Finally, estimated lifetime psychedelic use occasions interacted only with a personal history of psychotic disorders on one measure, such that auditory hallucinations were less severe as psychedelic use occasions increased among those with a personal history of psychotic disorder; there was no relationship between psychedelic use and auditory hallucinations among those without a personal history of psychotic disorder.
Naturalistic psychedelic use may not be associated with psychotic symptoms, even among those with a personal or family history of psychotic or bipolar disorders. Further work probing the risk-benefit profile for people typically excluded from clinical trials involving psychedelics is needed.
先前关于迷幻药使用与一般精神病症状之间关联的研究结果不一。然而，尚无研究调查迷幻药使用与特定精神病症状之间的关系，以及这些关系在有精神病易感性的人群（即有精神病或双相情感障碍病史的人群）中是否存在差异。
我们使用来自一个有目的样本（n = 548）的横断面调查数据，首先在未调整以及针对一系列协变量进行调整的情况下，将估计的终生迷幻药使用次数以及精神病或双相情感障碍的个人和家族史，对神奇观念量表、牵连观念量表、阴性症状自我评估量表以及幻觉状态连续体评估量表进行回归分析。然后，我们在未调整以及针对同一组协变量进行调整的情况下，测试估计的终生迷幻药使用次数与精神病或双相情感障碍的个人和家族史在这些相同量表上的交互作用。
在未调整模型中，估计的终生迷幻药使用次数与较少的牵连观念密切相关，而精神病和双相情感障碍的个人和家族史在所有量表上分别与中等或略高的得分相关。协变量调整后的回归模型显示，估计的终生迷幻药使用次数与任何测量的精神病症状均无关联。精神病障碍的个人史与中等程度更高的神奇观念、牵连观念和幻觉相关，而精神病障碍的家族史与略高的阴性症状相关。双相情感障碍的个人史和家族史均与任何精神病症状无关。最后，估计的终生迷幻药使用次数仅在一项测量中与精神病障碍的个人史存在交互作用，即对于有精神病障碍个人史的人来说，随着迷幻药使用次数的增加，幻觉症状不那么严重；在没有精神病障碍个人史的人群中，迷幻药使用与幻觉之间没有关系。
即使在有精神病或双相情感障碍个人或家族史的人群中，自然使用迷幻药可能也与精神病症状无关。需要进一步研究探索那些通常被排除在涉及迷幻药的临床试验之外的人群的风险 - 效益概况。
