Psychedelic drug use and schizotypy in young adults
Psychedelic use was only weakly associated with increased schizotypy in this large adult sample — an association that became non‑significant after controlling for psychiatric comorbidity and concomitant drug use. In a small experimental subsample, greater psychedelic exposure correlated with slightly improved evidence integration and markedly increased sensitivity of instructed fear responses, suggesting psychedelics may alter evidence‑integration and aversive‑learning processes relevant to therapeutic effects.
Abstract
Despite recently resurrected scientific interest in classical psychedelics, few studies have focused on potential harms associated with abuse of these substances. In particular, the link between psychedelic use and psychotic symptoms has been debated while no conclusive evidence has been presented. Here, we studied an adult population (n = 1032) with a special focus on young (18–35 years) and healthy individuals (n = 701) to evaluate the association of psychedelic drug use with schizotypy and evidence integration impairment typically observed in psychosis-spectrum disorders. Experimental behavioural testing was performed in a subsample of the subjects (n = 39). We observed higher schizotypy scores in psychedelic users in the total sample. However, the effect size was notably small and only marginally significant when considering young and healthy subjects (Cohen’s d = 0.13). Controlling for concomitant drug use, none of our analyses found significant associations between psychedelic use and schizotypal traits. Results from experimental testing showed that total exposure to psychedelics (frequency and temporal proximity of use) was associated with better evidence integration (Cohen’s d = 0.13) and a higher sensitivity of fear responses (Cohen’s d = 1.05) to the effects instructed knowledge in a reversal aversive learning task modelled computationally with skin conductance response and pupillometry. This effect was present even when controlling for demographics and concomitant drug use. On a group level, however, only difference in sensitivity of fear responses to instructed knowledge reached statistical significance. Taken together, our findings suggest that psychedelic drug use is only weakly associated with psychosis-like symptoms, which, in turn, is to a large extent explained by psychiatric comorbidities and use of other psychoactive substances. Our results also suggest that psychedelics may have an effect on flexibility of evidence integration and aversive learning processes, that may be linked to recently suggested therapeutic effects of psychedelic drugs in non-psychotic psychiatric populations.
Research Summary of 'Psychedelic drug use and schizotypy in young adults'
Introduction
Earlier research into classical serotonergic psychedelics (for example LSD, psilocybin, DMT, mescaline) has re-emerged over the past decades with growing interest in their therapeutic potential. At the same time, investigation of possible harms has lagged behind, and the long-standing question of whether psychedelic use is linked to psychosis-spectrum outcomes remains unresolved. Some smaller studies reported associations between psychedelic use and psychosis-like symptoms, whereas larger population studies have not confirmed such links; differences in assessment strategies and the ability to detect subclinical, dimensional traits (for example schizotypy, cognitive biases such as Bias Against Disconfirmatory Evidence, and learning abnormalities) may underlie these discrepant findings. Lebedev and colleagues set out to examine whether past psychedelic use in otherwise healthy young adults is associated with schizotypal traits and cognitive biases typically observed in the schizophrenia spectrum. The study aimed to address limitations of prior cross-sectional work by combining a large online survey (n = 1,032) with an experimental subsample (n = 39) that completed behavioural tasks probing evidence integration (BADE task) and instructed aversive reversal learning, and by collecting follow-up data on frequency and recency of drug use to derive an exposure metric. The pre-registered hypothesis was that psychedelic use and greater total exposure would be associated with higher schizotypy and with impairments in evidence integration and reversal aversive learning.
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Study Details
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Lebedev, A. V., Acar, K., Garzón, B., Almeida, R., Råback, J., Åberg, A., Martinsson, S., Olsson, A., Louzolo, A., Pärnamets, P., Lövden, M., Atlas, L., Ingvar, M., & Petrovic, P. (2021). Psychedelic drug use and schizotypy in young adults. Scientific Reports, 11(1). https://doi.org/10.1038/s41598-021-94421-z
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Lebedev, A. V., Kaelen, M., L€ Ovd En, M. et al. · Human Brain Mapping (2016)
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Zhou, K., De Wied, D., Carhart-Harris, R. L. et al. · PNAS (2025)
Evans, J., Robinson, O., Ketzitzidou-Argyri, E. et al. · PLOS ONE (2023)
Simonsson, O., Goldberg, S. B., Chambers, R. et al. · Psychopharmacology (2023)
Lebedev, A. V., Acar, K., Horntvedt, O. et al. · Scientific Reports (2023)
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