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Prediction of hallucinogen persisting perception disorder and thought disturbance symptoms following psychedelic use

Summary

Researchers followed 654 people planning to use psychedelics and measured their thinking patterns before and after. They found that delusional thinking actually decreased after use, while about one-third experienced visual effects like seeing trails or intensified colors. However, very few people (less than 1%) found these visual effects bothersome. Younger people, women, and those with psychiatric history were more likely to experience these visual effects.

Background

While modern clinical trials show favorable safety profiles for psychedelics in treating psychiatric disorders, broader use in more heterogeneous populations raises questions about adverse effects. This study investigated the frequency and predictors of delusional ideation, magical thinking, and hallucinogen persisting perception disorder (HPPD) symptoms following psychedelic use in real-world conditions.

Objective

To assess changes in delusional ideation, magical thinking, and HPPD-type symptoms before and after psychedelic use in a naturalistic setting, and to identify baseline predictors of these adverse outcomes.

Results

Delusional ideation significantly decreased one month after psychedelic use (P<0.001), while magical thinking showed no change. Over 30% reported HPPD-type effects at 4 weeks, but less than 1% found them distressing. Predictors of HPPD included younger age, female gender, psychiatric history, and higher trait absorption.

Conclusion

HPPD-like effects are common following psychedelic use but clinically significant cases are rare. The reduction in delusional ideation suggests schizotypal traits may correlate with but not be caused by psychedelic use. Age, gender, psychiatric history, and trait absorption are important risk factors for HPPD-type symptoms.
  • Published in:PNAS Nexus,
  • Study Type:Prospective Cohort Study,
  • Source: PMID: 40264850, DOI: 10.1093/pnasnexus/pgae560
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