Positive effects of psychedelics on depression and wellbeing scores in individuals reporting an eating disorder

This prospective survey study (n=28) found significant improvements in depression and well-being scores after psychedelics use for those with eating disorders (EDs).

Abstract

Purpose Psychedelic therapy is showing promise for a broad range of mental health conditions, indicative of a transdiagnostic action. While the efficacy of symptom-focused treatments for eating disorders (EDs) is limited, improved mental health and psychological wellbeing are thought to contribute to greater treatment outcomes. This study provides the first quantitative exploration of the psychological effects of psychedelics in those reporting an ED diagnosis.

Methods Prospective, online data were collected from individuals planning to take a psychedelic drug. Twenty-eight participants reporting a lifetime ED diagnosis completed measures of depressive symptomology (Quick Inventory of Depressive Symptomology; QIDS-SR16) and psychological wellbeing (Warwick–Edinburgh Mental Wellbeing Scale; WEMWBS) 1–2 weeks before, and 2 weeks after a psychedelic experience. Twenty-seven of these participants also completed a measure of emotional breakthrough [Emotional Breakthrough Inventory (EBI)] in relation to the acute psychedelic experience.

Results Bayesian t-tests demonstrated overwhelming evidence for improvements in depression and wellbeing scores following the psychedelic experience. Marginal evidence was also found for a correlation between emotional breakthrough and the relevant mental health improvements.

Conclusion These findings provide supportive evidence for positive psychological aftereffects of a psychedelic experience that are relevant to the treatment of EDs. It is hoped that this will encourage further research and will bolster initiatives to directly examine the safety and efficacy of psychedelic-assisted therapy as a treatment of EDs in future clinical trials.”

Authors: Meg J. Spriggs, Hannes Kettner & Robin L. Carhart-Harris

Notes

“The current study provides the first quantitative exploration of the psychological aftereffects of a psychedelic experience in those reporting a lifetime diagnosis of an ED. In interpreting this study, it is important to emphasise the preliminary nature of the results which require replication and further exploration in future controlled trials. Consistent with previous studies in clinical and non-clinical populations, the results demonstrate overwhelming evidence for improvements in both depression symptomology (QIDS-SR16) and psychological wellbeing (WEMWBS) two weeks after a psychedelic experience.”

Clinical studies are planned for 2021 which should shed more light onto the mechanisms in a more controlled environment. This study does however points out (again) that psychedelics have a positive effect on those suffering from mental anguish. Further study is needed, but surely also warranted.

Summary

Psychedelic therapy is showing promise for a broad range of mental health conditions, including eating disorders.

Prospective, online data were collected from individuals planning to take a psychedelic drug. The results demonstrated overwhelming evidence for improvements in depression and psychological wellbeing scores following the psychedelic experience.

This study provides supportive evidence for the positive psychological aftereffects of a psychedelic experience that may be relevant to the treatment of EDs.

Anorexia, bulimia, binge eating disorder, psychedelics

Introduction

There is no consensus on a first-line psychotherapeutic model for anorexia nervosa, and current treatments focus on symptom-focused approaches that may be overlooking other, more fundamental components that underlie EDs.

There is growing interest in the therapeutic use of classic psychedelic compounds, including LSD, psilocybin, and ayahuasca, with recent clinical trials yielding supportive evidence for the safety and positive mental health impact of psychedelic therapy.

To date, no controlled trials have been published on the treatment of EDs with psychedelics. However, reports of naturalistic use can provide pilot data to inspire early phase trials, and the present study utilises online prospective survey data completed before and after a psychedelic experience.

Design

Data were collected through the online platform ‘Psychedelic Survey’ as part of three anonymous, online cohort studies conducted between March 2017 and December 2019.

Participants

Inclusion criteria were age > 18 and intention to take a psychedelic drug in the near future. Of the 50 participants, 28 completed measures of their acute experience.

WEMWBS

The Warwick – Edinburgh Mental Wellbeing Scale measures hedonic (subjective experience of happiness) and eudemonic aspects of positive mental health/ wellbeing.

QIDS‑SR16

The QIDS-SR16 is a 16-item measure of depressive symptom severity. It is rated on a scale from 0 to 3.

The Emotional Breakthrough Inventory (EBI) is a measure of emotional release/breakthrough during the acute psychedelic experience.

Statistics

All analyses were performed using Bayesian hypothesis testing and moderate JZS and Jefferies-Beta priors. Parametric frequentist t tests were employed on QIDS-SR16 and WEMWBS.

Demographics and preliminary analyses

Preliminary analyses showed weak evidence for a difference in baseline QIDS-SR16 scores or change in QIDS-SR16 from baseline to endpoint between those with and without a co-morbid diagnosis of depression.

WEMWBS

A Bayesian t test and paired Student’s t test showed that WEMWBS scores were greater two weeks after the psychedelic experience than at baseline.

QIDS‑SR16

A Bayesian t test and paired Student’s t test showed that QIDS-SR16 scores decreased 2 weeks after the psychedelic experience, and that there was weak evidence for a positive relationship between EBI score and change in WEMWBS and QIDS-SR16 scores.

Discussion

The current study demonstrated that participants with a lifetime diagnosis of an ED experienced improvements in both depression symptomology (QIDS-SR16) and psychological wellbeing (WEMWBS) two weeks after a psychedelic experience.

Improvements in QIDS-SR16 scores were highly correlated with improvements in WEMWBS scores in people in remission from an ED. This suggests that psychedelic assisted psychotherapy may be relevant for EDs.

The current results hint towards a potential mediating role for emotional breakthrough during the acute psychedelic experience in the positive outcomes of ED treatment. However, the results must be interpreted with caution due to the weak Bayes Factors and marginal significance.

The limitations of this study include the use of online, self-report surveys, a self-selection bias cannot be ruled out, and no control group or control substance. Nevertheless, the knowledge acquired from this prospective, naturalistic study reflects well on mental health improvements that are relevant for the treatment of EDs.

In this study, individuals with a self-reported diagnosis of an ED experienced improvements in depression and wellbeing scores two weeks after a psychedelic experience. Additionally, tentative evidence was found for emotional breakthroughs during the acute experience.