Sociodemographic and mental-health characteristics of psychedelic-assisted therapy participants: Latent class analysis of a cross-sectional, purposive online sample

People seeking psychedelic-assisted therapy (PAT) currently access it through diverse and unregulated avenues, including ketamine clinics, psilocybin centers, clinical trials, and underground therapy. A survey of 244 self-identified PAT patients identified three distinct patterns of lifetime drug use: a High-PAT class (55.7% of the sample) who used many psychedelics, a Medium-PAT class (29.1%), and a Psilocybin-Ketamine class (15.2%) whose members universally used psilocybin and often ketamine. The High-PAT class reported higher levels of depression and anxiety, suggesting that extensive PAT involvement may be linked to more severe psychiatric symptoms, though whether this reflects selection or iatrogenic effects remains unclear. Psilocybin and ketamine may serve as common entry points into PAT.

Study at a glance

Abstract

Psychedelic-assisted therapy (PAT) is an emerging treatment approach that often combines pharmacotherapeutic dosing sessions with more traditional psychotherapy. Despite limited formal regulatory approval, treatment seekers can currently access PAT through a variety of avenues, including ketamine treatment centers and “supported adult use” psilocybin centers in the U.S., drug tourism, “underground” therapy, and participation in clinical trials, among other ways. This has created a heterogenous landscape of PAT access in which people self-report PAT utilization with a variety of psychedelic and hallucinogenic drugs. However, there is limited published data on patterns of PAT involvement across drugs among real-world patients.Therefore, the present study investigated patterns of PAT utilization by applying latent class analysis (LCA) to a purposive sample of 244 self-identified PAT patients. Participants were recruited from a variety of sources (e.g., ketamine clinics, social media groups, a large U.S. university) and asked to report lifetime PAT utilization involving six compounds: psilocybin, ketamine, mescaline, ayahuasca/N,N-Dimethyltryptamine (DMT), lysergic acid diethylamide (LSD), and 3,4-methylenedioxymethamphetamine (MDMA). Participants also completed sociodemographic and internalizing measures (e.g., Beck Depression Inventory II, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7), and responses were compared across classes.LCA yielded a three-class solution. In addition to High- (55.7% of the sample) and Medium-PAT classes (29.1%), a unique Psilocybin-Ketamine class (15.2%) was identified—membership in this class was characterized by universal involvement with psilocybin and notable involvement with ketamine PAT compared to other compounds. Between-class comparisons of mental-health assessments indicated that the High-PAT class reported elevated depression and anxiety.These findings suggest that high levels of lifetime involvement in a variety of PAT modalities may be associated with more severe self-reported psychiatric symptoms, raising questions about selection or iatrogenic effects within the current PAT landscape. The emergence of a Psilocybin-Ketamine class implies that these substances may serve as initial entry points into PAT.