Academic Journal
Hallucinogen-Psychosis Associations Are Confounded by Baseline Psychiatric History.
| Τίτλος: | Hallucinogen-Psychosis Associations Are Confounded by Baseline Psychiatric History. |
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| Συγγραφείς: | Steinle JT; Division of Addiction Science, Prevention, and Treatment, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri.; The Center for Advancing Health Services, Policy & Economics Research (CAHSPER), Washington University, St. Louis, Missouri.; Division of Child and Adolescent Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts., Shankar S; Division of Addiction Science, Prevention, and Treatment, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri.; The Center for Advancing Health Services, Policy & Economics Research (CAHSPER), Washington University, St. Louis, Missouri., Siegel JS; Center for Psychedelic Medicine, Department of Psychiatry, NYU Grossman School of Medicine, New York, New York.; Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York., Cabassa LJ; Center for Mental Health Services Research, George Warren Brown School of Social Work, Washington University, St. Louis, Missouri.; Center for Holistic Interdisciplinary Research in Psychedelics, Washington University, St. Louis, Missouri., Adams DR; School of Social Work, College of Health Sciences, University of Missouri, Columbia, Missouri., Cavazos-Rehg P; Division of Addiction Science, Prevention, and Treatment, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri.; Washington University School of Public Health, St. Louis, Missouri., Agrawal A; Division of Addiction Science, Prevention, and Treatment, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri., Nicol GE; Center for Holistic Interdisciplinary Research in Psychedelics, Washington University, St. Louis, Missouri.; Division of Child and Adolescent Psychiatry, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri., Grucza R; Advanced Health Data Institute, Department of Health and Clinical Outcomes Research and Department of Family and Community Medicine, Saint Louis University, St. Louis, Missouri., Xu KY; Division of Addiction Science, Prevention, and Treatment, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri.; Washington University School of Public Health, St. Louis, Missouri.; Corresponding Author: Kevin Y. Xu, MD, MPH, 4940 Children's Place, Saint Louis, MO 63110 (xukeviny@wustl.edu). |
| Πηγή: | The Journal of clinical psychiatry [J Clin Psychiatry] 2026 Jun 10; Vol. 87 (3). Date of Electronic Publication: 2026 Jun 10. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Physicians Postgraduate Press Country of Publication: United States NLM ID: 7801243 Publication Model: Electronic Cited Medium: Internet ISSN: 1555-2101 (Electronic) Linking ISSN: 01606689 NLM ISO Abbreviation: J Clin Psychiatry Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Memphis, Tenn., Physicians Postgraduate Press. |
| Ιατρικοί όροι (MeSH): | Hallucinogens*/adverse effects , Hospitalization*/statistics & numerical data , Psychotic Disorders*/epidemiology , Substance-Related Disorders*/epidemiology , Psychoses, Substance-Induced*/epidemiology , Psychoses, Substance-Induced*/etiology , Mental Disorders*/epidemiology, United States/epidemiology ; Humans ; Female ; Male ; Retrospective Studies ; Adult ; Middle Aged ; Comorbidity ; Young Adult |
| Περίληψη: | Background: Current drug policy debates often center on whether hallucinogen-related hospital admissions indicate a causal relationship with psychosis. This study examines the extent to which observed associations between hallucinogen use and psychosis are mediated by preexisting psychiatric conditions, providing important evidence for psychedelic policy formulation. Methods: We conducted a retrospective analysis using MarketScan Medicaid and commercial claims databases from 2015-2019. The population-based sample included individuals receiving substance use disorder treatment with documented substance-related emergency admissions or hospitalizations. We compared psychosis-related admissions occurring 30 days to 6 months postindex event between individuals with hallucinogen-related admissions versus those with nonhallucinogen substance-related admissions. Cox regression models adjusted for demographics and clinical characteristics to determine whether prior psychiatric history explained observed associations. Results: Among 273,466 individuals with substance-related admissions, psychosis diagnoses were more prevalent following hallucinogen-related admissions (16.4%) compared to nonhallucinogen substance admissions (6.6%, P<.001). While unadjusted models showed increased psychosis risk for hallucinogen-related admissions (hazard ratio [HR]=1.22, 95% CI=1.19-1.25), this association became nonsignificant after adjusting for clinical characteristics (HR=0.97, 95% CI=0.95-1.00). Conclusions: Apparent associations between hallucinogen use and psychosis appear largely attributable to baseline psychiatric comorbidities rather than direct causal effects. These findings carry implications for evidence-based policy development, suggesting that observed epidemiologic associations may reflect underlying vulnerability factors rather than hallucinogen-induced psychosis. Policymakers should consider these results when interpreting population-level data regarding hallucinogen safety profiles and regulatory frameworks. (© Copyright 2026 Physicians Postgraduate Press, Inc.) |
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| Grant Information: | K08 DA061258 United States DA NIDA NIH HHS; P50 MH122351 United States MH NIMH NIH HHS; R25 MH112473 United States MH NIMH NIH HHS |
| Substance Nomenclature: | 0 (Hallucinogens) |
| Entry Date(s): | Date Created: 20260612 Date Completed: 20260613 Latest Revision: 20260813 |
| Update Code: | 20260813 |
| PubMed Central ID: | PMC13296641 |
| DOI: | 10.4088/JCP.25m16034 |
| PMID: | 42283542 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1555-2101 |
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| DOI: | 10.4088/JCP.25m16034 |