A systematic review of income and education reporting in psychedelic clinical trials
Daniel H. Grossman, Kevin R. Madden, Nicky J. Mehtani, Brian T Anderson, Lori L. Davis, Jennifer Mitchell, Peter S. Hendricks
Nature Mental Health May 1, 2025 DOI: 10.1038/s44220-025-00417-3 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review Peer reviewed |
|---|---|
| Sample size | 98 |
| Population | Articles on classic psychedelics and MDMA for mental health conditions |
| Topics | Psychedelic-assisted therapy |
| Keywords | Psychedelic treatment Hallucinogen-assisted therapy Entheogenic medicine Clinical trials Research studies Medical trials Drug trials Clinical research Diversity in research Participant diversity Research equity Inclusion in studies Socioeconomic diversity Demographic representation Health equity Healthcare access Equitable healthcare Treatment accessibility Health disparities |
| Citations | 10 |
| Key findings | Socioeconomic status is widely underreported in psychedelic-assisted therapy trials, and US trial participants have substantially higher SES than the general population. |
Abstract
Socioeconomic status (SES) substantially influences mental health outcomes and treatment access, yet its reporting in psychedelic-assisted therapy trials remains underexplored. Here we systematically reviewed 98 articles (49 primary trials and 49 secondary analyses) published between 2006 and 2024 examining classic psychedelics and MDMA for mental health conditions. Only 12% of primary trials reported participant income data, and 31% reported educational attainment. In US-based trials, participants showed markedly higher SES than the general population: 93% had some college education (versus 62% nationally), and median incomes in major trials substantially exceeded the national median for all workers. Non-US trials showed variable patterns. This widespread underreporting of SES data and evidence of socioeconomic disparities, particularly in US trials, highlights an urgent need for standardized SES reporting and targeted strategies to improve socioeconomic diversity in psychedelic-assisted therapy research, ensuring broader generalizability and access to these emerging treatments
Comparable studies
Other systematic reviews and meta-analyses on psychedelic-assisted therapy, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| A Meta-Analysis of Placebo-Controlled Trials of Psychedelic-Assisted Therapy | 2020 | Systematic review | |
| Psychedelic-Assisted Psychotherapy—A Systematic Review of Associated Psychological Interventions | 2022 | Systematic review | |
| Psychedelic therapy for depressive symptoms: A systematic review and meta-analysis. Participants in studies of psychedelic therapy for depressive symptoms (Major... | 2023 | Systematic review with meta-analysis | n = 14 |
| Psilocybin-assisted therapy for depression: A systematic review and meta-analysis. Patients diagnosed with life-threatening illnesses or major depressive disorder | 2023 | Systematic review and meta-analysis | n = 686 |
| Treating posttraumatic stress disorder with MDMA-assisted psychotherapy: A preliminary meta-analysis and comparison to prolonged exposure therapy Patients with PTSD | 2016 | Meta-analysis |
Citations in the library
Cited by 14
- Psychedelic medicine: mechanisms, evidence, and translation to practice BMJ February 23, 2026
- Psilocybin in the Treatment of Cocaine Use Disorder JAMA Network Open May 7, 2026
- Low-income group psilocybin assisted therapy for depression: An Oregon feasibility study Journal of Psychedelic Studies February 12, 2026
- Quantitative and qualitative influences of spiritual connection and natural imagery on perception of art in clinical psychedelic dosing settings. Scientific Reports July 21, 2025
- Beyond Efficacy Signals: Regulatory, Methodological, and Translational Challenges in Clinical Research on Ketamine and Psilocybin in Psychiatry Psychiatry International September 1, 2026
and 9 more in the library
Cites 38
- Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial Journal of Psychopharmacology November 30, 2016
- Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: a randomized controlled trial Journal of Psychopharmacology November 30, 2016
- Psilocybin can occasion mystical-type experiences having substantial and sustained personal meaning and spiritual significance Psychopharmacology July 7, 2006
- Psilocybin with psychological support for treatment-resistant depression: an open-label feasibility study. The Lancet Psychiatry May 17, 2016
- Trial of Psilocybin versus Escitalopram for Depression New England Journal of Medicine April 14, 2021
and 33 more in the library