Characteristics and mental health of psychedelic mushroom and multi-psychedelic users relative to non-psychedelic users in American adults, 2020-2021.
Sofia Abramsky-Sze, Elliot Marseille, Richard Matzopoulos, Robert Morlock, Leonard Lerer
Frontiers in Psychiatry 2025 DOI: 10.3389/fpsyt.2025.1508811 (opens in new tab)
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Study at a glance
AI-extracted from the abstract| Characteristics | Cross-sectional survey Peer reviewed |
|---|---|
| Sample size | 6,869 |
| Population | American adults |
| Topics | Anxiety Depression Psilocybin |
| Keywords | Mental health Psychedelics hallucinogens Behavioral health Emotional wellbeing Psychological distress |
| Citations | 4 |
| Post-publication review | 3 comments on PubPeer (opens in new tab) · last active February 2026 |
| Key findings | Psychedelic mushroom users, especially those using multiple psychedelics, reported lower mental health composite scores and higher anxiety and depression than non-users, even after adjusting for confounding factors. |
Abstract
Few population-based studies have examined associations between psychedelic use and mental health outcomes. This work describes characteristics of exclusive psychedelic mushroom use (referred to as PM use), PMs in combination with other psychedelic substances (multi-psychedelic or MP) use, and non-psychedelic use and explores mental health ratings in non-clinical settings. This work uses cross-sectional survey data from American adults collected by Acumen Health Research Institute, including demographic characteristics, general health-related quality of life (Veterans RAND derived mental and physical health composite scores), depression (PHQ 9-item), anxiety (GAD 7-item), comorbid conditions (CCI), health resource utilization, and perceptions, knowledge, and use of psychedelics. Multivariate and descriptive statistics were used to describe participant characteristics. Correlation analysis assessed anxiety and depression scores across groups. Mean anxiety and depression scores were compared using ANOVA and Tukey's HSD. A multivariate linear regression model controlling for past-year depression, past-year anxiety, age, region, ethnicity, sex, educational attainment, employment, and psychedelic use predicted mental health composite scores (MCS). Of the 6,869 participants included in the dataset, 256 (3.7%) reported using psychedelics in the last 12 months. Of those using psychedelics, 122 (47.7%) reported PM use and 134 (52.3%) reported MP use. All psychedelic users reported lower MCS and higher levels of anxiety and depression relative to non-users (those who said they had not used psychedelics in the past year). The lowest mental health scores were reported in the MP users followed by the PM users (higher MCS corresponded to better mental health). When controlling for confounding characteristics including past-year anxiety and depression, disparities in mental health scores persisted between those with any psychedelic use and the non-psychedelic group (p<0.001). This paper extends previous work describing the association between psychedelic use and mental health, controlling for confounding mental health factors such as comorbid anxiety and depression. These results suggest psychedelic users may have poorer mental health than their non-using counterparts in certain contexts and emphasize the need for future research in this field. Both non-adjusted and adjusted analyses demonstrate lower mental health scores for PM and MP users relative to non-psychedelic users. These differential effects highlight the need for further detailed, population-based research on the use of exclusive psilocybin and on psychedelics in combination.
Comparable studies
Other cross-sectional and survey studies on psilocybin for anxiety, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| The Challenging Experience Questionnaire: Characterization of challenging experiences with psilocybin mushrooms Internet survey respondents reporting challenging experiences with psilocybin | 2016 | Questionnaire development and validation | |
| Psychedelics and Mental Health: A Population Study Adult population in the United States | 2013 | Cross-sectional survey | n = 130,152 |
| Microdosing psychedelics: Motivations, subjective effects and harm reduction People aged 16 years or older who had used psychedelics and could comprehend written... | 2019 | Cross-sectional survey | n = 525 |
| People of color in North America report improvements in racial trauma and mental health symptoms following psychedelic experiences Black, Indigenous, and people of color (BIPOC) in the US and Canada | 2020 | Cross-sectional survey | n = 313 |
| Naturalistic psilocybin use is associated with persisting improvements in mental health and wellbeing: results from a prospective, longitudinal survey Adults planning to take psilocybin outside clinical research, primarily... | 2023 | Prospective longitudinal survey | n = 2,833 |