Decreases in State and Trait Anxiety Post-psilocybin: A Naturalistic, Observational Study Among Retreat Attendees

Abstract

Anxiety disorders are the most common type of psychiatric disorders among Western countries. Evidence-based treatment modalities including pharmacological and cognitive-behavioral therapy result in deficient treatment responses. Historical and recent research suggests psychedelic drugs may be efficacious in alleviating anxiety-related symptoms among healthy and clinical populations. The main aim of the present study was investigation of the effects of psilocybin-containing truffles, when taken in a supportive group setting, on ratings of state and trait anxiety across self-reported healthy volunteers. Attendees of psilocybin ceremonies were asked to complete a test battery at three separate occasions: before the ceremony (baseline), the morning after, and 1 week after the ceremony. The test battery included questionnaires assessing state and trait anxiety (State-Trait Anxiety Inventory), mindfulness capacities (Five Facet Mindfulness Questionnaire), and personality (Big Five Inventory). Additionally, the psychedelic experience was quantified with the Persisting Effects Questionnaire and the Ego Dissolution Inventory. The total amount of psilocybin-containing truffles consumed by each participant was recorded, and a sample of the truffles was analyzed to determine psilocin concentrations. Fifty-two attendees (males = 25; females = 25; others = 2) completed parts of the baseline assessment, 46 (males = 21; females = 24; others = 1) completed assessments the morning after the ceremony, and 23 (males = 10; females = 13) completed assessments at the 1-week follow-up. Average psilocin consumption across individuals was 27.1 mg. The morning after the ceremony, we observed medium reductions in anxiety measures (both state and trait) compared to baseline ( $\underset{¯}{d}$ = 6.4; p < 0.001 and $\underset{¯}{d}$ = 6; p = 0.014, respectively), which persisted over a 1-week period post-ceremony ( $\underset{¯}{d}$ = 6.7; p = 0.001 and $\underset{¯}{d}$ = 8.6; p = 0.004, respectively). At 1 week post-ceremony, the non-judging facet of the mindfulness scale was increased ( $\underset{¯}{d}$ = 1.5; p = 0.03), while the personality trait neuroticism decreased ( $\underset{¯}{d}$ = 5.2; p = 0.005), when compared to baseline. Additionally, we found ratings of ego dissolution (mean: 59.7, SD: 28.3) and changes in neuroticism to be the strongest predictors of reductions in state and trait anxiety, respectively. In sum, results suggest rapid and persisting (up to 1 week) anxiolytic effects in individuals with sub-clinical anxiety symptoms, which are related to the acute experience of ego dissolution, as well as lasting changes in trait neuroticism. Results also add support to the feasibility and potential efficacy of group sessions with psychedelics. To understand whether these effects extend to wider populations suffering from heightened anxiety, and the mechanisms involved, further experimental research is needed.

Keywords: anxiety; mindfulness; neuroticism; personality; psilocybin.

FIGURE 1

Flow-chart of participants’ enrollment and survey completion.

FIGURE 2

Violin plots displaying scores on measures of state anxiety, which demonstrated significant differences between baseline and the other two time points. The plot consists of median (SE) ratings of state anxiety before, 1-day after and 7-days after psilocybin truffles. The thick line indicates the interquartile range, whereas the white dot indicates the median. Each gray dot indicates a data point, whereas the density is scaled to the relative count across all bins. Wider sections of the violin plot represent a higher probability of observations of a given value.

FIGURE 3

Violin plots displaying scores on measures of trait anxiety, which demonstrated significant differences between baseline and the other two time points. The plot consists of median (SE) ratings of trait anxiety before, 1-day after and 7-days after psilocybin truffles. The thick line indicates the interquartile range, whereas the white dot indicates the median. Each gray dot indicates a data point, whereas the density is scaled to the relative count across all bins. Wider sections of the violin plot represent a higher probability of observations of a given value.

FIGURE 4

Probability distribution plot of the experience of ego dissolution as assessed by the EDI morning after the psilocybin ceremony. The plot depicted kernel density estimation (KDE), histogram, and raw data points.