A Retrospective Study to Determine the Impact of Psychedelic Therapy for Dimensional Measures of Wellness: A Quantitative Analysis

The paper frames wellness using the World Health Organization's multidimensional conception of health, emphasising physical, psychological, social and spiritual domains rather than solely categorical diagnoses. The authors note limitations of conventional diagnostic systems and argue that many people present with comorbidity or subthreshold problems that are not well captured by trials that select participants on single categorical diagnoses. They position a dimensional approach—evaluating symptom severity, life impact and global perceptions of change—as better suited to studying interventions aimed at improving overall wellness. Against this background, the study investigates how people who self‑reported therapeutic (non‑recreational) use of psychedelic medicines describe impacts on dimensional measures of wellness. Rather than reporting change scores over time, the paper presents a retrospective qualitative analysis of participant comments collected alongside standardised psychometric measures; the authors state that quantitative analyses of those measures will be reported separately. The stated aim here is to identify and organise recurring themes in participants' descriptions of how psychedelic use affected aspects of their wellness.

This retrospective study recruited 65 civilian or veteran adults (aged 18–99) who self‑identified as having used a psychedelic medicine for therapeutic purposes within the previous three years. Active military personnel and individuals who reported using psychedelics only for non‑therapeutic purposes were excluded. The clinical trial registration is NCT05469243. Participants provided demographic and medical history information and completed standardised psychometric instruments including the Patient Global Impression of Change (PGIC) scale (applied to overall quality of life and to subdomains such as anxiety, mood, pain and disability), the Pain, Enjoyment of Life and General Activity (PEG) scale, the Hospital Anxiety and Depression (HAD) scale, and a Disability Index (DI). The authors note that the scores reflect participants' status at the time of reporting and that change over time was not measured in this paper; quantitative analysis of those instruments will be reported elsewhere. This article focuses on qualitative data: free‑text comments supplied by participants about their experiences with psychedelic medicines. Comments were coded using a thematic analysis approach adapted from prior qualitative work. Two authors (VD and GG) organised and reviewed the comments and applied a primary set of categories developed from the literature. The main categories used were: (A) mysticism/spirituality; (B) functional improvement/self‑awareness; (C) social connection/cultural impact; (D) impact on medical/mental health conditions; and (E) neutral impressions, sensations or difficult experiences. Comments were sub‑categorised where appropriate and themes integrated from prior qualitative studies to inform coding.

Sixty‑five participants returned questionnaires. The extracted text reports 38 women and an average age of 45.1 years. Employment status differed by sex in this sample: 20 of the 38 women were unemployed or on leave compared with five men. Anxiety and depression were the most commonly cited medical conditions among participants. The authors do not provide a fully detailed breakdown of other demographic variables in the extracted text. A total of 93 participant comments were analysed and classified by the psychedelic associated with each comment. Psilocybin and ayahuasca accounted for the largest share of comments: 51 for psilocybin and 17 for ayahuasca, together comprising 73.1% of all comments. Other medicines/comments were 7 for ketamine, 5 for LSD (lysergic acid diethylamide), 5 for methamphetamine, 3 for ecstasy, 3 for marijuana, 1 for ibogaine and 1 with no associated medication; 11 participants did not report which psychedelic they had used most recently (as noted elsewhere in the extraction). Thematic distribution showed that categories related to mysticism/spirituality (A), functional improvement/self‑awareness (B) and neutral impressions/sensations/difficult experiences (E) were the most commonly reported, together representing over 75% of comments. The authors reported counts for several categories: functional improvement/self‑awareness was identified in 35 comments (including subcategories such as revised life priorities, increased quality of life, physical well‑being and introspection); impact on medical and mental health conditions was also reported in 35 comments, with participants describing reduced anxiety, reduced pain and other symptom relief (though some noted that benefits were time‑limited); social connection and cultural impact appeared in 14 comments and encompassed improved interpersonal relationships, feelings of interconnectedness and altered perspectives on indigenous worldviews; neutral impressions, sensations or difficult experiences were coded in 39 comments and included physiological effects (purging, nausea, shaking), transient distress, catharsis and confrontation of traumatic memories. The extracted text includes illustrative participant remarks. Examples provided by the authors include brief verbatim excerpts such as: "Mental resolution, removed brain fog, relieved pain in my joints and head, relieved anxiety for up to about a month" and a longer passage referencing spiritual and life‑changing effects after ayahuasca and psilocybin. The authors report that thematic experiences were not exclusive to a single medicine and that individual participants often described multiple domains of impact.

Di and colleagues interpret the findings as indicating that participants who used psychedelic medicines for self‑identified therapeutic purposes described improvements across multiple dimensions of wellness, including medical and mental health symptoms, social functioning, spirituality and overall function. The authors stress that wellness is not merely absence of disease and that qualitative reports show impacts spanning psychological, physiological and social domains. They note that the thematic patterns observed were not unique to a single psychedelic; similar qualitative experiences were reported across different medicines, with psilocybin and ayahuasca most frequently represented in this sample. The investigators suggest that determining whether perceived benefits are class‑specific or medicine‑specific will require further study, and they highlight the potential value of linking thematic qualitative data to neurobiological mechanisms and to participant‑level factors in order to develop personalised treatment approaches. The authors acknowledge several important limitations: the retrospective design, the modest sample size, reliance on self‑report, and lack of standardisation for time since administration and for measurement of change over time. They emphasise that qualitative comments were not collected via structured in‑person interviews but were left to participants' discretion, which may limit completeness and comparability of responses. Finally, the team recommends future research using more structured thematic assessments to validate the categories reported here, to quantify effect sizes for different medicines and domains, and to investigate neurophysiological correlates that could inform treatment planning and personalisation.

The authors conclude that use of various psychedelic medicines is associated with a broad range of qualitative experiences that map onto multiple domains of wellness. They observe recurring, circumscribed themes in participants' accounts and propose that, with development of validated thematic language and a clearer understanding of underlying neurobiology, qualitative and quantitative outcomes could become more predictable. Such advances would be important for designing patient‑specific treatment strategies using these medicines in future clinical contexts.