Increased nature relatedness and decreased authoritarian political views after psilocybin for treatment-resistant depression

Earlier research indicates that classical psychedelics such as LSD, psilocybin and DMT can produce enduring changes in personality, attitudes and beliefs, and some studies have linked lifetime psychedelic use with greater concern for others and the environment. Psilocybin in particular has been associated with persistent increases in openness and wellbeing in healthy volunteers, and with therapeutic effects in addiction, anxiety and depression when given with psychological support. Nature relatedness—the subjective sense of connection to the natural environment—is associated with lower anxiety and better wellbeing, and prior correlational work by the authors suggested that lifetime psychedelic use positively predicts nature relatedness and negatively predicts authoritarian political views, potentially mediated by acute experiences of ego-dissolution. This study set out to examine whether psilocybin administered with psychological support alters nature relatedness and libertarian–authoritarian political perspective in patients with treatment-resistant depression (TRD). Measures were collected at screening (baseline), 1 week and 7–12 months after dosing. An age-matched, untreated healthy control group was assessed over the same intervals to provide test–retest comparison and help address order effects. The investigation was framed as a pilot, open-label study exploring whether changes in these attitudes accompany the antidepressant effects previously reported in this cohort.

This was an open-label pilot study with a mixed-model design comparing seven patients with TRD to seven age-matched healthy control subjects. All participants provided informed consent and the study received ethical and regulatory approvals; it was sponsored by Imperial College London and reviewed by the MHRA. TRD patients were required to have major depressive disorder of at least moderate severity (HAM-D score 16+), and to have failed two adequate antidepressant courses during the current episode. Exclusion criteria included current or past psychotic disorder, a first-degree relative with psychosis, serious suicide attempts requiring hospitalisation, prior manic episodes, pregnancy, current substance dependence and medically significant conditions. Controls were physically and mentally healthy and subjected to the same exclusion criteria; however, they did not undergo the psilocybin treatment procedures. Psilocybin (sourced from THC Pharm GmbH and formulated locally) was administered to patients in two oral sessions separated by 1 week: an initial safety dose of 10 mg followed by a treatment dose of 25 mg. Before dosing, patients attended preparatory sessions with two allocated psychiatrists to build rapport and set expectations. During dosing, patients were supervised in a dimly lit, music-accompanied room with psychiatrists providing a non-directive supportive presence; vital signs and urine/breathalyser screens were obtained prior to dosing, and discharge assessments occurred about 6 hours post-administration. A close contact accompanied patients to and from the research facility. Primary psychometric outcomes were the 6-item Nature Relatedness Scale (NR-6) to measure connection with nature, and a 5-item subset of the Libertarian–Authoritarian Questionnaire termed the Political Perspective Questionnaire (PPQ-5) to assess libertarian–authoritarian orientation. Self-rated depressive symptoms were assessed with the Quick Inventory of Depressive Symptoms (QIDS) at baseline, 1 week and 7–12 months post-dosing. Statistical analyses were conducted in SPSS v23. Within-group tests used one-tailed paired t-tests or Wilcoxon signed ranks tests as appropriate; between-group comparisons used two-tailed independent t-tests or Mann–Whitney U tests. Ninety-five percent confidence intervals were reported for mean differences, and Hedges' g was calculated for effect sizes to account for the small sample. The authors note that the NR-6 and PPQ-5 were introduced late in the trial, and that this reduced the available sample for those measures, though exact reduced counts are not clearly reported in the extracted text.

Fourteen participants were enrolled (7 patients with TRD, 7 controls). Demographically, most participants were Caucasian (78.6%), 64.3% were male, and 85.7% had post-secondary education. In the patient group baseline clinician-rated severity confirmed TRD: HAM-D scores ranged 24–36 (M=28.6, SD=3.7) and MADRS scores ranged 28–40 (M=35.9, SD=5). No serious adverse events were reported and acute drug effects were described as well tolerated. Nature relatedness (NR-6): Patients showed a statistically significant increase in NR-6 scores at 1 week post-treatment compared with baseline (baseline M=3.67, SD=1.00; 1 week M=4.14, SD=0.75; t(6)=-4.242, p=0.003, 95% CI [-0.75, 0.2]; Hedges' g=2.5). This increase was sustained at the 7–12-month follow-up (M=4.12, SD=0.60; t(5)=-2.707, p=0.021, 95% CI [-1.15, -0.03]; g=1.2). Non-treated controls showed no significant change between screening and either follow-up (screening M=4.02, SD=0.79; first follow-up M=4.02, SD=0.94; t(6)=0.008, p=0.994; second follow-up M=4.05, SD=0.62; t(5)=-1.228, p=0.274). Between-group differences at baseline and follow-ups were not significant, indicating that the within-patient increase was not mirrored by change in controls over the same period. Authoritarianism (PPQ-5): Patients exhibited a significant reduction in authoritarian political perspective at 1 week post-treatment; the extracted text reports a significant change at 1 week and a trend-level decrease at 7–12 months. The authors report a Hedges' g of 0.7 for the relevant contrast, described as a medium-to-large effect, and indicate that the study was underpowered to detect statistical significance on some comparisons. Controls showed no significant changes on PPQ-5 between screening and either follow-up. No significant between-group differences were observed at baseline or follow-ups. Depressive symptoms (QIDS): At baseline, patients had substantially higher self-rated depressive symptoms than controls (patients M=19.43, SD=4.04; controls M=3.86, SD=2.41; U=0.0E0, p=0.001; Hedges' g=4.7). Patients' QIDS scores decreased significantly 1 week after psilocybin (M=12.29, SD=9.18 vs baseline M=19.43; Z=-2.04, p=0.025; g=1.3), and remained significantly reduced at 7–12 months (M=13.00, SD=6.39 vs baseline; Z=-1.782, p=0.038; g=0.7). Controls showed no significant change in QIDS across the study period. Between-group comparison at 1 week approached but did not reach significance (U=10.000, p=0.062), whereas a between-group difference was reported at 7–12 months (U=3.500, p=0.020).

Lyons and colleagues interpret their findings as preliminary evidence that psilocybin administered with psychological support may produce sustained increases in nature relatedness and reductions in authoritarian attitudes in patients with TRD, alongside rapid and durable antidepressant effects. The pattern—significant increases in NR-6 at 1 week sustained to 7–12 months, and a significant decrease in authoritarianism at 1 week with a trend at long-term follow-up—was not observed in the untreated control group, which the authors argue reduces the likelihood that results reflect simple order or retest effects. The authors situate these results within prior literature showing enduring personality and wellbeing changes after psychedelic exposure, and note converging findings from surveys linking lifetime psychedelic use to higher nature relatedness and lower authoritarianism, often mediated by ego-dissolution experiences. They also discuss mechanistic hypotheses: increased connectedness (a construct the authors define broadly as feeling integrated with self, others and the world) may underlie both therapeutic improvements and shifts in belief systems. Neurobiological observations cited include acute psilocybin-induced decreases in subgenual prefrontal cortex and default mode network activity and increases in global brain connectivity, which the authors suggest could relate to ego-dissolution and connectedness. Several important limitations are acknowledged. The study was open-label with a very small sample, and the NR-6 and PPQ-5 were added late in the trial so the effective sample for those measures was reduced (the extracted text does not clearly report the exact reduced counts). Controls were healthy and did not undergo the same preparatory or therapeutic procedures, so non-drug factors—particularly the psychological support and caring therapeutic context—could have contributed to the observed changes. Gender imbalance is another concern: all TRD patients were male, whereas the control group was majority female, limiting generalisability and leaving open the possibility of sex effects. The authors also recognise that changes in nature relatedness and authoritarianism could be epiphenomena of improvements in depression rather than specific outcomes caused by psilocybin; no correlations between those attitude changes and depression change were found in this small sample. Lyons and colleagues therefore call for larger, double-blind randomised controlled trials with active control conditions to test causality, specificity and durability more rigorously. They also flag broader questions about how psychoactive drugs might influence belief systems at a societal level, while emphasising neutrality about the value of any particular political change. A short patient quote is included to illustrate the phenomenological shift reported by at least one participant: "Before I enjoyed nature, now I feel part of it. Before I was looking at it as a thing, like TV or a painting… [But now I see] there's no separation or distinction, you are it."