David Sjöström - Institutionen för kliniska vetenskaper, Lund

Title: Psychedelic Use and Mental Health in Adolescents

Main supervisor: Docent Emma Claesdotter-Knutsson, Lunds universitet 

Reviewers: Professor Anette Kjellgren, Karlstad Universitet and Phd Claudia Cicognola, Lunds universitet

Abstract 

Background
Research on classical psychedelics has expanded rapidly in recent years, with clinical trials in adults suggesting benefits for depression, anxiety, substance use disorders and eating disorders. Far less is known about psychedelic use in adolescents and associations with mental health, despite indications of rising prevalence. Adolescence is a sensitive developmental period, marked by ongoing brain maturation and psychosocial vulnerability, which may shape responses to psychoactive substances. Previous findings suggest that adolescents may experience more adverse effects, including anxiety and destabilizing experiences, compared with adults. Personality traits, particularly neuroticism, appear to play a crucial role in explaining both mental health outcomes and the nature of psychedelic experiences. To date, no randomized controlled trial has been conducted in adolescent populations.

Research Questions
I. What does the existing literature show about adolescent psychedelic use and its associations with mental health?
II. What is the prevalence of psychedelic use among Swedish adolescents?
III. How do adolescents describe their lived experiences with psychedelics, including perceived benefits, challenges, and integration into everyday life?
IV. How do adolescent and adult psychedelic users differ in reported outcomes, and what role does personality play in explaining these differences?
V. Can psilocybin be studied safely in adolescents with anorexia nervosa, and how should a protocol be designed to ensure ethical and developmental safeguards?

Preliminary Results
The scoping review revealed sparse and methodologically limited research and a lack of controlled trials in adolescents. The National Swedish School Survey (Research Question I)) showed that 1,9% of adolescents reported lifetime use of psychedelics, and they reported higher anxiety, largely explained by neuroticism rather than use itself. Research Question IV results are  in review and demonstrate the adolescents report more adverse outcomes than adults, and that personality traits explain of the variance than age alone. Results regarding Research Question III and V is being prepared for submission. 

Significance
This research program provides novel insights into adolescent psychedelic use, emphasizing the importance of personality traits, developmental stage, and contextual factors in shaping outcomes. The findings highlight both risks and therapeutic potential, underscoring the need for longitudinal, ethically sound, and developmentally informed research. By combining epidemiological, qualitative, and clinical trial approaches, this thesis contributes knowledge essential for public health, harm reduction, and the future development of safe psychedelic-assisted therapies for adolescents.

Publications

Sjöström, D. K., Claesdotter-Knutsson, E., Gripe, I., Thor, S., & Kajonius, P. J. (2025). Adolescent psychedelic use and mental health is associated with user personality: A representative national study on drug use. International Journal of Mental Health and Addiction. Advance online publication. https://doi.org/10.1007/s11469-025-01481-7

Sjöström, D. K., Claesdotter-Knutsson, E., & Kajonius, P. J. Adverse outcomes following psychedelic use in adolescents and adults: Associations with age and personality traits [Manuscript submitted for publication 2025.09.23]