A Systematic Review of Participant Diversity in Psychedelic-Assisted Psychotherapy Trials
August 25, 2024 Stephanie L. Haft, Amanda E. Downey, Marissa Reymond-Flesch et al. 1 citation preprint
Limited participant diversity in mental health intervention research perpetuates health disparities, a concern especially relevant to psychedelic-assisted psychotherapy (PAT). This systematic review of 21 randomized controlled trials of psilocybin- and MDMA-assisted therapies (total 1,034 participants) found that gender (100%) and race or ethnicity (76%) were frequently reported, while socioeconomic status was sometimes reported (57%) using varied measures. Sexual orientation (9.5%) and immigration status (4.8%) were rarely reported, and no studies reported gender identity. Black/African-American (12.2%) and Hispanic/Latino (7.2%) participants were significantly underrepresented compared to the US population and non-psychedelic clinical trials. MDMA trials enrolled more diverse samples than psilocybin trials. Analyses of treatment effects by sociodemographic variables were virtually nonexistent, highlighting the need for inclusive recruitment and rigorous reporting to improve generalizability.