ORIGINAL RESEARCH published: 16 June 2021 doi: 10.3389/fpsyt.2021.687546 Cross-Sectional Associations Between Lifetime Use of Psychedelic Drugs and Psychometric Measures During the COVID-19 Confinement: A Transcultural Study Dóra Révész 1 , Genís Ona 2,3 , Giordano N. Rossi 4 , Juliana M. Rocha 4 , Rafael G. dos Santos 2,4,5 , Jaime E. C. Hallak 4,5 , Miguel Á. Alcázar-Córcoles 6 and José C. Bouso 2,3,4* 1 Center of Research on Psychological and Somatic Disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands, 2 ICEERS—International Center for Ethnobotanical Education, Research, and Service, Barcelona, Spain, 3 Medical Anthropology Research Center (MARC), Universitat Rovira i Virgili, Tarragona, Spain, 4 Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil, 5 National Institute of Science and Technology—Translational Medicine, São Paulo, Brazil, 6 Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid (UAM), Madrid, Spain Edited by: Background: One of the main public health strategies adopted at the beginning Katrin H. Preller, University of Zurich, Switzerland of the COVID-19 pandemic consisted of implementing strict lockdowns to stop the Reviewed by: transmission of the virus. Despite being an effective measure, the confinement and the Rafael Lanza Lancelotta, associated social isolation create a stressful, potentially lengthy situations that has been The Ohio State University, proven to have several psychological consequences. Given the potential benefits that United States Natasha Leigh Mason, certain psychedelic drugs have shown for the treatment of psychological disorders, this Maastricht University, Netherlands study aimed to assess the impact of lifetime psychedelic drug use on mental health in *Correspondence: relation to the first strict lockdown adopted by various countries (April-July 2020). José C. Bouso jcbouso@iceers.org Methods: Subjects completed an online survey that inquired about sociodemographic factors, activities, and lifestyle factors during confinement, as well as health and mental Specialty section: health related factors. Subjects were asked about their lifetime use of psychedelic This article was submitted to Psychopharmacology, drugs (MDMA, ayahuasca, psilocybin-containing mushrooms, LSD, peyote, San Pedro, a section of the journal Bufo alvarius or 5-MeO-DMT, and others), being classified as regular users (more than Frontiers in Psychiatry once per 6 months), occasional users, or non-users. The survey included psychometric Received: 07 April 2021 Accepted: 25 May 2021 tests used to assess psychological distress, peritraumatic stress, social support, Published: 16 June 2021 psychopathological symptoms, and personality. Linear regressions were performed with Citation: psychedelic drug users as the independent variable and psychometric factors as the Révész D, Ona G, Rossi GN, Rocha outcomes, while correcting for age, gender, language, religion, spirituality, and use of JM, dos Santos RG, Hallak JEC, Alcázar-Córcoles MÁ and Bouso JC non-psychedelic drugs. (2021) Cross-Sectional Associations Between Lifetime Use of Psychedelic Results: The study included 2,974 English, Portuguese, and Spanish speakers (497 Drugs and Psychometric Measures regular users of psychedelic drugs, 606 occasional users, and 1,968 non-users). On During the COVID-19 Confinement: A average, respondents were 36 years old and 70% were female. Psychedelic drug Transcultural Study. Front. Psychiatry 12:687546. users, especially regular ones, reported less psychological distress, less peritraumatic doi: 10.3389/fpsyt.2021.687546 stress, and more social support. Regarding personality measures, psychedelic drug Frontiers in Psychiatry | www.frontiersin.org 1 June 2021 | Volume 12 | Article 687546 Révész et al. Psychedelics and Psychometrics During COVID-19 users scored higher on the novelty-seeking and self-transcendence scales, and lower on cooperativeness. Conclusion: Our findings showed that regular users of psychedelic drugs had less psychological stress and some personality differences when compared to occasional users and non-users. This suggests that either the use of psychedelics might be a protective factor itself or people with certain previous traits are more prone to frequently using psychedelic drugs. Future prospective longitudinal research should investigate the underlying processes observed in this study to develop consistent hypotheses. Keywords: psychedelic drugs, distress, social support, psychopathology, personality, COVID−19, cross-cultural INTRODUCTION during the COVID-19 pandemic, including depression, anxiety, insomnia, and distress, as they are constantly exposed to The new 2019 coronavirus (SARS-COV-2) is a serious and fatal contamination sources in hospitals and are afraid of spreading public health concern that has spread globally following the the virus to family and friends (8, 16–21). Remarkably, outbreak of the virus between late December 2019 and early adopting a positive coping style has been negatively correlated January 2020 (1). On March 11th, 2020, the World Health with anxiety and depression (21). Studies conducted outside Organization (WHO) officially declared this to be a worldwide of Asia and Europe, while transcultural, reported similar pandemic. At the time of this manuscript’s preparation (March results (22, 23). 2021), the total number of confirmed cases is about 124,535,520 Parallel with the pandemic, several studies have been million worldwide, with almost 2,738,876 deaths linked to this published regarding the potential therapeutic effects of virus (2). As this virus is closely related to previous coronavirus psychedelic drugs, such as ayahuasca, psilocybin, and lysergic outbreaks, such as the severe acute respiratory syndrome (SARS)- acid diethylamide (LSD) (24–27), especially for the treatment CoV and the Middle East respiratory syndrome (MERS)- of mental health issues (25, 28–30). Other studies have CoV, the primary symptoms of COVID-19 contraction are shown their potential for the treatment of pain (31, 32) and generally related to these other respiratory syndromes, including neurodegenerative disorders (33, 34). These benefits have also pneumonia, acute respiratory distress syndrome, fever, cough, been observed in real-world situations through large population fatigue, hemoptysis, acute cardiac injury, hypoxemia, dyspnea, surveys, where psychedelic drug users have been shown to and lymphopenia, but also other more specific symptoms, such as have a lower rate of mental health problems (35, 36), reduced rhinorrhea, sneezing, sore throat, and diarrhea (1). The primary psychological distress and suicidality (37), and better outcomes dispersion mechanism is believed to be direct contact or droplets in terms of internationally-validated health indicators (38). spread by infected individuals coughing or sneezing. Regarding the latter study, a remarkable result concerned the Considering the seriousness of this virus and how quickly it involvement of complex psychological variables previously spreads, medical experts have advised governments around the unassessed in this population, such as coping strategies and world to implement social distancing policies in their countries personal values (38). Notably, the benefits associated with in order to hamper the virus’s transmission. Nevertheless, in psychedelic drugs go beyond clinical outcomes, reaching addition to the fear of contracting the disease, quarantine causes social aspects. For instance, a relationship between psychedelic its own set of problems, particularly associated with mental drug use and pro-environmental behavior has been found health and well-being (3–9). Several stressors, including infection (39), as well as with a lower risk of partner violence (40). fears, frustration, boredom, inadequate supplies, inadequate Considering these results, some authors have suggested that information, financial loss, and stigma have been found to be psychedelic drugs can also play a role in terms of helping correlated with psychopathological symptoms (4, 5) as well as individuals face the psychological challenges associated with this post-traumatic symptoms (4, 10). pandemic (41). Indeed, in late February 2020, the first nationwide large- Given the negative impact of the COVID-19 pandemic scale survey of psychological distress in the general population on mental health (42), the aim of this study was to of China during the COVID-19 epidemic was performed explore the potential protective effect of lifetime use of (N = 52,730) (11). This survey demonstrated that almost psychedelic drugs through psychometric measures. In order 35% of the population was experiencing psychological distress to perform a comprehensive analysis, this research was (such as anxiety and depression), with females more affected carried out using a multi-language and transcultural approach, than males, and people from 18 to 30 and above 60 analyzing the associations between psychedelic drug use and years of age were more affected than the rest of the psychopathology, peritraumatic stress, and personality. We population (11). Other surveys showed similar findings (12– also investigated other lesser-explored sociodemographic data 15). Health professionals (e.g., doctors, nurses) seem to be possibly related to the current pandemic and its associated social at a greater risk of developing mental health problems distancing measures. Frontiers in Psychiatry | www.frontiersin.org 2 June 2021 | Volume 12 | Article 687546 Révész et al. Psychedelics and Psychometrics During COVID-19 MATERIALS AND METHODS at all”) to 4 (“extremely true”). The total score is obtained by determining the mean response across all 13 items. Setting and Participants Higher scores represent greater exposure to potentially An online survey was launched in three languages (Spanish, traumatic experiences. English, and Portuguese) on April 7th, 2020, when most countries were moving to implement lockdown measures. Brief Symptom Inventory Through snowball sampling, researchers from various The BSI is a brief form of the SCL-90-R questionnaire regarding countries, including mainly Spain and Brazil, spread the psychopathology. It is a self-report symptom inventory designed questionnaires among direct contacts and through social media. to assess psychological status. The 53-item English validated The questionnaire was also shared on the websites of the version (50) was used. For the Portuguese version, the same Mental Health Post-graduate Program of the Ribeirão Preto 53 BSI items were extracted from the Portuguese validated Medical School at the University of São Paulo, in the scientific version of the SCL-90-R (51). For the Spanish version of the journal Archives of Clinical Psychiatry, and on websites offering questionnaire, a similar 45-item validated short version of the information about psychedelics and cannabis (Lasdrogas.info, SCL-90-R [SA-45; (52)] was used. The three instruments use a 5- Cannabis Magazine, social media pages of ICEERS and local point Likert scale ranging from 0 (“not at all”) to 5 (“extremely”). community websites). The three versions of the questionnaire The scales included are the same as those included in the remained open for a period of 6 weeks. SCL-90-R: somatization (SOM), obsessive-compulsive (O-C), The study was approved by the Research Ethics Committee of interpersonal sensitivity (IS), depression (DEP), anxiety (ANX), the Universidad Autónoma de Madrid (Autonomous University hostility (HOST), phobic anxiety (PHOB), paranoid ideation of Madrid, Spain). All experimental procedures were performed (PAR), and psychoticism (PSY). Additionally, the general severity in accordance with the relevant guidelines and regulations, and index (GSI) was also extracted, with higher scores indicating all respondents gave informed consent. more severe symptoms. Psychometric Outcomes Temperament and Character Inventory-67 General Health Questionnaire–12 The TCI-R-67 is a short version of the TCI-R (53) self- The GHQ-12 is a 12-item questionnaire widely used to screen for report measure of personality. The Spanish (54) validated psychological distress in the general population. The validated version was used. The same 67 items were extracted from Spanish (43), English (44), and Portuguese (45) versions were the original questionnaire (53) and from the validated used. The GHQ-12 consists of 12 items scored using 4-point Portuguese version (55) in order to use them in the English Likert scales. There are various methods of correction. We and Portuguese versions of the questionnaire, respectively. used the dichotomous score (0-0-1-1), also called the “GHQ The questionnaire uses a 5-point Likert scale ranging from 1 score.” As informed by other studies (46), a score of >4 was (“strongly disagree”) to 5 (“strongly agree”). The questionnaire established as a cut-off point for considering the presence of includes four temperamental scales: novelty seeking (NS), harm mental health disturbance. A higher score represents greater avoidance (HA), reward dependence (RD), and persistence psychological distress. (PE). It also includes three character scales: self-directedness (SD), cooperativeness (CO), and self-transcendence (ST). Social Support by the Duke-UNC-11 Additionally, it includes a validity scale of 5 items. Each score The Duke-UNC-11 is an 11-item measure of perceived represents the degree to which respondents have particular social support. The validated Spanish (47) and English (48) personality traits. versions were used. The questionnaire was translated to Portuguese by native Portuguese-speaking researchers for the Portuguese version of the questionnaire. The Duke-UNC- Psychedelic and Non-psychedelic Drug 11 questionnaire has two dimensions, regarding confidential Use support (communication with other people) and affective Participants were asked about their use of drugs before support (expressions of love and affect to/by others). The items and during confinement. We included the use of these are scored using a Likert scale ranging from 1 (“much less than psychedelic drugs: MDMA, ayahuasca, psilocybin-containing I would like”) to 5 (“as much as I would like). The total score is mushrooms, LSD, peyote, San Pedro, Bufo alvarius or 5- calculated as the mean of all of the items. The higher the score, MeO-DMT, change, and other psychedelics. We described the more social support was perceived. the consumers of psychedelic drugs and compare them to the never-users. Furthermore, we categorized participants as Peritraumatic Stress Inventory (a) regular users (more than once per 6 months), (b) The PSI is a proposed measure of post-traumatic stress disorder occasional users (tried it, but do not use it regularly), and (PTSD); that is, symptoms associated with the exposure to (c) never-users. a potentially traumatic experience. The validated English We also asked for the settings in which participants were using version (49) was used. The questionnaire was translated into psychedelic drugs: alone, with friends or a partner, at parties or Spanish and Portuguese by native Spanish and Portuguese festivals, at rituals or in a therapeutic setting, or microdosing. We researchers, respectively. The 13 items of the PSI use a 5- only added MDMA to the list of psychedelic drugs when it is used point Likert scale response format, ranging from 0 (“not at rituals or in therapeutic settings. We defined non-psychedelic Frontiers in Psychiatry | www.frontiersin.org 3 June 2021 | Volume 12 | Article 687546 Révész et al. Psychedelics and Psychometrics During COVID-19 drugs as alcohol, tobacco, cannabis, cocaine, amphetamines, and Statistical Analyses MDMA when consumed in other contexts. All variables were described as percentages or means and standard deviations. Baseline sample characteristics of regular, Sociodemographic Data, Religion/Spirituality, and occasional, and never-users of psychedelic drugs were compared using chi-square tests for categorical variables and independent Health Factors sample t-tests for continuous variables. We first did this for the We recorded age, gender (male, female, transgender, or sociodemographic factors, religion and spirituality factors, health androgynous), the language of the participant (Spanish, English, factors, and drug use. Then we did the same for all COVID-19- or Portuguese), and nationality. For each participant, we related factors. Then, we made an overview in a figure of how recorded their partner status (yes/no). We asked for their religion psychedelic substances were rated by participants in terms of (atheist, agnostic, or religious) and whether they practice their helping them to manage their period of confinement better. Next, religion. They were asked about whether they felt like a spiritual we stratified for the regular and occasional users. As additional person or not, and whether they perform any spiritual practices analyses, we compared the means for all psychometric outcomes (e.g., prayer, meditation). Each person was asked whether they among the Spanish, Portuguese, and English speakers, using have any chronic physical or psychological conditions, and analyses of variances (ANOVA). housing-related information such as the kind of house they lived Subsequently, we performed linear regression analyses to in during the confinement or with whom they lived. determine associations between consuming psychedelic drugs (yes/no) and the general health score, peritraumatic stress Preliminary Factors Related to the Confinement scores, social support, Brief Symptom Inventory scores, and the Period personality scales. Next, we ran linear regressions with regular As most participants were still in confinement, we will show and occasional users vs. the never-users of psychedelic drugs preliminary analyses of the following factors. We asked whether as predictors and psychometric factors as outcomes. For each persons were diagnosed with COVID-19 or showed any COVID- analysis, we adjusted for age, gender, language, religion, and like symptoms, whether their relatives had COVID-19, and practitioner of religion. All analyses were conducted using SPSS whether anyone around them died from this virus. We asked version 24.0 (IBM Corp., Armonk, NY, USA). After Bonferroni- the number of days they spent in confinement, how well they correction (p-value of 0.05 divided by 33), we set the significant maintained their confinement, and whether they had a house p-value at 0.002, two-tailed. with an outdoor area. We also asked how many hours per week participants spent outdoors, and whether they followed any anti-contagion advice (e.g., wore gloves, masks). We also asked RESULTS them to rate their well-being and level of discomfort during Sample Characteristics confinement on a scale from 1 to 10, with 1 indicating a very low A total of 2,974 subjects were recruited, with an average age level of well-being and no discomfort at all, while 10 indicated of 36 years, and 29% were male, 70% female, and 1% queer, excellent well-being and a very high level of discomfort. androgynous, or other genders (Table 1). Of all the participants, Additionally, subjects were asked about their lifestyle and the 54% completed the questionnaires in Spanish, 23% in Portuguese, activities they had been engaging in during confinement (yes/no), and 23% in English. In accordance with these numbers, the including aerobic exercise; martial arts; music and singing; largest group of subjects responded from Spain (N = 1,191), playing videogames; watching pornography; reading; watching followed by Brazil (N = 652), and the United States (N = TV, movies, series, or COVID-19 related news; weightlifting or 265). Most of the sample was single (37.6%), followed by “in a bending; yoga; pilates; and meditation. We also assessed changes relationship” (29.9%), and married (22.8%). The majority of the in diet since confinement, in terms of whether participants were participants lived in an apartment or flat (51.3%) or a house with eating better, the same, or worse. We also asked whether they had a garden (41.4%), in both cases with more than 70 square meters less libido or sex during this confinement period. (62.4%). Only 11.6% of the sample lived alone, while 22% shared a Regarding societal and economic changes, we determined how house with their partner, and 21.2% lived with their parents. Only participants’ vision of the economic system and the predominant 8.5% of the respondents were taking care of people aged between values of our society (i.e., consumerism, competitiveness, 60 and 90 years, and 2.3% of the sample was living with someone progress) were altered. We asked whether they were now in with special needs. favor of changes, against changes, or that they did not change Regarding ethnicity, most respondents to the Portuguese in this respect. We asked them whether they had lost their job questionnaire were “white” (branca, 85.2%), and most as a consequence of the COVID-19 crisis or if their income respondents to the English and Spanish questionnaires were was reduced. We also asked participants if their past psychedelic Caucasian (88.5%). Other ethnicities included preta/black substance use impacted their ability to manage their confinement. (3.8% in Brazil and 0.43% for the other questionnaires) or indígena/indigenous (0.5% in Brazil and 2.2% for the other questionnaires). The majority of the sample defined themselves Covariates as religious (43.0%), followed by atheists (30%) and agnostics Age, gender, language, and religion were used as covariates in the (24.6%). For the Portuguese questionnaire, the majority of linear regression models. respondents were Catholics (38%), followed by agnostics (17%), Frontiers in Psychiatry | www.frontiersin.org 4 June 2021 | Volume 12 | Article 687546 Révész et al. Psychedelics and Psychometrics During COVID-19 TABLE 1 | Sample characteristics of the total sample, and regular vs. occasional vs. never users of psychedelic substances in the past. Total Regular users Occasional users Never users pa (N = 2,974) (N = 497) (N = 606) (N = 1,868) Sociodemographics, N (%) Age [years, mean (SD)] 36.3 (13.3) 40.0 (11.0) 38.5 (12.0) 34.7 (14.1) <0.001 Gender <0.001 Men 852 (28.6) 247 (49.8) 202 (33.7) 403 (21.7) Women 2,087 (70.2) 248 (50.0) 392 (65.3) 1,447 (77.8) Queer/androgynous/others 18 (0.6) 1 (0.2) 6 (1.0) 11 (0.6) Language questionnaire <0.001 English 673 (22.6) 223 (44.9) 205 (33.8) 243 (13.0) Portuguese 689 (23.2) 47 (9.5) 70 (11.6) 572 (30.6) Spanish 1,613 (54.2) 227 (45.7) 331 (54.6) 1,053 (56.4) Partner status 1,565 (52.6) 268 (54.0) 322 (53.2) 974 (52.2) 0.74 Religion and spirituality, N (%) Religion groups <0.001 Atheist 845 (28.4) 96 (21.8) 185 (33.8) 564 (30.8) Agnostic 695 (23.4) 164 (37.3) 194 (35.4) 337 (18.4) Religious 1,280 (43.0) 180 (40.9) 169 (30.8) 930 (50.8) Practitioner of religion 931 (31.3) 186 (42.7) 176 (33.5) 569 (34.5) 0.003 Spiritual person 1,948 (65.5) 435 (87.5) 451 (74.4) 1,062 (56.9) <0.001 Spiritual practices 1,686 (56.7) 404 (81.3) 397 (65.5) 885 (47.4) <0.001 Health factors, N (%) Chronic diseases 736 (24.7) 115 (23.1) 150 (24.8) 471 (25.2) 0.63 Mental diseases 670 (22.5) 96 (19.3) 153 (25.2) 421 (22.5) 0.06 Substance use, N (%) Non-psychedelic Alcohol 1,684 (56.6) 330 (66.4) 403 (66.5) 950 (50.9) <0.001 Tobacco 681 (22.9) 155 (31.2) 206 (34.0) 320 (17.1) <0.001 Cannabis 1,212 (40.7) 345 (69.4) 438 (72.5) 429 (23.0) <0.001 Cocaine 331 (11.1) 119 (23.9) 174 (28.7) 38 (2.0) <0.001 Amphetamines 266 (8.9) 113 (22.7) 132 (21.8) 21 (1.1) <0.001 Psychedelic MDMA, ecstasy, mollyb 701 (23.6) 303 (61.0) 325 (53.6) 73 (3.9) <0.001 Ayahuasca 609 (20.5) 357 (71.8) 252 (41.6) 0 <0.001 Magic mushroom 841 (28.3) 418 (84.1) 423 (69.8) 0 <0.001 LSD 737 (24.8) 354 (71.2) 383 (63.2) 0 <0.001 Other psychedelics 487 (16.4) 296 (59.6) 191 (31.5) 0 <0.001 Context of use of psychedelic substances <0.001 Not using anything 1,899 (63.8) 6 (1.8) 25 (5.6) 1,868 (100) Alone 65 (2.2) 42 (12.9) 23 (5.2) 0 With friends or partner 293 (9.8) 91 (28.0) 202 (45.5) 0 At parties or festivals 60 (2.0) 8 (2.5) 52 (11.7) 0 Rituals/therapeutic 315 (10.6) 174 (53.5) 141 (31.8) 0 Microdosing 5 (0.2) 4 (1.2) 1 (0.2) 0 a Chi square tests for categorical variables and independent sample T-test for continuous variable; b Is only determined as a psychedelic drug when used for rituals or therapeutic settings. Significant (Bonferroni-corrected) p < 0.002 are represented bold. atheists (13.9%), Espírita/Spiritism (12.3%), and afro-Brazilian commonly reported physical disorder was asthma (4.7%), and the (3.5%). Among the total sample, only 35.6% were active religious most commonly reported psychological disorders were anxiety practitioners, while 65.5% considered themselves spiritual. (12.3%), depression (10.4%), and PTSD (1.6%). A notable percentage of the total sample reported having a There were 1,103 participants (37%) who had used psychedelic physical diseases (28.3%) or mental disorder (31.1%). The most drugs, and these included 606 occasional users (20%) and 497 Frontiers in Psychiatry | www.frontiersin.org 5 June 2021 | Volume 12 | Article 687546 Révész et al. Psychedelics and Psychometrics During COVID-19 regular users (17%). We considered a regular user to be anyone reported eating healthier since the beginning of confinement who reported having used psychedelic drugs more than once per measures, while nearly half of the sample (48.7%) noted a 6 months. Table 1 shows differences in sample characteristics reduction in their libido. Most of the subjects rated the quality between the never, occasional, and regular users of psychedelic or reliability of the information about COVID-19 received drugs. Regular users were slightly older, more often men, from either politicians or the media as mostly poor (4 and more often English speakers, more often agnostic or religious, 4.4, respectively). practiced religion more often, and they more often considered Regarding drug use during confinement, 51.3% of subjects themselves spiritual or performed spiritual practices. Regular used alcohol, 23.1% cannabis, 21.6% tobacco, 4.9% psilocybin- users of psychedelic drugs used more non-psychedelic drugs than containing mushrooms, 3.3% LSD, 2.4% ayahuasca, 2.1% ecstasy, the occasional or never users. Also, regular users more often and 1.5% cocaine, among other drugs. Notably, there were more used psychedelic drugs alone or in rituals or therapeutic contexts, subjects who reported using fewer drugs than usual during while the occasional users used them with friends or at parties confinement (18.7%) than those who reported using more than and festivals. usual (13.4%). The most remarkable increase was in the case of alcohol, with 3.9% of the sample drinking more during confinement, followed by cannabis (2.3% of the sample). Only Preliminary Factors Related to COVID-19 0.9% of subjects reduced their alcohol use. Confinement Period All confinement-related factors are shown in Table 2, both for the entire sample and in terms of comparisons between regular, Psychometric Measures Among English, occasional, and never users of psychedelic drugs. The majority Spanish, and Portuguese Speakers of the sample (90.4%) did not experience COVID-19-related Most of the countries were under strict lockdowns when the symptoms, while 9.3% experienced symptoms and were not questionnaire was launched, with the remarkable exception of tested, and 0.3% had symptoms with a positive result after testing. Brazil. This information is relevant when considering differences Among those who tested positive, 5.1% required health care. across countries and/or cultures. Indeed, respondents to the Moreover, 17.3% of subjects had a relative who had COVID- Portuguese questionnaire showed a higher mean score in the 19, and 4.7% reported the death of a relative due to COVID- GHQ-12 questionnaire, which reflects greater psychological 19. Users spent more time outdoors and had more access to distress (Table 3). In the case of Spanish speakers, they showed an outdoor space. Although the regular users followed fewer significantly higher scores for peritraumatic stress than the of the anti-contagion tips, they reported higher levels of well- English speakers (p = 0.001), but not than the Portuguese. being and lower discomfort during the confinement period Spanish speakers also showed significantly higher scores on as compared to the never users of psychedelic drugs. While the psychopathology scales for somatization and depression. some activities were performed more often by regular users The score for perceived social support provided by the (e.g., music, singing and yoga, pilates, and meditation), others Duke-UNC-11 questionnaire was almost the same across the were performed more often by the never users (e.g., aerobic three questionnaires. exercise; watching COVID-related news, TV, movies, and series; and playing videogames). Furthermore, regular users reported having better diets during the confinement period, and a higher Associations Between Use of Psychedelic libido and more sex. Regular users were also more often in favor Drugs and Psychometric Measures of change regarding the economic system or the predominant Among the users of psychedelic drugs, 49% reported that their values of our society, and suffered more from working less and past drug use had a large positive impact on how they managed having a decreased income. A high percentage of the sample to cope with the confinement period, while 16% reported that it (80.4%) declared having some personal space in which to relax. had a small positive impact, and 35% did not notice a difference Similarly, 61.9% of subjects had a specific space inside the house (Figure 1). Among the regular users of psychedelic drugs, 73% in which to work. Remarkably, 17% of respondents lost their jobs saw a large positive impact, while only 31% of occasional users due to the pandemic, while 47.4% experienced a reduction in reported a large positive impact. their income. Lifetime use of psychedelic drugs was associated with less Similarly, the self-rated well-being of participants (on a scale psychological distress (Table 4). Lastly, having used psychedelic ranging from 1 to 10) decreased significantly, as they rated their drugs was associated with higher scores for the novelty seeking well-being before the lockdown with a mean of 7.3, while the and self-transcendence scales in the TCI-R-67 test, but lower current rating was 5.8. The rating of their house environment scores for cooperativeness. When we examined the frequency decreased as well, but to a much lesser degree (7.6 vs. 7.2). of psychedelic drug consumption, regular users had lower Regarding confinement measures, most of the sample went psychological distress and peritraumatic stress scores and more outside only to buy food or medicines (52.5%), or they were social support, while occasional users only showed lower completely locked down (13.5%). Indeed, 90% of the sample peritraumatic stress (Table 4). Among the personality traits, was in confinement for at least 20 days. Accordingly, 61% of both occasional and regular users had higher scores for self- the sample noted that they did not normally go out, leaving transcendence, while only regular users reported more novelty home only out of necessity. Further, 43.8% of the subjects seeking and less cooperativeness. Frontiers in Psychiatry | www.frontiersin.org 6 June 2021 | Volume 12 | Article 687546 Révész et al. Psychedelics and Psychometrics During COVID-19 TABLE 2 | Preliminary factors related to COVID-19 and the confinement period in the total sample, and in regular vs. occasional vs. never users of psychedelic substances in the past. N (%) Total (N = 2,974) Regular users Occasional users Never users p (N = 496) (N = 606) (N = 1,865) Diagnosed with COVID-19 0.06 No 2,686 (90.3) 433 (87.1) 545 (89.9) 1,708 (91.4) No test, but clear symptoms 275 (9.2) 62 (12.5) 58 (9.6) 155 (8.3) Yes, tested positive 10 (0.3) 2 (0.4) 3 (0.5) 5 (0.3) Relatives with COVID-19 514 (17.3) 95 (19.2) 108 (17.8) 311 (16.7) 0.40 Deaths for COVID-19 140 (4.7) 25 (5.1) 21 (3.5) 94 (5.0) 0.27 Confinement, N (%) Days in confinement [mean (SD)] 29.2 (12.5) 30.7 (12.6) 30.9 (13.1) 28.2 (12.1) <0.001 Maintaining confinement <0.001 I go out every day (with dog) 227 (7.6) 78 (15.8) 60 (10.0) 88 (4.7) I go out 4–6 days/week 136 (4.6) 36 (7.3) 30 (5.0) 70 (3.8) Up to 3 days/week 654 (22.0) 152 (30.9) 162 (26.9) 340 (18.2) Only for necessities or not at all 1,943 (65.3) 227 (46.0) 350 (58.1) 1,366 (73.5) House with outdoor area 1,274 (42.8) 243 (48.9) 265 (43.9) 766 (41.1) 0.01 Hours/week outdoors [median (IQR)] 2.0 (4) 4.0 (8) 3.0 (6) 2.0 (3) <0.001 Following anti-contagion tips 2,685 (90.3) 420 (84.5) 533 (88.0) 1,731 (92.7) <0.001 Well-being [1–10, mean (SD)] 5.8 (2.1) 6.6 (2.1) 5.9 (2.1) 5.6 (2.1) <0.001 Level of discomfort [1–10, mean (SD)] 5.6 (2.5) 4.6 (2.4) 5.4 (2.4) 5.9 (2.5) <0.001 Lifestyle during confinement, N (%) Aerobic exercise 1,674 (56.3) 273 (54.9) 325 (53.6) 1,075 (57.5) 0.19 COVID-19 related news 2,531 (85.1) 379 (76.3) 504 (83.2) 1,648 (88.2) <0.001 Martial arts 136 (4.6) 28 (5.6) 42 (6.9) 65 (3.5) 0.001 Music and singing 1,026 (34.5) 258 (51.9) 244 (40.3) 524 (28.1) <0.001 Playing videogames 1,005 (33.8) 107 (21.5) 174 (28.7) 723 (38.7) <0.001 Pornography 739 (24.8) 149 (30.0) 179 (29.5) 410 (21.9) <0.001 Reading 2,436 (81.9) 430 (86.5) 529 (87.3) 1,477 (79.1) <0.001 TV, movies or series 2,702 (90.8) 420 (84.5) 552 (91.1) 1,729 (92.6) <0.001 Weight lifting or bending 1,115 (37.5) 179 (36.0) 220 (36.3) 715 (38.3) 0.52 Yoga, pilates or meditation 1,684 (56.6) 404 (81.3) 452 (74.6) 827 (44.3) <0.001 Change in diet <0.001 Better 1,303 (43.8) 259 (52.1) 287 (47.4) 756 (40.5) Same 1,166 (39.2) 187 (37.6) 227 (37.5) 752 (40.3) Worse 503 (16.9) 51 (10.3) 92 (15.2) 360 (19.3) Less libido or sex 1,448 (48.7) 218 (43.9) 280 (46.2) 950 (50.9) 0.01 Societal and economic changes, N (%) Change in values of society <0.001 Yes, in favor of change 841 (28.3) 195 (39.2) 188 (31.0) 458 (24.5) Yes, against change 948 (31.9) 128 (25.8) 201 (33.2) 619 (33.2) No changes 1,180 (39.7) 174 (35.0) 217 (35.8) 789 (42.3) Working less <0.001 No 2,313 (77.7) 333 (67.4) 438 (73.2) 1,541 (82.9) Yes (or reduced hours) 595 (20.0) 154 (31.2) 149 (24.9) 292 (15.7) Retired 44 (1.5) 7 (1.4) 11 (1.8) 26 (1.4) Income decreased 1,404 (47.2) 266 (53.6) 314 (52.2) 824 (44.3) <0.001 Significant (Bonferroni-corrected) p < 0.002 are represented bold. DISCUSSION of sociodemographic, activity, and lifestyle factors during the confinement, health-related factors, lifetime psychedelic drug For this study, a large sample was recruited from different use, and psychometric questionnaires. Most of the subjects countries and cultures and comprehensively assessed in terms recruited were in the unique situation of being confined at home Frontiers in Psychiatry | www.frontiersin.org 7 June 2021 | Volume 12 | Article 687546 Révész et al. Psychedelics and Psychometrics During COVID-19 TABLE 3 | Comparing means of psychometric measures among Spanish, Portuguese, and English speakers. Portuguese [mean English [mean (SD)] Spanish [mean (SD)] p-value (SD)] N = 689 N = 672 N = 1,610–1,613 Stress and social support Psychological distress 3.56 (3.60) 3.13 (3.33) 2.66 (3.35) <0.001 Peritraumatic stress 1.52 (0.75) 1.46 (0.78) 1.57 (0.77) 0.01 Social support 41.29 (9.69) 40.82 (9.59) 41.71 (9.15) 0.11 Brief symptom inventory scores Somatization 0.64 (0.75) 0.62 (0.70) 1.21 (1.10) <0.001 Obsessive-compulsive 1.45 (0.93) 1.37 (0.96) 1.30 (0.98) 0.002 Interpersonal sensitivity 1.16 (0.98) 1.13 (0.99) 1.02 (0.97) 0.002 Depression 1.37 (0.97) 1.31 (1.00) 1.56 (1.08) <0.001 Anxiety 1.30 (0.93) 1.03 (0.90) 1.34 (1.02) <0.001 Hostility 0.95 (0.81) 0.84 (0.81) 0.71 (1.03) <0.001 Phobic anxiety 1.07 (1.07) 1.15 (0.99) 0.85 (1.20) <0.001 Paranoid ideation 0.88 (0.81) 0.81 (0.78) 0.90 (1.01) 0.12 Psychoticism 0.84 (0.78) 0.79 (0.76) 0.46 (0.75) <0.001 General severity index 0.95 (0.72) 1.15 (0.86) 1.13 (0.80) <0.001 Personality scales Novelty seeking 23.11 (2.54) 22.65 (3.48) 23.25 (3.91) 0.001 Harm avoidance 23.64 (2.86) 23.70 (3.57) 20.39 (4.37) <0.001 Reward dependence 21.36 (2.78) 21.02 (3.38) 23.09 (3.37) <0.001 Persistence 26.15 (3.22) 26.03 (3.10) 27.74 (6.13) <0.001 Excitability 18.38 (2.42) 18.75 (2.40) 17.49 (2.85) <0.001 Self-directedness 24.07 (3.98) 23.38 (3.77) 17.94 (6.06) <0.001 Cooperativeness 23.48 (3.09) 22.10 (4.04) 20.45 (3.45) <0.001 Self-transcendence 24.91 (3.22) 25.12 (3.40) 22.14 (9.24) <0.001 Significant (Bonferroni-corrected) p < 0.002 are represented bold. FIGURE 1 | Self-rated impact of psychedelic drug use on managing the COVID-19 confinement period. Black bar refers to persons that have never taken psychedelic drugs; dark gray bar refers to the regular users; and light gray bar refers to occasional users. Overall p-value is calculated with Chi square test, and * mark significances between regular and occasional users with p < 0.05. Frontiers in Psychiatry | www.frontiersin.org 8 June 2021 | Volume 12 | Article 687546 Révész et al. Psychedelics and Psychometrics During COVID-19 TABLE 4 | Baseline associations between lifetime psychedelic drug users vs. non-users and more specifically, regular vs. occasional vs. never users of psychedelic drugs in the past and psychometric measures. Psychedelic vs. never Occasional vs. never Regular vs. never B (SE) p B (SE) p B (SE) p Stress and social support (N = 2,467–2,468) Psychological distress (GHQ) −0.52 (0.18) 0.004 −0.32 (0.21) 0.12 −0.79 (0.23) <0.001 Peritraumatic stress −0.17 (0.04) <0.001 −0.16 (0.05) 0.001 −0.18 (0.05) <0.001 Social support (Duke 11) 1.53 (0.51) 0.003 1.03 (0.57) 0.07 2.19 (0.63) <0.001 Brief symptom inventory scores (N = 2,468) Somatization 0.01 (0.05) 0.81 0.03 (0.06) 0.56 −0.02 (0.06) 0.80 Obsessive-compulsive −0.05 (0.05) 0.30 −0.05 (0.06) 0.42 −0.06 (0.06) 0.33 Interpersonal sensitivity 0.01 (0.05) 0.88 0.01 (0.06) 0.81 −0.00 (0.07) 0.99 Depression −0.08 (0.06) 0.15 −0.06 (0.06) 0.36 −0.11 (0.07) 0.12 Anxiety −0.05 (0.05) 0.38 0.00 (0.06) 0.99 −0.11 (0.07) 0.10 Hostility −0.06 (0.05) 0.28 −0.03 (0.06) 0.62 −0.09 (0.06) 0.15 Phobic anxiety −0.14 (0.06) 0.03 −0.10 (0.07) 0.16 −0.19 (0.08) 0.02 Paranoid ideation −0.02 (0.05) 0.69 0.04 (0.06) 0.54 −0.10 (0.06) 0.13 Psychoticism −0.05 (0.04) 0.28 −0.03 (0.05) 0.58 −0.07 (0.05) 0.16 General severity index −0.01 (0.04) 0.86 −0.02 (0.05) 0.63 0.01 (0.05) 0.79 Personality scales (N = 2,467) Novelty seeking 0.75 (0.18) <0.001 0.62 (0.21) 0.003 0.93 (0.23) <0.001 Harm avoidance −0.10 (0.21) 0.62 −0.14 (0.24) 0.55 −0.05 (0.26) 0.84 Reward dependence 0.08 (0.18) 0.64 0.07 (0.20) 0.72 0.10 (0.22) 0.65 Persistence −0.18 (0.27) 0.49 −0.37 (0.30) 0.22 0.07 (0.33) 0.83 Excitability 0.12 (0.14) 0.39 0.14 (0.16) 0.37 0.09 (0.18) 0.61 Self-directedness −0.22 (0.28) 0.44 −0.10 (0.32) 0.75 −0.37 (0.35) 0.28 Cooperativeness −0.63 (0.19) 0.001 −0.29 (0.21) 0.17 −1.09 (0.23) <0.001 Self-transcendence 2.26 (0.36) <0.001 1.89 (0.41) <0.001 2.75 (0.44) <0.001 All linear regressions were corrected for age, gender, languages, religion, practitioner of religion, alcohol, tobacco, cannabis, cocaine and amphetamine use. Significant (Bonferroni- corrected) p < 0.002 are represented in bold. due to COVID-19, a very unusual scenario in recent history. users (both regular and occasional) had various confinement- We were interested in assessing the potential psychological related differences. For example, they were confined more days consequences of such an uncommon social scenario and, more than never-users, but the difference, while statistically significant, specifically, the possible role that lifetime use of psychedelic might not be relevant (a mean of 30.7 and 30.9 days in the drugs might play in dealing with those consequences, given the case of users, and 28.2 in never-users). A more clearly relevant recently reported clinical and community benefits associated difference regards time spent outdoors and access to outdoor with psychedelic drugs (41). We found that lifetime use of spaces, where psychedelic drug users had more access. This is psychedelic drugs, especially when used regularly (defined as at in accordance with the enhancement observed in relating to least once per 6 months), was associated with less psychological nature after using psychedelic drugs (39, 58, 59). Psychedelic drug distress, less peritraumatic stress, and more social support. users also showed more interest in having healthy habits, such Regarding personality measures, psychedelic drug users scored as maintaining a better diet during confinement. This was also higher on the novelty seeking and self-transcendence scales, and found in a previous study with long-term ayahuasca ceremony lower on cooperativeness. participants (38), suggesting that beyond the plant/drug itself, Regular psychedelic drug users scored better on several other factors might contribute to the generally better health psychometric measures. There are various potential explanations found among this population. Psychedelic drug users also showed for our finding. For instance, this could be related to the better higher levels of well-being and lower discomfort levels during mental health measures that have been found among psychedelic confinement, in contrast with the never users. This finding drug users (35–37). Moreover, other survey studies informed might be linked to the reality that 49% of users self-rated about an increasing trend in the use of psychedelic drugs, their past psychedelic drug use as having a positive impact particularly for self-treatment of mental health conditions (56). on their management of lockdown, while 16% considered it The intensity of the so-called mystical-type experience induced to have a small positive impact. Interestingly, the percentage by these substances has also been associated with a higher change of people who noted a strong positive impact in Figure 1 in well-being (57). It should be noted that psychedelic drug is larger among regular users (73%) and reaches only the Frontiers in Psychiatry | www.frontiersin.org 9 June 2021 | Volume 12 | Article 687546 Révész et al. Psychedelics and Psychometrics During COVID-19 31% among occasional users. This may suggest that regular a period of confinement can only be speculative. First, they users believe that psychedelic drugs offer greater benefits, or are 5-HT2A agonists and have interesting anti-inflammatory, that those supposed benefits are observed only after sustained plasticity-promoting, and neuroprotective properties that could use. Another potential explanation is that the sample may be be associated with mood enhancement (34, 64–66). Also, the biased, being only those who have a strong positive impact feelings of awe produced by the psychedelic experience (67) and the ones who use psychedelic drugs regularly. Moreover, the the enhancement of certain traits or psychological processes, more psychedelic drugs participants used, the more likely such as decentering (68), can be especially beneficial during a they were to be religious practitioners or define themselves as prolonged lockdown. It seems that long-term psychedelic users spiritual and/or performing spiritual practices. These tendencies tend to show these traits (38, 61, 62). This evidence can partially are highly related to the self-transcendence personality trait explain some of the differences observed in this study between (60), which was also measured by the TCI-R-67 test and, users and non-users, but further studies should reveal the specific accordingly, showed higher scores among psychedelic drug mechanisms at work. users (both regular and occasional). Regarding religious/spiritual Regular users of psychedelic drugs also reported having tendencies, previous studies (61, 62) in which personality traits used more non-psychedelic drugs in the past. Although drug were measured by the TCI/TCI-R-67 questionnaires, involving use is generally associated with poorer outcomes in terms both long-term ayahuasca ceremony participants and non-users of psychological and physical health, in this case, as we will controls, found significant differences for the self-transcendence discuss below, regular psychedelic users scored better on several scale and no differences for the cooperativeness scale. Bouso et al. measures. Notably, we also observed that regular users were (61) study was performed with Brazilian ritual ayahuasca users more likely using psychedelic drugs alone, in rituals/ceremonies, living in urban and jungle areas, whereas the sample for Bouso and in therapeutic contexts, while occasional users used them et al. (62) consisted of Spanish people living in urban areas. with friends or at parties and festivals. From a harm reduction The lower score for cooperativeness obtained from psychedelic perspective, it has been observed that ritualistic and therapeutic drug users in our study could be related to differential effects contexts are generally safer (69–71). Thus, it might be suggested between ayahuasca and psychedelic drugs in general, as well that regular users tend to choose healthier approaches to drug as being affected by participants belonging to formal religious use, whether psychedelic or not, and, as a consequence, they are groups, in the case of the samples used by Bouso et al. (61, less likely to experience negative outcomes. 62). Interestingly, in another study with Spanish ayahuasca- Our sample was gender-biased (70% women), and was naïve subjects (28), the score for self-transcendence increased composed of mostly Spanish speakers (54%), mostly from Spain through the follow-ups until 6 months after ayahuasca intake, but also from various South American countries. Thus, the whereas the score for cooperativeness did not. Although this results should be interpreted in light of these characteristics. was not statistically significant, it suggests that having an intense Additionally, it should be noted that the sample was confined psychedelic experience for the first time can potentiate this trait, for only 20–30 days at the time when they responded to the and thus the higher scores observed among long-term users questionnaire. The lockdown was quite strict in most cases, can be partially regarded as a consequence of their habits and and these measures lasted much longer than 30 days, so not due only to previous personality patterns. It should be longitudinal studies should discuss the impact of prolonged noted that Bouso et al. (62) found associations between greater lockdown in order to appropriately assess the consequences for self-transcendence scores and increased cortical thinning of the both physical and psychological health. While most of the sample posterior cingulate cortex in the ayahuasca group. The provision was under strict lockdown measures, the exception of Brazil is of a potential neural basis for this character dimension, and the remarkable. Some state and municipal Brazilian governments fact that subjects could experience increased self-transcendence had implemented certain social distancing measures, whereas after starting to use psychedelic drugs, supports the hypothesis the central government opposed such measures (72). In this that this trait is especially notable among long-term psychedelic context, we should ask about the degree of distress that the drug users. absence of sensible public health policies can cause, and if such Other factors that explain the better scores obtained by distress is similar to or even greater than the stress caused by psychedelic drug users might include the physical activity of the strict lockdowns found in most of countries. Indeed, the regular users in our sample. Indeed, psychedelic drug users GHQ-12 score was significantly higher among the respondents reported playing music, singing, and doing yoga, pilates, or to the Portuguese questionnaire, a finding that supports other meditation during confinement, while non-users spent more data recently published (73). Moreover, according to our results, time watching COVID-related news or TV in general. Some the feeling of untrustworthiness with regards to politicians and research has warned about inappropriate media exposure during the media was generalized among the entire sample. The reasons the current pandemic (63), so this may have affected the underlying this issue are beyond the scope of this manuscript, but non-users included in our sample. Additionally, regular users due to our social responsibility as scientists we cannot dismiss also reported having improved their dietary habits during the the opportunity to encourage social scientists, philosophers, lockdown, and having a higher libido and more sex than and policymakers to analyze and confront this unfortunate non-users. However, as a counterpart, they suffered more from social phenomenon. working less and having a reduced income. The reasons why The most remarkable difference between different versions of the regular use of psychedelic drugs might be protective during the questionnaire and psychopathology measures was observed Frontiers in Psychiatry | www.frontiersin.org 10 June 2021 | Volume 12 | Article 687546 Révész et al. Psychedelics and Psychometrics During COVID-19 in the case of Spanish speakers, who scored significantly higher cannabis use during lockdown, but the increase in alcohol use than the other speakers on the somatization and depression was consistent with this study’s findings. scales. This is in line with a recent study (74) that analyzed This study has some limitations that should be discussed. First, several variables related to the mental health impacts of the despite the large sample size, the proportion of Spanish speakers COVID-19 crisis, in which it can be observed that the percentage was higher than the proportion of English and Portuguese of the population using benzodiazepines doubled during the speakers, so the results might not be equally representative for all lockdown (5.8% of the Spanish population was prescribed of these populations. Additionally, regular users of psychedelic benzodiazepines as a consequence of the crisis). The high scores drugs were not matched with non-users for some characteristics that were observed for some scales (depression and obsessive- (e.g., age, gender, and religion). It should be noted that the compulsiveness) were consistently higher across all countries. impact of confinement is difficult to measure, as it includes Thus, this might suggest similar sources of distress across cultures several aspects that have been only marginally addressed in the that could be related to the well-known stressors associated with recent history of psychology and psychiatry. Thus, the real impact a global pandemic (e.g., social isolation, disease, and poverty, of the pandemic might not be fully reflected in the measures among others). Unemployment and poverty could be related used. Despite our intention to examine the pandemic using a to enhanced distress (75, 76). The fact that 17% of our sample transcultural approach, the psychometric scores obtained should recently lost their job and that almost half of the total sample be compared to the normative data for each country to ensure reported reductions in income is worrying, since this suggests their appropriate interpretation. This is highly challenging since potential vulnerabilities in terms of health, while also suggesting our sample included a large number of nationalities, so we enormous costs in terms of the global economy. Nearly half of encourage caution when comparing scores between different the sample reported a reduction in their libido as well. This nationalities without considering intrinsic cultural differences. has been observed in various studies with contrasting results. Lastly, apart from the main interest of this manuscript (i.e., While the same percentage of the sample analyzed by Arafat the influence of psychedelic drug use on stress associated with et al. (77) reported that the pandemic affected their sexual life, no the pandemic), we tried to address some preliminary factors alterations were observed in terms of the psychometric measures. involved in general health and well-being, ranging from self- Similarly contradictory findings were reported by Yuksel and ratings of discomfort, housing, or family issues, to activities Ozgor (78), where they found that sexual desire and frequency of performed during the lockdown. Nevertheless, we are aware of intercourse significantly increased during the pandemic, whereas the complexity of the variables we are studying, so we must quality of sexual life decreased. This is a complex matter, and clarify that other unassessed variables could have influenced the future studies should explore the effects of the pandemic on it results obtained. Furthermore, when classifying our sample in in depth. regular/occasional/never users we should not forget that maybe Non-psychedelic drug use during confinement mainly our results reflect more the characteristics of the people who involved alcohol, cannabis, and tobacco. Remarkably, more use psychedelic drugs frequently or not rather than the effects people reported a general reduction in drug use (18.7%) than of psychedelic drugs. It should be noted that in the analyses reported increased use (13.4%) during lockdown. Specifically, performed in this manuscript it was not taken into consideration 3.9 and 2.3% of participants increased their use of alcohol whether subjects were living alone or not during the confinement and cannabis, respectively, whereas only 0.9% of participants period. Nevertheless, this study has several strengths, such as its reported a decrease in their alcohol use. These results are in line large sample size, its precise timing during the first lockdown with findings reported by the Global Drug Survey (GDS) using a and related confinement, and the inclusion of persons from sample of 55,000 people recruited in May-June 2020, which also various cultures. showed a general increase in alcohol and cannabis use, while a smaller part of the sample reduced their use. The use of other drugs decreased dramatically (79). The increase in alcohol use CONCLUSION was also reported in US population by the APA (9). However, a Spanish study (80) found that the risky consumption of alcohol The global pandemic caused by SARS-COV-2 has had a notable actually decreased during the confinement period. Some studies impact on several countries across the globe. The consequences have warned about the clinical risks that cannabis users may face, go far beyond the virus itself, given the necessary measures since they could be more exposed to contagion and have specific for controlling the spread of the virus, which generally consist vulnerabilities in terms of respiratory issues (81). However, other of limiting social contact. Our sample showed some clear and studies have suggested that some compounds of cannabis might remarkable signs of psychological distress, and several variables be beneficial for the treatment of some COVID-19 symptoms have been analyzed. We found that psychedelic drug use, mostly (82–86). Moreover, other studies reported that cannabis use when used regularly, was associated with better outcomes in had positive effects in terms of helping individuals to cope with terms of general health and regarding stress measures. However, stressful situations, effects that could partially explain its benefits given the observational nature of the design of this study, other with regards to chronic disorders (87). These factors should also factors than psychedelic drug use (e.g., previous personality traits, be considered in the conducting of a risk-benefit assessment. local lockdown measures, or differences in sociodemographic Another online survey (88) that recruited a sample with a similar factors) could be involved in this outcome. This suggests that the size as the present study (n = 3,632) did not find an increase in use of psychedelic drugs might be a protective factor itself, or Frontiers in Psychiatry | www.frontiersin.org 11 June 2021 | Volume 12 | Article 687546 Révész et al. Psychedelics and Psychometrics During COVID-19 people with better psychometric characteristics are more prone AUTHOR CONTRIBUTIONS to frequently using psychedelic drugs. Therefore, future studies should investigate the different roles that psychedelic drugs can JB conceived the study. JB, GO, MA-C, RdS, and play in this pandemic or in a future pandemic outbreak. JH designed the study. GO developed the online survey. GO, GR, and JR performed the data collection. DR performed the statistical analyses. GO, GR, JR, DATA AVAILABILITY STATEMENT and DR wrote the first draft of the manuscript. The raw data supporting the conclusions of this article will be All authors contributed to the final version of made available by the authors, without undue reservation. the manuscript. ETHICS STATEMENT ACKNOWLEDGMENTS The studies involving human participants were reviewed and approved by Comité ético de la investigación (Universidad We would like to thank the study participants for time Autónoma de Madrid). The patients/participants provided their and effort invested in this research. 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