Psychedelics and sexual functioning: a mixed-methods study.


Journal

Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288

Informations de publication

Date de publication:
07 Feb 2024
Historique:
received: 16 05 2023
accepted: 12 12 2023
medline: 8 2 2024
pubmed: 8 2 2024
entrez: 7 2 2024
Statut: epublish

Résumé

Do psychedelics affect sexual functioning postacutely? Anecdotal and qualitative evidence suggests they do, but this has never been formally tested. While sexual functioning and satisfaction are generally regarded as an important aspect of human wellbeing, sexual dysfunction is a common symptom of mental health disorders. It is also a common side effect of selective serotonin reuptake inhibitors (SSRIs), a first line treatment for depression. The aim of the present paper was to investigate the post-acute effects of psychedelics on self-reported sexual functioning, combining data from two independent studies, one large and naturalistic and the other a smaller but controlled clinical trial. Naturalistic use of psychedelics was associated with improvements in several facets of sexual functioning and satisfaction, including improved pleasure and communication during sex, satisfaction with one's partner and physical appearance. Convergent results were found in a controlled trial of psilocybin therapy versus an SSRI, escitalopram, for depression. In this trial, patients treated with psilocybin reported positive changes in sexual functioning after treatment, while patients treated with escitalopram did not. Despite focusing on different populations and settings, this is the first research study to quantitively investigate the effects of psychedelics on sexual functioning. Results imply a potential positive effect on post-acute sexual functioning and highlight the need for more research on this.

Identifiants

pubmed: 38326446
doi: 10.1038/s41598-023-49817-4
pii: 10.1038/s41598-023-49817-4
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

2181

Informations de copyright

© 2024. Crown.

Références

Nichols, D. E. & Walter, H. The history of psychedelics in psychiatry. Pharmacopsychiatry 54(04), 151–166 (2021).
pubmed: 33285579 doi: 10.1055/a-1310-3990
Lee, M. A. & Shlain, B. Acid Dreams: The Complete Social History of LSD: The CIA, the Sixties, and Beyond (Grove Press, 1992).
Nutt, D., Erritzoe, D. & Carhart-Harris, R. Psychedelic psychiatry’s brave new world. Cell 181(1), 24–28 (2020).
pubmed: 32243793 doi: 10.1016/j.cell.2020.03.020
Carhart-Harris, R. L. & Friston, K. J. REBUS and the anarchic brain: Toward a unified model of the brain action of psychedelics. Pharmacol. Rev. 71(3), 316 (2019).
pubmed: 31221820 pmcid: 6588209 doi: 10.1124/pr.118.017160
Davis, A. K. et al. Effects of psilocybin-assisted therapy on major depressive disorder: A randomized clinical trial. JAMA Psychiatry 78(5), 481–489 (2021).
pubmed: 33146667 doi: 10.1001/jamapsychiatry.2020.3285
Carhart-Harris, R. L. et al. Psilocybin with psychological support for treatment-resistant depression: An open-label feasibility study. Lancet Psychiatry 3(7), 619–627 (2016).
pubmed: 27210031 doi: 10.1016/S2215-0366(16)30065-7
Carhart-Harris, R. et al. Trial of psilocybin versus escitalopram for depression. N. Engl. J. Med. 384(15), 1402–1411 (2021).
pubmed: 33852780 doi: 10.1056/NEJMoa2032994
Goodwin, G. M. et al. Single-dose psilocybin for a treatment-resistant episode of major depression. N. Engl. J. Med. 387(18), 1637–1648 (2022).
pubmed: 36322843 doi: 10.1056/NEJMoa2206443
Otte, C. et al. Major depressive disorder. Nat. Rev. Dis. Primers 2, 16065 (2016).
pubmed: 27629598 doi: 10.1038/nrdp.2016.65
Kennedy, S. H. & Rizvi, S. Sexual dysfunction, depression, and the impact of antidepressants. J. Clin. Psychopharmacol. 29(2), 157–164 (2009).
pubmed: 19512977 doi: 10.1097/JCP.0b013e31819c76e9
Jing, E. & Straw-Wilson, K. Sexual dysfunction in selective serotonin reuptake inhibitors (SSRIs) and potential solutions: A narrative literature review. Mental Health Clin. 6(4), 191–196 (2016).
doi: 10.9740/mhc.2016.07.191
Montejo-González, A. L. et al. SSRI-induced sexual dysfunction: Fluoxetine, paroxetine, sertraline, and fluvoxamine in a prospective, multicenter, and descriptive clinical study of 344 patients. J. Sex Marital Ther. 23(3), 176–194 (1997).
pubmed: 9292833 doi: 10.1080/00926239708403923
Alhuwaydi, A. Development of erectile dysfunction in men treated for major depressive disorder with selective serotonin reuptake inhibitors: A systematic review. Arch. Med. Sci. 16, 1 (2020).
Montejo, A. L. et al. Better sexual acceptability of agomelatine (25 and 50 mg) compared to escitalopram (20 mg) in healthy volunteers. A 9-week, placebo-controlled study using the PRSexDQ scale. J. Psychopharmacol. 29(10), 1119–1128 (2015).
pubmed: 26268533 doi: 10.1177/0269881115599385
Abler, B. et al. Neural correlates of antidepressant-related sexual dysfunction: A placebo-controlled fMRI study on healthy males under subchronic paroxetine and bupropion. Neuropsychopharmacology 36(9), 1837–1847 (2011).
pubmed: 21544071 pmcid: 3154102 doi: 10.1038/npp.2011.66
Nafziger, A. N. et al. Incidence of sexual dysfunction in healthy volunteers on fluvoxamine therapy. J. Clin. Psychiatry 60(3), 187–190 (1999).
pubmed: 10192595 doi: 10.4088/JCP.v60n0307
Stahl, S. M. The psychopharmacology of sex, part 2: Effects of drugs and disease on the 3 phases of human sexual response. J. Clin. Psychiatry 62(3), 147–148 (2001).
pubmed: 11305697 doi: 10.4088/JCP.v62n0301
Laumann, E. O., Paik, A. & Rosen, R. C. Sexual dysfunction in the United States: Prevalence and predictors. JAMA 281(6), 537–544 (1999).
pubmed: 10022110 doi: 10.1001/jama.281.6.537
Fallis, E. E. et al. The longitudinal association of relationship satisfaction and sexual satisfaction in long-term relationships. J. Fam. Psychol. 30(7), 822–831 (2016).
pubmed: 27077235 doi: 10.1037/fam0000205
Buczak-Stec, E., König, H.-H. & Hajek, A. The link between sexual satisfaction and subjective well-being: A longitudinal perspective based on the German ageing survey. Qual. Life Res. 28(11), 3025–3035 (2019).
pubmed: 31264125 doi: 10.1007/s11136-019-02235-4
Balon, R. Burden of sexual dysfunction. J. Sex Marital Ther. 43(1), 49–55 (2017).
pubmed: 26683616 doi: 10.1080/0092623X.2015.1113597
Davison, S. L. et al. Psychology: The relationship between self-reported sexual satisfaction and general well-being in women. J. Sex. Med. 6(10), 2690–2697 (2009).
pubmed: 19817981 doi: 10.1111/j.1743-6109.2009.01406.x
Rosen, R. C. & Bachmann, G. A. Sexual well-being, happiness, and satisfaction, in women: The case for a new conceptual paradigm. J. Sex Marital Ther. 34(4), 291–297 (2008).
pubmed: 18576229 doi: 10.1080/00926230802096234
Stephenson, K. R. & Meston, C. M. The conditional importance of sex: Exploring the association between sexual well-being and life satisfaction. J. Sex Marital Ther. 41(1), 25–38 (2015).
pubmed: 24308354 doi: 10.1080/0092623X.2013.811450
Henderson-King, D. H. & Veroff, J. Sexual satisfaction and marital well-being in the first years of marriage. J. Soc. Person. Relationsh. 11(4), 509–534 (1994).
doi: 10.1177/0265407594114002
Yoo, H. et al. Couple communication, emotional and sexual intimacy, and relationship satisfaction. J. Sex Marital Ther. 40(4), 275–293 (2014).
pubmed: 24111536 doi: 10.1080/0092623X.2012.751072
Witting, K. et al. Female sexual function and its associations with number of children, pregnancy, and relationship satisfaction. J. Sex Marital Ther. 34(2), 89–106 (2008).
pubmed: 18224545 doi: 10.1080/00926230701636163
Ganong, K. & Larson, E. Intimacy and belonging: The association between sexual activity and depression among older adults. Soc. Mental Health 1(3), 153–172 (2011).
doi: 10.1177/2156869311431612
Gupta, K. “Screw health”: Representations of sex as a health-promoting activity in medical and popular literature. J. Med. Hum. 32(2), 127–140 (2011).
doi: 10.1007/s10912-010-9129-x
Newland, C. A. My Self and I: The Intimate and Completely Frank Record of One Woman’s Courageous Experiment with Psychiatry’s Newest Drug LSD-25 (Coward-McCann, 1962).
doi: 10.1037/14472-025
Hoffman, A., Dass, R. & Shulgin, S. Manifesting Minds: A Review of Psychedelics in Science, Medicine, Sex, and Spirituality (2014).
Sprinkle, A. I-Iow psychedelics informed my sex life and sex work. In Manifesting Minds: A Review of Psychedelics in Science, Medicine, Sex, and Spirituality 155 (2014).
Grof, S. LSD Psychotherapy (Hunter House, 1980).
Jacobs, L., Banbury, S. & Lusher, J. Micro-dosing psychedelics as a plausible adjunct to psychosexual and couple’s therapy: A qualitative insight. Sex. Relationsh. Ther. 5, 1–14 (2022).
Alpert, R. Drugs and sexual behavior. J. Sex Res. 5(1), 50–56 (1969).
doi: 10.1080/00224496909550596
Payne, J. E., Chambers, R. & Liknaitzky, P. Combining psychedelic and mindfulness interventions: Synergies to inform clinical practice. ACS Pharmacol. Transl. Sci. 4(2), 416–423 (2021).
pubmed: 33860171 pmcid: 8033772 doi: 10.1021/acsptsci.1c00034
Madsen, M. K. et al. A single psilocybin dose is associated with long-term increased mindfulness, preceded by a proportional change in neocortical 5-HT2A receptor binding. Eur. Neuropsychopharmacol. 33, 71–80 (2020).
pubmed: 32146028 doi: 10.1016/j.euroneuro.2020.02.001
Kettner, H. et al. Psychedelic communitas: Intersubjective experience during psychedelic group sessions predicts enduring changes in psychological wellbeing and social connectedness. Front. Pharmacol. 12, 234 (2021).
doi: 10.3389/fphar.2021.623985
Dolder, P. C. et al. LSD acutely impairs fear recognition and enhances emotional empathy and sociality. Neuropsychopharmacology 41(11), 2638–2646 (2016).
pubmed: 27249781 pmcid: 5026740 doi: 10.1038/npp.2016.82
Pokorny, T. et al. Effect of psilocybin on empathy and moral decision-making. Int. J. Neuropsychopharmacol. 20(9), 747–757 (2017).
pubmed: 28637246 pmcid: 5581487 doi: 10.1093/ijnp/pyx047
Ona, G. et al. Ayahuasca and public health: Health status, psychosocial well-being, lifestyle, and coping strategies in a large sample of ritual ayahuasca users. J. Psychoact. Drugs 51(2), 135–145 (2019).
doi: 10.1080/02791072.2019.1567961
Teixeira, P. J. et al. Psychedelics and health behaviour change. J. Psychopharmacol. 36(1), 12–19 (2022).
pubmed: 34053342 doi: 10.1177/02698811211008554
Knudsen, G. M. Sustained effects of single doses of classical psychedelics in humans. Neuropsychopharmacology 48, 1–6 (2022).
Erritzoe, D. et al. Recreational use of psychedelics is associated with elevated personality trait openness: Exploration of associations with brain serotonin markers. J. Psychopharmacol. 33(9), 1068–1075 (2019).
pubmed: 30816797 doi: 10.1177/0269881119827891
Fielder, R. Sexual functioning. In Encyclopedia of Behavioral Medicine (eds Gellman, M. D. & Turner, J. R.) 1774–1777 (Springer, 2013).
doi: 10.1007/978-1-4419-1005-9_668
Mize, S. J. A review of mindfulness-based sex therapy interventions for sexual desire and arousal difficulties: From research to practice. Curr. Sex. Health Rep. 7(2), 89–97 (2015).
doi: 10.1007/s11930-015-0048-8
Bossio, J. A. et al. Mindfulness-based group therapy for men with situational erectile dysfunction: A mixed-methods feasibility analysis and pilot study. J. Sex. Med. 15(10), 1478–1490 (2018).
pubmed: 30297094 doi: 10.1016/j.jsxm.2018.08.013
Rubin, H. & Campbell, L. Day-to-day changes in intimacy predict heightened relationship passion, sexual occurrence, and sexual satisfaction: A dyadic diary analysis. Soc. Psychol. Person. Sci. 3(2), 224–231 (2012).
doi: 10.1177/1948550611416520
Štulhofer, A., Ferreira, L. C. & Landripet, I. Emotional intimacy, sexual desire, and sexual satisfaction among partnered heterosexual men. Sex. Relationsh. Ther. 29(2), 229–244 (2014).
doi: 10.1080/14681994.2013.870335
Hamilton, M. A rating scale for depression. J. Neurol. Neurosurg. Psychiatry 23(1), 56–62 (1960).
pubmed: 14399272 pmcid: 495331 doi: 10.1136/jnnp.23.1.56
Beck, A. T., Steer, R. A. & Brown, G. K. Manual for the Beck Depression Inventory-II (Psychological Corporation, 1996).
Weiss, B. E. et al. A critical evaluation of QIDS-SR-16 using data from a trial of psilocybin vs escitalopram therapy for depression. J. Psychopharmacol. 37, 717 (2023).
pubmed: 37122239 pmcid: 10350722 doi: 10.1177/02698811231167848
Carhart-Harris, R. L. & Nutt, D. J. Serotonin and brain function: A tale of two receptors. J. Psychopharmacol. 31(9), 1091–1120 (2017).
pubmed: 28858536 pmcid: 5606297 doi: 10.1177/0269881117725915
McCabe, C. et al. Diminished neural processing of aversive and rewarding stimuli during selective serotonin reuptake inhibitor treatment. Biol. Psychiatry 67(5), 439–445 (2010).
pubmed: 20034615 pmcid: 2828549 doi: 10.1016/j.biopsych.2009.11.001
Opbroek, A. et al. Emotional blunting associated with SSRI-induced sexual dysfunction. Do SSRIs inhibit emotional responses? Int. J. Neuropsychopharmacol. 5(2), 147–151 (2002).
pubmed: 12135539 doi: 10.1017/S1461145702002870
Fried, E. I. & Nesse, R. M. The impact of individual depressive symptoms on impairment of psychosocial functioning. PLoS ONE 9(2), e90311 (2014).
pubmed: 24587318 pmcid: 3938686 doi: 10.1371/journal.pone.0090311
Harshitha, H. A. et al. Perceived barriers in the assessment and management of female sexual dysfunction: A survey among resident trainees in psychiatry. Acad. Psychiatry 1, 1–5 (2022).
Healy, D. Post-SSRI sexual dysfunction and other enduring sexual dysfunctions. Epidemiol. Psychiatr. Sci. 29, e55 (2020).
doi: 10.1017/S2045796019000519
Foreman, M. M., Hall, J. L. & Love, R. L. The role of the 5-HT2 receptor in the regulation of sexual performance of male rats. Life Sci. 45(14), 1263–1270 (1989).
pubmed: 2811596 doi: 10.1016/0024-3205(89)90128-8
Klint, T. & Larsson, K. Clozapine acts as a 5-HT2 antagonist by attenuating DOI-induced inhibition of male rat sexual behaviour. Psychopharmacology 119(3), 291–294 (1995).
pubmed: 7675963 doi: 10.1007/BF02246293
Gorzalka, B. B., Hanson, L. A. & Brotto, L. A. Chronic stress effects on sexual behavior in male and female rats: Mediation by 5-HT2A receptors. Pharmacol. Biochem. Behav. 61(4), 405–412 (1998).
pubmed: 9802835 doi: 10.1016/S0091-3057(98)00106-3
Osis, L. & Bishop, J. R. Pharmacogenetics of SSRIs and sexual dysfunction. Pharmaceuticals 3(12), 3614–3628 (2010).
pmcid: 4034069 doi: 10.3390/ph3123614
Watts, R. et al. Patients’ accounts of increased “connectedness” and “acceptance” after psilocybin for treatment-resistant depression. J. Hum. Psychol. 57(5), 520–564 (2017).
Soler, J. et al. Exploring the therapeutic potential of Ayahuasca: Acute intake increases mindfulness-related capacities. Psychopharmacology 233(5), 823–829 (2016).
pubmed: 26612618 doi: 10.1007/s00213-015-4162-0
Murphy-Beiner, A. & Soar, K. Ayahuasca’s ‘afterglow’: Improved mindfulness and cognitive flexibility in ayahuasca drinkers. Psychopharmacology 237(4), 1161–1169 (2020).
pubmed: 31927605 doi: 10.1007/s00213-019-05445-3
Nour, M. M., Evans, L. & Carhart-Harris, R. L. Psychedelics, personality and political perspectives. J. Psychoact. Drugs 49(3), 182–191 (2017).
doi: 10.1080/02791072.2017.1312643
Watts, R. et al. The Watts connectedness scale: A new scale for measuring a sense of connectedness to self, others, and world. Psychopharmacology 239(11), 3461–3483 (2022).
pubmed: 35939083 pmcid: 9358368 doi: 10.1007/s00213-022-06187-5
Barba, T. et al. Effects of psilocybin versus escitalopram on rumination and thought suppression in depression. BJPsych Open 8(5), e163 (2022).
pubmed: 36065128 pmcid: 9534928 doi: 10.1192/bjo.2022.565
Kleinplatz, P. J. et al. The components of optimal sexuality: A portrait of “great sex”. Can. J. Hum. Sex. 18(1–2), 1–13 (2009).
Sánchez-Sánchez, L. C. et al. Mindfulness in sexual activity, sexual satisfaction and erotic fantasies in a non-clinical sample. Int. J. Environ. Res. Public Health 18(3), 1161 (2021).
pubmed: 33525611 pmcid: 7908537 doi: 10.3390/ijerph18031161
Leavitt, C. E., Lefkowitz, E. S. & Waterman, E. A. The role of sexual mindfulness in sexual wellbeing, relational wellbeing, and self-esteem. J. Sex Marital Ther. 45(6), 497–509 (2019).
pubmed: 30714489 pmcid: 6640099 doi: 10.1080/0092623X.2019.1572680
Jamea, E. The role of sensuality, imagination, and curiosity in high and optimal sexual satisfaction. Sex. Relationsh. Ther. 37, 1–20 (2020).
Brotto, L. A. et al. A brief mindfulness-based cognitive behavioral intervention improves sexual functioning versus wait-list control in women treated for gynecologic cancer. Gynecol. Oncol. 125(2), 320–325 (2012).
pubmed: 22293042 pmcid: 3438201 doi: 10.1016/j.ygyno.2012.01.035
Stephenson, K. R. & Kerth, J. Effects of mindfulness-based therapies for female sexual dysfunction: A meta-analytic review. J. Sex Res. 54(7), 832–849 (2017).
pubmed: 28617103 doi: 10.1080/00224499.2017.1331199
Paterson, L. Q., Handy, A. B. & Brotto, L. A. A pilot study of eight-session mindfulness-based cognitive therapy adapted for women’s sexual interest/arousal disorder. J. Sex Res. 54(7), 850–861 (2017).
pubmed: 27712106 doi: 10.1080/00224499.2016.1208800
Birnbaum, G. E., Cohen, O. & Wertheimer, V. Is it all about intimacy? Age, menopausal status, and women’s sexuality. Person. Relationsh. 14(1), 167–185 (2007).
doi: 10.1111/j.1475-6811.2006.00147.x
Cacioppo, S. Neuroimaging of female sexual desire and hypoactive sexual desire disorder. Sex. Med. Rev. 5(4), 434–444 (2017).
pubmed: 28865901 doi: 10.1016/j.sxmr.2017.07.006
Carhart-Harris, R. L. et al. The entropic brain: A theory of conscious states informed by neuroimaging research with psychedelic drugs. Front. Hum. Neurosci. 8, 20 (2014).
pubmed: 24550805 pmcid: 3909994 doi: 10.3389/fnhum.2014.00020
Whiffen, V. E., Kallos-Lilly, A. V. & MacDonald, B. J. Depression and attachment in couples. Cogn. Ther. Res. 25(5), 577–590 (2001).
doi: 10.1023/A:1005557515597
Davis, D. et al. “I can’t get no satisfaction”: Insecure attachment, inhibited sexual communication, and sexual dissatisfaction. Person. Relationsh. 13(4), 465–483 (2006).
doi: 10.1111/j.1475-6811.2006.00130.x
Butzer, B. & Campbell, L. Adult attachment, sexual satisfaction, and relationship satisfaction: A study of married couples. Person. Relationsh. 15(1), 141–154 (2008).
doi: 10.1111/j.1475-6811.2007.00189.x
Stauffer, C. S. et al. Psilocybin-assisted group therapy and attachment: Observed reduction in attachment anxiety and influences of attachment insecurity on the psilocybin experience. ACS Pharmacol. Transl. Sci. 4(2), 526–532 (2020).
pubmed: 33860182 pmcid: 8033604 doi: 10.1021/acsptsci.0c00169
Timmermann, C. et al. Psychedelics alter metaphysical beliefs. Sci. Rep. 11(1), 22166 (2021).
pubmed: 34815421 pmcid: 8611059 doi: 10.1038/s41598-021-01209-2
Burris, J. L., Smith, G. T. & Carlson, C. R. Relations among religiousness, spirituality, and sexual practices. J. Sex Res. 46(4), 282–289 (2009).
pubmed: 19132602 doi: 10.1080/00224490802684582
Murray-Swank, N. A., Pargament, K. I. & Mahoney, A. At the crossroads of sexuality and spirituality: The sanctification of sex by college students. Int. J. Psychol. Relig. 15(3), 199–219 (2005).
doi: 10.1207/s15327582ijpr1503_2
Taylor, J. F., Rosen, R. C. & Leiblum, S. R. Self-report assessment of female sexual function: Psychometric evaluation of the Brief Index of sexual functioning for women. Arch. Sex. Behav. 23(6), 627–643 (1994).
pubmed: 7872859 doi: 10.1007/BF01541816
Peluso, D. et al. Reflections on crafting an ayahuasca community guide for the awareness of sexual abuse. J. Psychedelic Stud. 4(1), 24–33 (2020).
doi: 10.1556/2054.2020.00124
Haijen, E. C. et al. Predicting responses to psychedelics: A prospective study. Front. Pharmacol. 9, 897 (2018).
pubmed: 30450045 pmcid: 6225734 doi: 10.3389/fphar.2018.00897
George, J. R. et al. The psychedelic renaissance and the limitations of a White-dominant medical framework: A call for indigenous and ethnic minority inclusion. J. Psychedelic Stud. 4(1), 4–15 (2020).
doi: 10.1556/2054.2019.015
Jones, G. M. & Nock, M. K. Race and ethnicity moderate the associations between lifetime psychedelic use (MDMA and psilocybin) and psychological distress and suicidality. Sci. Rep. 12(1), 16976 (2022).
pubmed: 36216840 pmcid: 9551032 doi: 10.1038/s41598-022-18645-3
Watts, R. Psilocybin for Depression: The ACE Model Manual (Psyarxiv, 2021).
Villeneuve, N. & Prescott, D. Examining the dark sides of psychedelic therapy. Assoc. Treat. Sex. Abusers 34(3), 1–12 (2022).
Nutt, D. J. & Sharpe, M. Uncritical Positive Regard? Issues in the Efficacy and Safety of Psychotherapy 3–6 (Sage Publications, 2008).
Montejo, A. et al. Psychometric characteristics of the psychotropic-related sexual dysfunction questionnaire. Spanish work group for the study of psychotropic-related sexual dysfunctions. Actas Esp. Psiquiatr. 28(3), 141–150 (2000).
pubmed: 11000695
Diener, E., Wirtz, D. & Tov, W. New measures of well-being: Flourishing and positive and negative feelings. Soc. Indic. Res. 39, 247–266 (2010).
Rush, A. J. et al. The 16-item quick inventory of depressive symptomatology (QIDS), clinician rating (QIDS-C), and self-report (QIDS-SR): A psychometric evaluation in patients with chronic major depression. Biol. Psychiatry 54(5), 573–583 (2003).
pubmed: 12946886 doi: 10.1016/S0006-3223(02)01866-8
Christensen, R. H. B. Cumulative link models for ordinal regression with the R package ordinal. J. Stat. Softw. 35, 1 (2018).
Bartz, A. E. Basic Statistical Concepts 4th edn. (Merrill, 1999).

Auteurs

Tommaso Barba (T)

Department of Medicine, Centre for Psychedelic Research, Imperial College London, London, UK. tommaso.barba20@imperial.ac.uk.

Hannes Kettner (H)

Department of Medicine, Centre for Psychedelic Research, Imperial College London, London, UK.
Psychedelics Division, Neuroscape, Department of Neurology, University of California San Francisco, San Francisco, United States.

Caterina Radu (C)

Department of Medicine, Centre for Psychedelic Research, Imperial College London, London, UK.

Joseph M Peill (JM)

Department of Medicine, Centre for Psychedelic Research, Imperial College London, London, UK.

Leor Roseman (L)

Department of Medicine, Centre for Psychedelic Research, Imperial College London, London, UK.

David J Nutt (DJ)

Department of Medicine, Centre for Psychedelic Research, Imperial College London, London, UK.

David Erritzoe (D)

Department of Medicine, Centre for Psychedelic Research, Imperial College London, London, UK.

Robin Carhart-Harris (R)

Department of Medicine, Centre for Psychedelic Research, Imperial College London, London, UK.
Psychedelics Division, Neuroscape, Department of Neurology, University of California San Francisco, San Francisco, United States.

Bruna Giribaldi (B)

Department of Medicine, Centre for Psychedelic Research, Imperial College London, London, UK.

Classifications MeSH