Freyja’s Castle, Roger Dean 1987
Feelings of unity on psilocybin predicted better OCD outcomes
STUDY: Shnayder S et al, Front Psychiatry 2026
STUDY TYPE: Secondary analysis of a randomized controlled trial
FUNDING: Yale Center for Clinical Investigation, Heffter Foundation, Turnbull Family Foundation
Background
In a recent trial, one dose of psilocybin improved treatment-resistant OCD, but only around half the patients had a significant response. Mystical experiences predict response to psilocybin in some studies of depression and addiction, and this is the first to test it in OCD.
The Study
- 27 adults with OCD who had failed at least two treatments.
- All received psilocybin 0.25 mg/kg, in the blinded phase or after crossing over from placebo.
- The day after dosing, patients rated mystical experiences (MEQ-30) and challenging ones, such as fear, grief, and paranoia (CEQ).
- Outcome: the OCD scale (Y-BOCS) at 1 and 12 weeks.
Results
- Stronger mystical experiences predicted lower OCD at 1 week and 12 weeks, after adjusting for baseline severity, with a moderate to strong correlation (r = 0.5 to 0.6).
- Unity and sacredness showed the strongest link.
Limitations
- Small, secondary analysis.
- Patients rated their experience afterward, and correlation can’t show cause.
Practice Implications
- Psilocybin is not available in practice, but mystical experiences are.
- Ask your patients what brings a sense of awe, inspiration, or spirituality. It may be religious practice, music, communal experiences, or nature. We all need some of that.
—Chris Aiken, MD
Director, Psych Partners
Editor in Chief, Carlat Psychiatry Report
