A systematic review of income and education reporting in psychedelic clinical trials

Abstract

Socioeconomic status (SES) substantially influences mental health outcomes and treatment access, yet its reporting in psychedelic-assisted therapy trials remains underexplored. Here we systematically reviewed 98 articles (49 primary trials and 49 secondary analyses) published between 2006 and 2024 examining classic psychedelics and MDMA for mental health conditions. Only 12% of primary trials reported participant income data, and 31% reported educational attainment. In US-based trials, participants showed markedly higher SES than the general population: 93% had some college education (versus 62% nationally), and median incomes in major trials substantially exceeded the national median for all workers. Non-US trials showed variable patterns. This widespread underreporting of SES data and evidence of socioeconomic disparities, particularly in US trials, highlights an urgent need for standardized SES reporting and targeted strategies to improve socioeconomic diversity in psychedelic-assisted therapy research, ensuring broader generalizability and access to these emerging treatments. This systematic review analyzes how income and educational attainment are reported in psychedelic-assisted therapy trials. It reveals that only a minority of trials report this information and, when reported, the data have considerable variation in format and ambiguity in details. It also reveals disparities, with participants having higher income and being highly educated overrepresented in trials.