Confronting mortality: A meta-analysis and systematic review of psychedelic experiences and death anxiety

A meta-analysis and systematic review found that psychedelic substances are associated with moderate-to-large reductions in death anxiety, with a significant overall effect size (Cohen's d = 0.70). Stronger effects were observed in clinically controlled settings than in the general population, and mystical experiences were positively linked to these reductions. The qualitative review identified themes of ego dissolution, emotional catharsis, and living in the present moment. The findings suggest psychedelic-assisted interventions may be effective for reducing death anxiety, especially in end-of-life care, though limitations include a small number of studies, potential publication bias, and high heterogeneity in outcome measurement.

Study at a glance

Abstract

This meta-analysis and systematic review examined the effects of psychedelic substances on death anxiety, specifically evaluating whether psychedelic experiences are associated with statistically significant reductions in death anxiety. A systematic search identified 8 studies suitable for meta-analysis and 10 additional studies for systematic review. Using a random-effects model, the meta-analysis revealed a significant overall effect (Cohen’s d = 0.70; 95% confidence interval [0.42, 0.97]), indicating a moderate-to-large reduction in death anxiety following psychedelic administration. Subgroup analyses showed stronger effects in clinically controlled settings compared to the general population. A mixed-effects meta-regression also indicated that particularly mystical experiences were positively associated with reductions in death anxiety ( B = 4.90, p = 0.050). Moderator effects by substance type were not significant. The qualitative review reaffirmed these results and identified themes of ego dissolution, emotional catharsis, and living in the present moment. Psychedelic-assisted interventions may be effective for reducing death anxiety, particularly in end-of-life care. However, limitations include a small number of studies, potential publication bias, and high heterogeneity in outcome measurement. Future research should employ more methodologically rigorous trials in order to clarify the mechanisms of psychedelic-assisted approaches to death anxiety.