A scoping review of the effects of serotonergic psychedelics on attitudes towards death.

A systematic review of 31 studies found largely consistent evidence that psychedelic experiences can change attitudes towards death and reduce death anxiety in both clinical and non-clinical populations. However, significant gaps remain in understanding the role of set and setting, differences across psychedelic substances, underlying psychological mechanisms, the potential for worsening death anxiety, and the influence of expectancy and placebo effects. Less is known about the reliability and strength of these effects, the conditions under which they emerge, and which aspects of the experience best predict them.

Study at a glance

Abstract

Emerging evidence suggests that psychedelic experiences have the potential to change attitudes towards death and reduce death anxiety. Improved attitudes towards death, specifically reduced death anxiety, are of psychological significance for clinical and non-clinical populations alike. Despite this emerging evidence, little is known about the phenomenology of this potential outcome. To provide a systematic overview of studies reporting effects of psychedelics on attitudes towards death and death anxiety, thereby identifying any gaps in the current literature and informing suggestions for future research. MEDLINE, Scopus, PsycINFO, and Web of Science were systematically searched for empirical studies that measured attitudes towards death and death anxiety as an outcomes of classical psychedelic use. There were no limits on the date or design of the study. The thirty-one studies included in the review all reported changes in attitudes towards death and/or changes in death anxiety. Despite finding evidence for psychedelics improving death anxiety, we found significant gaps in the existing research relating to the role of set and setting, potential differences across substances, the underlying psychological mechanisms involved, the potential for worsening of death anxiety, and the role of expectancy and placebo effects. There is largely consistent evidence that psychedelics can often change attitudes towards death and reduce death anxiety. However, less is known about the reliability and strength of these effects, the conditions under which they are likely to emerge and aspects of the experience that best predict them.