The effects of psychedelic-assisted therapy on illness and death anxiety: A systematic review and meta-analysis

Illness anxiety (IA) is characterized by worry or fear in response to living with a chronic illness or a preoccupation with having or acquiring a serious disease in conjunction with absent to mild somatic symptomatology. Death anxiety (DA) may underpin IA and is more common in individuals with life-threatening illness. Treatments for DA and IA, such as psychotherapy and antidepressant drugs, are limited. Serotonergic psychedelic assisted therapy (PT) is a promising treatment alternative as it acts more rapidly than antidepressants and has been shown to decrease anxiety associated with life-threatening illness. This meta-analysis aims to systematically analyze PTs efficacy for DA and IA. A literature search of English language publications was conducted through the Ovid database using Medline®, PsychINFO®, and Embase® from date of inception to February 2024. Validated measures were available to assess DA. However, the State Trait Anxiety Inventory (STAI) was the only measure consistently available across studies to assess anxiety. Given the STAI State scale assesses transient anxiety, which may occur as a result of stressful circumstances, we employed it as a measure of anxiety in the context of a life-threatening illness. Five randomized controlled trials were included. The results showed that PT was associated with sustained decreases in DA and State and Trait anxiety in the context of having a life-threatening illness. This meta-analysis highlights PT as a treatment for DA and anxiety in the context of a life-threatening illness. Future studies should attempt to replicate these findings in other contexts, such as IA Disorder and somatic symptom disorders.