Psychological interventions for death anxiety and distress: Systematic review and meta-analysis

Mortality-oriented psychological interventions target death anxiety and related distress, but their effects vary across studies and population contexts. I systematically reviewed 45 controlled studies published from January 2019 through May 2026 and meta-analyzed eligible immediate post-intervention outcomes. The primary dependency-aware multilevel random-effects model included 31 effects from 30 study clusters (2,149 participants) and favored intervention. Heterogeneity was substantial, and the prediction interval included null and unfavorable effects. The average effect therefore warrants cautious clinical interpretation. Sensitivity analyses preserved the positive pooled direction. Risk-of-bias concerns were common. Exploratory moderator analyses did not identify reliable differences by population context, study design, or outcome construct; an intervention-approach omnibus test was nominally significant but too sparse for comparative ranking. Mortality-oriented interventions appear beneficial on average, but current evidence does not establish uniform benefit, a preferred approach, or reliable treatment-matching rules. Future trials should prespecify mortality-specific outcomes, recruit adequate samples, and extend follow-up across contexts.