Exploring the role of psychedelic-assisted therapy in enhancing spirituality and mystical experiences in patients with life-threatening illnesses: A systematic review

Introduction: Psychedelic-Assisted Therapy (PAT) is gaining traction as a novel approach to addressing the psychological and existential distress experienced by patients. Objectives: This systematic review aimed to investigate the impact of PAT on spirituality, mystical experiences, and spiritual well-being (SpWB) in patients with life-threatening, incurable, or terminal illnesses. Methods: A comprehensive search was conducted across PubMed, Web of Science, and Cochrane databases to identify relevant studies published between 2013 and 2023. The study population comprised patients diagnosed with life-threatening illnesses. Various forms of PAT, encompassing both typical and atypical psychedelic substances, were considered as interventions, with no specific comparators outlined. The primary outcomes of interest included spirituality, mystical experience, and SpWB. Risk of bias assessment was performed using Cochrane's tools. Results: Six studies with a high risk of bias were included in the review, all conducted in the United States of America, involving 140 patients, the majority of whom had cancer (99 %). PAT, especially with psilocybin, demonstrated significant enhancements in spirituality, mystical experiences, and SpWB. Notably, SpWB showed improvements in all studies which assessed this spiritual outcome following PAT. Mystical experiences were correlated with improvements in spirituality in one study. Conclusions: This systematic review underscores the potential of PAT to address unmet spiritual needs and enhance SpWB in patients with life-threatening illnesses. However, further research is needed to elucidate the mechanisms underlying these therapeutic effects. Rigorous evaluation of healthcare practitioners' role in guiding patients through PAT protocols is essential to ensure safe and effective implementation in palliative care settings.