Reduced death anxiety and obsessive beliefs as mediators of the therapeutic effects of psychedelics on obsessive compulsive disorder symptomology

ABSTRACT

Objective

Emerging research suggests that the use of serotonergic psychedelics can be associated with reductions in obsessions and compulsions. However, little research to date has attempted to understand why this may be the case. The present study aimed to extend existing research by examining reduced death anxiety and obsessive beliefs as potential mechanisms underpinning the relationship between acute psychedelic effects and reductions in obsessions and compulsions.

Methods

Participants (N = 312) who had reported having a significant psychedelic experience completed a retrospective survey that measured aspects of their experience as well as changes in death anxiety, obsessive beliefs, and obsessions and compulsions.

Results

Acute subjective effects (i.e., mystical experiences; psychological insight) significantly predicted self-reported reductions in (a) obsessive beliefs, (b) death anxiety, and (c) obsessions and compulsions following a psychedelic experience. Mediation analyses evidenced significant indirect effects of mystical experiences, but not psychological insights, on obsessions and compulsions through reduced death anxiety and obsessive beliefs.

Conclusion

These findings highlight the links between death anxiety, obsessive beliefs and obsessive-compulsive disorder symptomology, suggesting that reductions in obsessions and compulsions as a result of psychedelic use might, in part, be due to persisting effects of acute psychedelic experiences on these variables.

KEY POINTS

What is already known about this topic:

(1) Preliminary evidence suggests that psychedelic experiences may be able to reduce symptoms of obsessive-compulsive disorder (OCD).

(2) Psychedelics can change beliefs about the self and attitudes towards death and dying.

(3) Obsessive beliefs and death anxiety have been previously linked with OCD symptomology.

What this topic adds:

(1) Psychedelics may reduce OCD symptomology, obsessive beliefs and death anxiety in some people following a personally meaningful psychedelic experience.

(2) Reductions in obsessive beliefs and death anxiety may contribute to reductions in OCD symptomology following meaningful psychedelic experiences.

(3) The strength of subjective effects (mystical experience; psychological insight) is related to self-reported reductions in OCD symptomology.

KEYWORDS:

• Psychedelics
• obsessive compulsive disorder
• OCD
• death anxiety
• obsessive beliefs

Disclosure statement

No potential conflict of interest was reported by the author(s).

Supplementary material

Supplemental data for this article can be accessed at https://doi.org/10.1080/13284207.2022.2086793.

Data availability statement

The data are available at https://doi.org/10.1080/13284207.2022.2086793

Open Scholarship

This article has earned the Center for Open Science badge for Open Data. The data are openly accessible at https://osf.io/j3hga/?view_only=d676f0cba3634f86bc45ccb215b95bd3

Notes

1. After the data collection and analysis of this study were complete, the PIQ was recently revised to remove five items that were loading on both subscales. In the present study, we did not look at each subscale separately and all items had acceptable item-total score correlations (>.5). Therefore, we have reported the analyses including these five items.