Psychiatric Outpatients and Near Death Experiences

Can near-death experiences act as a buffer against psychological distress caused by close encounters with death?

People who have had near-death experiences (NDEs) may experience high levels of psychological distress and disruptions in their daily lives, leading them to seek psychiatric services more often. Some individuals who have come close to death have reported profound NDEs, including feeling like they are outside of their body, encountering deceased or religious figures, and transcending ego and spatiotemporal boundaries. Contrary to expectations, NDEs can provide individuals with a heightened sense of purpose, confidence, and appreciation for life, as well as fewer feelings of fear and post-traumatic stress symptoms. In this study, Greyson found that among patients who had been close to death, those individuals who reported having NDEs had less psychological distress than patients who did not have NDEs after brushes with death. 

What Problem Does This Study Address?

Coming close to death can have profound and lasting effects on an individual’s psychological health, potentially leading to significant distress, impaired daily functioning, and an increased reliance on psychiatric care. Not all encounters with death are the same. Encounters with the brink of death can sometimes involve intense near-death phenomena, where individuals report sensations of departing their physical bodies, seeing visions of passed away loved ones and spiritual entities, and experiencing a loss of self and the dissolution of time and space. Individuals who have undergone NDEs often report an amplified sense of purpose in and appreciation of life. They also tend to exhibit more confidence and self-esteem, coupled with diminished fear of death and reduced suicidal thoughts and symptoms associated with post-traumatic stress. Considering these positive effects of NDEs, the author’s objective in this study was to evaluate psychological distress in patients who have encountered such experiences. 

How Was This Study Conducted?

This cross-sectional study included patients attending the psychiatric outpatient clinic at the University of Connecticut over a period of one year. A total of 832 patients completed a computerized version of the revised 90-item Symptom Checklist (SCL-90-R) upon their initial visit. The computerized screening required approximately 15 minutes to complete. The SCL-90-R is a widely recognized tool for assessing psychological symptoms and functioning. Respondents evaluated the severity of symptoms using a 5-point scale, ranging from 0 (not at all) to 4 (extremely). The questionnaire assesses 9 symptom dimensions: somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism. Additionally, the SCL-90-R provides three global indices of distress: the Global Severity Index (the total of all 90 items), the Positive Symptom Scale (the total number of items rated 1 or higher), and the Positive Symptom Distress Scale (the Global Severity Index divided by the Positive Symptom Scale). Higher scores signify more distress. 

Participants were also queried about NDEs. Those who confirmed coming close to death were then given the 16-item Near-Death Experience Scale (NDES) to determine if they had experienced a near-death event characterized by profound personal events such as intense feelings of peace and joy, paranormal experiences, or an out-of-body sensation. Participants who scored 7 or higher out of 32 were classified as a NDE group. 

What Did This Study Find?

Patients who had come close to death showed greater distress overall, but those with NDEs reported less distress than those without such experiences.

33% of patients who were initially screened reported having been close to death. 22% of those had NDEs (7% of the initial patient sample). Based on the SCL-90-R scores, patients who had faced life-threatening events reported higher levels of distress relative to those who had not encountered such incidents. However, within the group of patients who had come close to death, those who described having NDEs exhibited lower levels of distress compared to their counterparts who did not report such experiences.

What Are the Implications of the Study Findings?

The study’s findings contribute to a nuanced understanding of the psychological aftermath of near-death events, suggesting that while such encounters generally increase psychological distress, affirming prior knowledge of trauma’s impact on mental health, they also raise the possibility that NDE may exert a protective effect on psychological well-being. This protective effect could mitigate distress levels compared to those who have faced near death without the accompanying profound experiences. Clinically, these insights underline the importance of integrating patients’ near-death history into psychological assessments and treatment planning, recognizing the influence of NDEs on a patient’s current mental state and potential therapeutic needs. Furthermore, the study adds to the literature by framing NDEs as complex experiences that could potentially yield positive psychological benefits, challenging the notion that they are solely pathological stress responses.

Limitations

The study’s design introduces several limitations. It cannot establish causality due to its cross-sectional nature, and its findings are not necessarily representative, as the sample comes exclusively from a psychiatric clinic. Important variables, such as demographic and diagnostic details (e.g., psychiatric diagnosis), were not controlled for, possibly influencing the results. The study did not explore the potential for risk-taking behavior linked to psychopathology (individuals with a mental disorder may be more likely to engage in risk-taking behaviors and thus experience NDEs), nor did it detail the specifics of the near-death events, which could affect the experiences reported. There is also the issue of recall bias, given the reliance on participants’ memories. Crucially, the study did not compare distress levels between those who had not come close to death and those who had and had experienced an NDE, missing an opportunity to understand the full impact of NDEs on psychological well-being.

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