Commentary and perspectiveIncidence and correlates of near-death experiences in a cardiac care unit
Introduction
Unusual experiences at the approach of death, which have come to be called near-death experiences in recent decades, have been reported anecdotally for centuries and described in medical journals since the 19th century [1]. These experiences, which often include subjective impressions of being outside the physical body and of seeing deceased relatives, are of importance to mental health professionals because they may be followed by pervasive changes in attitudes and behavior. Cassem and Hackett [2] a quarter century ago wrote that the incidence of near-death experiences was unknown, but estimated it at about 2% of survivors of cardiac arrest. Since that time, studies using objective measures among unbiased samples of patients coming close to death suggest an incidence of between 9% and 18% [1]. In the past year, a Dutch study of 344 consecutively admitted cardiac patients reported near-death experiences in 12% [3], a British study of 63 survivors of cardiac arrest reported near-death experiences in 11% [4], and an American study of 30 survivors of cardiac arrest reported near-death experiences in 23% [5].
This study investigated the incidence and correlates of near-death experiences among a large cohort of patients who came close to death from heart disease and were admitted to the cardiology service of the University of Virginia Health System. It was hypothesized that the incidence of near-death experience would be higher among patients with cardiac arrest than with those having other cardiac diagnoses.
Section snippets
Methods
Prospective subjects were all patients admitted to the cardiac intensive care unit (CCU) or the cardiology step-down unit of the University of Virginia Hospital who were not too ill, psychotic, or cognitively impaired to be interviewed. Patients were approached as soon after admission as their condition had stabilized, by study personnel who explained the project and invited them to participate.
Eligible patients who signed informed consent agreements to participate in the study were given a
Results
The mean age of the 1595 patients interviewed was 63 years ± 13; 970 patients (61%) were male. A total of 459 patients (29%) were employed, and 353 (22%) lived alone.
Of the 1595 patients, 675 (42%) were admitted to the cardiac intensive care unit (CCU); the rest were admitted directly to a step-down cardiac unit. Screening interviews were conducted in the CCU for 246 patients (15%) and on the step-down unit for the remaining patients. Screening interviews were conducted 3.8 ± 3.9 days after
Discussion
The findings of this study, the largest survey of near-death experiences among cardiac patients, confirm and extend findings of the three comparable but smaller studies published within the past year. A Dutch study [3] reported that 12% of cardiac patients described near-death experiences, and found no influence of unconsciousness, duration of arrest, or medication, although experiences were significantly associated with younger age. The latter finding was replicated in the present study. A
Acknowledgements
This study was supported by a research grant from the Institut für Grenzgebiete der Psychologie und Psychohygiene, Freiburg i. Br., Germany. I am indebted to Ian Stevenson, M.D., for his help in designing this research; and to Christina Fritz, R.N., Tiffany Pankow, M.D., and Jim B. Tucker, M.D., for their invaluable assistance in conducting patient interviews and evaluating medical records.
References (33)
- et al.
Near-death experience in survivors of cardiac arresta prospective study in the Netherlands
Lancet
(2001) - et al.
A qualitative and quantitative study of the incidence, features and aetiology of near death experiences in cardiac arrest survivors
Resuscitation
(2001) - et al.
“Mini-Mental State:”a practical method for grading the cognitive state of patients for the clinician
J Psychiatr Res
(1975) - et al.
A brief self-administered questionnaire to determine functional capacity (The Duke Activity Status Index)
Am J Cardiol
(1989) - et al.
Treatment of myocardial infarction in a coronary care unita two year experience with 250 patients
Am J Cardiol
(1967) - et al.
Features of “near-death experience” in relation to whether or not patients were near death
Lancet
(1990) - et al.
Near death experiences in cardiac arrestvisions of a dying brain or visions of a new science of consciousness?
Resuscitation
(2002) The biocultural paradigmThe neural connection between science and mysticism
Exper Geront
(1998)The incidence of near-death experiences
Med Psychiatry
(1998)- et al.
The setting of intensive care
A prospective analysis of near-death experiences in cardiac arrest patients
J Near-Death Studies
The Near-Death Experience Scaleconstruction, reliability, and validity
J Nerv Ment Dis
Near-death encounters with and without near-death experiencescomparative NDE Scale profiles
J Near-Death Studies
Social networks and coronary artery diseasea comparison of the structure and function of social relations as predictors of disease
Psychom Med
Quality of life following intensive care
J Gen Intern Med
Acceptance and healing
J Relig Health
Cited by (130)
Bridging the gap: (a)typical psychedelic and near-death experience insights
2024, Current Opinion in Behavioral SciencesReflections on extraordinary knowing: Insight into the nature of the mind
2023, ExploreCitation Excerpt :And these experiences have also been likened to ketamine-induced experiences that result when the NMDA receptor is blocked (Ketamines are synthetic drugs used in anesthesia)3. To counter these arguments17, another NDE researcher, Dr. Bruce Greyson, a professor of psychiatry and neurobehavioral sciences at the University of Virginia who has also performed carefully designed prospective studies to examine the characteristics of the NDE, stated that the surprising incidence of both “lucid awareness” and “logical thought” at a time when the brain does not have sufficient oxygen to function raises “perplexing questions” in regard to the current scientific view of the relation between consciousness and the functioning of the brain. In short, it challenges “the concept that consciousness” is located “exclusively in the brain”3,17.
The Near-Death Experience Content (NDE-C) scale: Development and psychometric validation
2020, Consciousness and CognitionCitation Excerpt :Other frequently reported features are seeing a bright light, seeing a tunnel, encountering people or spirits, a sense of harmony/unity, and experiencing heightened senses (i.e., more vivid sensations than usual) (Charland-Verville et al., 2014; Greyson, 2003; Parnia, Waller, Yeates, & Fenwick, 2001; Schwaninger et al., 2002; Zhi-ying & Jian-xun, 1992). The precognitive visions (i.e., seeing events occurring in the future), extrasensory perception (i.e., acquisition of information without the use of the five physical senses), and life review are also prototypical NDE features but are less often encountered (Charland-Verville et al., 2014; Greyson, 2003; Zhi-ying & Jian-xun, 1992). Interestingly, all these features are subsequently recalled with vividness and details, even decades later (Cassol et al., 2020; Cassol, D’Argembeau, & Charland-Verville, 2019; Martial, Charland-Verville, et al., 2017; Moore & Greyson, 2017; Thonnard et al., 2013).