Effects of religiosity and spirituality on the treatment response in patients with depressive disorders

Meditation-Based Lifestyle Modification in Mild-to-Moderate Depression: Outcomes and Moderation Effects of Spirituality

Objective: Understanding the relevance of religion or spirituality (R/S) in the treatment of mental disorders is central to clinical and academic psychiatry. In this secondary analysis, associations of R/S with depression were investigated with respect to a new second-generation mindfulness-based intervention, the Meditation-Based Lifestyle Modification (MBLM) program. Methods: Different aspects of spirituality, spiritual coping, and spiritual engagement were assessed in 81 patients with a diagnosis of mild-to-moderate depression. Treatment effects on R/S postscores and predictor and moderation effects of depression severity and stress change-scores were evaluated at 8 weeks (MBLM vs. CONTROL [drug continuation therapy] vs. TAU [inpatient treatment as usual]) and 6 months (TAU+MBLM vs. TAU). Results: At both time points, significant differences between MBLM versus TAU and CONTROL were found in a range of spiritual outcomes, most of them with a medium-to-large effect size and in favor of MBLM. Baseline interest in spirituality (p = 0.001) and baseline spiritual mind-body practice (p = 0.017) were identified as independent predictors of change in depression severity at 6 months. Moreover, moderation analyses found that patients reporting often/regular spiritual mind-body practice at 6 months did not benefit differently from TAU+MBLM versus TAU (p = 0.437) regarding their change in depression severity and stress, while those reporting no/seldom spiritual mind-body practice at 6 months benefited significantly worse from TAU than from TAU+MBLM (p = 0.002). Conclusions: Participation in the MBLM program resulted in significantly greater increases in spirituality in depressed patients than standard therapy. Interest in spirituality and engagement in spiritual mind-body practices at baseline were positive predictors of clinical outcome in both groups. Patients of any group who regularly performed spiritual mind-body practices benefited equally in terms of antidepressant outcomes, underlining the benefit of these practices within a general therapeutic framework. ClinicalTrials.gov Identifier: NCT03652220.

Use of Spirituality in the Treatment of Depression: Systematic Literature Review

Spirituality has been gaining recognition as a potential treatment modality. Our paper aimed to provide a systematic overview of existing research examining the use of spirituality as a treatment method for depression. All articles published between 2000 and 2018 that scientifically evaluated therapeutic interventions with elements of spirituality were included in the review. Ten studies met the inclusion criteria. Their analysis showed that there were elements of spirituality-based treatments that were repeatedly mentioned, including gratitude, forgiveness, self-acceptance, and compassion. Most often, spirituality was used together with psychotherapy. The review also noted the emergence of digital interventions.

Is the presence of a psychiatric patient at home associated with higher addictions (alcohol, cigarette, and waterpipe dependence) in caregivers? The role of work fatigue, mental illness, spirituality, and religiosity

PURPOSE

To assess if living with a psychiatric patient, depression, anxiety, stress, fatigue, insomnia, spirituality, and religiosity would be associated with more problematic alcohol use, cigarette, and waterpipe dependence in Lebanese caregivers.

METHODS

A case-control study was performed in Lebanon that recruited 587 caregivers (July-September 2019).

RESULTS

Higher religiosity was associated with lower problematic alcohol use. Having low versus no income was significantly associated with more cigarette dependence. Being Christian and high anxiety were significantly associated with more waterpipe dependence, whereas higher insomnia was significantly associated with lower waterpipe dependence. PRACTICAL IMPLICATIONS: Family caregivers go through a lot of stress and burden and need help coping with it in a healthy way for better outcomes for them and the care recipient.

Examining Cultural, Ethnic, and Religious Differences with the Brief Multidimensional Measure of Religiousness and Spirituality in the U.S. and India

The Brief Multidimensional Measure of Religiousness/Spirituality (BMMRS) is regularly used to measure spirituality and religiosity in U.S. Christian populations, although it has not been used for making comparisons with non-Western groups. This study compared BMMRS results for 109 individuals (60 in the U.S. and 49 in India) with traumatic brain injury (TBI) from different cultures (U.S., India), ethnic groups (African American, Caucasian, South Asian), and religions (Christian, Hindu, Muslim). In general, the results indicated that U.S. African Americans and Christians reported being the most spiritual, South Asians and Hindus the least. Groups differed significantly in self-reported spiritual experiences, but less in frequency of religious activities. Results suggest using caution when applying Western-based measures of religion and spirituality in non-Western, non-Christian populations.

The Effect of Spirituality on the Subjective Recovery of Psychiatric Patients

Spiritual well-being is among the factors that affect subjective recovery. This study aimed to explore the relationship between subjective recovery and spiritual well-being among psychiatric patients and to identify the factors that affected their subjective recovery. A descriptive, cross-sectional study was conducted with 96 patients admitted to the psychiatry clinic of a hospital. It was found that the patients had high subjective recovery assessment levels and medium levels of spiritual well-being. There was a positive association between the patients' subjective recovery assessments and their spiritual well-being, and spiritual well-being was a significant predictor of the subjective recovery level. It is recommended that mental health professionals focus on serving patients through a holistic healthcare approach and enhancing patients' subjective recovery levels through applications that will strengthen the spiritual dimension.

Religiosity and Mental Health: A Contribution to Understanding the Heterogeneity of Research Findings

Most studies report positive associations between religiosity and spirituality and aspects of mental health, while a small proportion report mixed or fully negative associations. The aim of this study was to assess the associations of religiosity measured more specifically, with mental health in a secular environment, using a nationally representative sample of Czech adults (n = 1795). We measured religious affiliation, conversion experience, non-religious attitudes and the stability of these attitudes, mental health problems, and anxiety levels. Compared to stable non-religious respondents, unstable non-religious and converted respondents who perceived God as distant were more likely to experience anxiety in close relationships, and had higher risks of worse mental health. Our findings support the idea that the heterogeneity of findings in associations between religiosity/spirituality and mental health could be due to measurement problems and variation in the degree of secularity. A shift towards religiosity could be expected to be seen in a substantial part of non-religious respondents in problematic times.

Religiosidade/Espiritualidade na Prática Clínica: Círculo Vicioso entre Demanda e Ausência de Treinamento

Resumo Diante do crescente número de pesquisas sobre Religiosidade e Espiritualidade (R/E), este artigo objetiva analisar a percepção de profissionais da saúde em relação a esses temas. Foram realizadas entrevistas semiestruturadas, coletadas nos locais de trabalho de seis profissionais liberais, utilizando a Análise de Conteúdo de Bardin, na abordagem qualitativa. Seis categorias emergiram das análises qualitativas: 1. R/E: fusão de conceitos e conexão com o transcendente; 2. Espiritualidade como facilitadora; 3. Demanda aparece informalmente; 4. Falta de treinamento; 5. Na prática é diferente; 6. A temática nos currículos acadêmicos. Os resultados indicaram que os profissionais observam a relevância da temática, embora ela apareça apenas de forma implícita. Como um círculo vicioso, a ausência de treinamento adequado pode levar à falta de inserção do tema na formação acadêmica. Futuros profissionais precisam receber treinamento para saber como acolher a religiosidade e a espiritualidade de pacientes/clientes de forma ética, visando a promoção de saúde.

The Role of Religion in Buffering the Impact of Stressful Life Events on Depressive Symptoms in Patients with Depressive Episodes or Adjustment Disorder

Most studies into the role of religiousness in relation to depression severity have mainly found an inverse relationship between greater religiousness and lower levels of depressive symptoms. There is reason to assume that religiousness has a buffering effect on the relationship between stressful life events and depressive symptoms. The aim of this study was to investigate the role of religiousness in moderating the impact of stressors on depressive symptoms. n = 348 patients with either a depressive episode or adjustment disorder were assessed at referral to the liaison psychiatry services in three Dublin hospitals and n = 132 patients were followed up six months later. We assessed depressive symptoms, life events, social support, and religiosity, and used hierarchical and multiple linear regression for data analysis. The interaction of organised religious activity and the amount of life events was significant (β = −0.19, p = 0.001) in the cross-sectional prediction of depressive symptoms while non-organised religious activity (β = −0.23, p = 0.001) and intrinsic religiousness (β = −0.15, p = 0.033) interacted significantly with life events in the longitudinal analysis. This study demonstrated that various dimensions of religiousness buffered the impact of life events on outcome.

Religiosity and Meditation Practice: Exploring Their Explanatory Power on Psychological Adjustment

There has been increased interest in the relationships between religiosity, meditation practice and well-being, but there is lack of understanding as to how specific religious components and distinct meditation practices could influence different positive and negative psychological adjustment outcomes. The aim of this study was to assess the explanatory power of religious beliefs and the practice of prayer, focused attention (FA), open monitoring (OM), and compassion meditation (CM) on psychological adjustment, taking into consideration a number of practice-related variables such as session length, frequency of practice and lifetime practice. Psychological adjustment was assessed by means of happiness, positive affect, depression, negative affect, and emotional overproduction. A cross-sectional design was used, with a final sample comprising 210 Spanish participants who completed an online assessment protocol. Hierarchical regressions were performed, including age, sex and psychotropic medication use in the first step as possible confounders, with the addition of religious beliefs and the practice of prayer, FA, OM, and CM in the second step. FA session length was related to all psychological adjustment outcomes: happiness (ΔR 2 = 0.09, p = 0.002; β = 0.25, p = 0.001), positive affect (ΔR 2 = 0.09, p = 0.002; β = 0.18, p = 0.014), depression (ΔR2 = 0.07, p = 0.004; β = -0.27, p < 0.001), negative affect (ΔR 2 = 0.08, p = 0.007; β = -0.27, p < 0.001) and emotional overproduction (ΔR 2 = 0.07, p = 0.013; β = -0.23, p = 0.001). CM session length was related to positive affect (β = 0.18, p = 0.011). CM practice frequency was associated with happiness (ΔR 2 = 0.06, p = 0.038; β = 0.16, p = 0.041). Lifetime practice of FA was related to happiness (ΔR 2 = 0.08, p = 0.007; β = 0.21, p = 0.030) and OM to emotional overproduction (ΔR 2 = 0.08, p = 0.037; β = -0.19, p = 0.047). Religious beliefs and prayer seemed to be less relevant than meditation practices such as FA, OM, and CM in explaining psychological adjustment. The distinct meditation practices might be differentially related to distinct psychological adjustment outcomes through different practice-related variables. However, research into other forms of institutional religiosity integrating social aspects of religion is required.

Understanding the Association Between Spirituality, Religiosity, and Feelings of Happiness and Sadness Among HIV-Positive Indian Adults: Examining Stress-Related Growth as a Mediator

This study examined the role of stress-related growth as a mediator of the associations between spirituality, religiosity, and feelings of happiness and sadness in a sample of 178 HIV-positive Indian adults. Results indicated that spirituality, but not religiosity, was associated with feelings of happiness and sadness. Subsequent mediation analyses indicated that stress-related growth fully mediated the relationships involving spirituality and feelings of happiness and sadness. Overall, our findings point to the importance of facilitating greater spiritual development among HIV-positive Indians, as well as promoting strategies that help them develop and apply stress-related growth coping methods in their lives.

Validation of Brief Multidimensional Spirituality/Religiousness Inventory (BMMRS) in Italian Adult Participants and in Participants with Medical Diseases

This study aimed at assessing the reliability and construct validity of Brief Multidimensional Measure of Religiousness/Spirituality (BMMRS) on Italian sample.

SAMPLE

353 Italian participants: 58.9% affected by different diseases and 41.1% healthy subjects. The results of descriptive statistics of internal consistency reliabilities (Chronbach's coefficient) of the BMMRS revealed a remarkable consistency and reliability of different scales DSE, SpC, SC, CSC, VB, SPY-WELL and a good Inter-Class Correlations ≥70 maintaining a good stability of the measures over the time. BMMRS is a useful inventory for the evaluation of the principal spiritual dimensions.

Do spirituality and religiousness differ with regard to personality and recovery from depression? A follow-up study

BACKGROUND

The studies show that both spirituality and religiousness are protective for mental health. Personality is related with course and outcome of depression, as well as spirituality and religiousness, and their relations toward to recovery from depression are underresearched. This study followed influence of spirituality and religiousness on course and outcome of depression in patients with depressive episode, controlled for personality dimensions.

METHODS

The patients were assessed with self-report measures of depression (Beck Depression Inventory), spirituality (WHO-Quality of Life-Spiritual, Religious, Personal Beliefs), religiousness (Duke University Religion Index) and personality (Temperament and Character Inventory). Ninety nine patients finished a year long follow up.

RESULTS

Higher spirituality influenced recovery of depression in patients with depressive episode, but religiousness did not show to be significant predictor of recovery for depression. Dimension harm avoidance was significant predictor of improvement of depression in all points of measurement.

LIMITATIONS

Some limitations of this research are small sample size, usage of the self-report measures of depression in follow-up period, and the predominantly Catholic affiliation of the participants that can impact the generalizability of our data to other denominations.

CONCLUSION

Spirituality and dimension harm avoidance are significant predictors of recovery from depression during a year long follow up.

Types of childhood trauma and spirituality in adult patients with depressive disorders

OBJECTIVE

The aim of this study was to investigate the differences in spirituality among adult patients with depressive disorders, who had suffered various types of abuse or neglect in childhood.

METHODS

A total of 305 outpatients diagnosed with depressive disorders completed questionnaires on socio-demographic variables, childhood trauma history, and spirituality. We used the Childhood Trauma Questionnaire-Short Form (CTQ-SF) to measure five different types of childhood trauma (emotional abuse, physical abuse, sexual abuse, emotional neglect, and physical neglect) and the Functional Assessment of Chronic Illness Therapy-Spiritual Well-being Scale (FACIT-Sp-12) to assess spirituality.

RESULTS

Depressive symptoms and total CTQ-SF scores showed a negative correlation with spirituality. In the regression model, being older and belonging to a religion significantly predicted greater spirituality. Depressive symptoms significantly predicted lower spirituality. From among the five types of childhood trauma assessed by the CTQ-SF, only emotional neglect significantly predicted lower spirituality.

CONCLUSION

A history of childhood emotional neglect was significantly related to lower spirituality, especially in the case of the Meaning aspect of spirituality. This finding suggests the potential harmful influence of childhood emotional neglect on the development of spirituality in psychiatric patients. Investigating different aspects of childhood trauma might be important in order to develop a more comprehensive psychiatric intervention that aids in the development of spirituality.