Intrinsic religiosity, resilience, quality of life, and suicide risk in depressed inpatients

Religious affiliation and oral health-related quality of life: a cross-sectional study based on a nationally representative survey in Germany

BACKGROUND

Studies have shown an association between a person's religiosity, and physical as well as psychological, health status. However, results differ between certain religious affiliations. While good oral health is important for our overall health and wellbeing, research on religious affiliation and oral health status, specifically oral health-related quality of life (OHRQoL), is lacking. Thus, our aim was to investigate the association between religious affiliation and OHRQoL.

METHODS

A nationally representative online survey (n = 3,075 individuals) was conducted in August/September 2021. The mean age was 44.5 years (SD: 14.8 years, 18 to 70 years) and 51.1% of the individuals were female. OHRQoL was measured using the Oral Health Impact Profile (OHIP-G5). Religious affiliation served as key explanatory variable. Several covariates were included in regression analyses.

RESULTS

Regressions revealed that compared to individuals with no religious affiliation, individuals belonging to Christianity had poorer OHRQoL (β = 0.31, p < 0.01), individuals belonging to Islam had poorer OHRQoL (β = 2.62, p < 0.01) and individuals belonging to another religious affiliation also had poorer OHRQoL (β = 1.89, p < 0.01).

CONCLUSION

Our study demonstrated an association between religious affiliation and OHRQoL. Individuals with specific religious affiliations should be addressed to avoid low OHRQoL.

Death Anxiety Among Pakistani HCWs: The Role of COVID-19 Vaccine Acceptance and Positive Religious Coping Strategy

Background: The mental health of healthcare workers (HCWs) has been significantly impacted by the COVID-19 pandemic. To address this, spirituality and religious coping mechanisms have been suggested as a way to maintain well-being and reduce anxiety levels. Additionally, vaccination has been shown to play an essential role in lowering anxiety levels, including death anxiety. However, there is a lack of evidence on how positive religious coping strategies and COVID-19 immunization affect death anxiety levels. To fill this gap, this study uses a Pakistani HCWs sample. Methods: This study collected cross-sectional data from 389 HCWs on socio-demographics, positive religious coping strategies, vaccine acceptance, and death anxiety. Hypothesis testing was done using Statistical Package for the Social Sciences (SPSS) and Partial Least Squares (PLS) by adopting the Structural Equation Modeling (SEM) technique. Results: The results showed that the positive religious coping strategy and acceptance of the COVID-19 vaccine reduced death anxiety among HCWs in Pakistan. HCWs practicing the positive religious coping strategy and vaccine acceptance had lower levels of death anxiety symptoms. Thus, the positive religious coping strategy has a direct effect on reducing death anxiety. Conclusion: In conclusion, COVID-19 immunization positively affects individual mental health by reducing death anxiety. Vaccines protect individuals from COVID-19 infection, providing a sense of security that reduces the chance of death anxiety among HCWs attending to COVID-19 patients.

Religiosity, Theism, Perceived Social Support, Resilience, and Well-Being of University Undergraduate Students in Singapore during the COVID-19 Pandemic

The COVID-19 pandemic infection control measures severely impacted mental well-being, allowing insight into possible protective parameters. With religion playing a role during challenging times, this study investigated theism and religiosity on the mental well-being of university students during the COVID19 pandemic and how social support and resilience can mediate this effect. One hundred eighty-five university students between 17 and 42 years old responded to online surveys on their theism, religious affiliations, religiosity, well-being, perceived support, and resilience. Pearson's correlations and single and sequential mediation analyses showed that theism did not significantly predict well-being (r = 0.049), but religiosity mediated the relationship (r = 0.432, effect size = 0.187). Sequential mediation analysis showed that resilience did not mediate the relationship between religiosity and well-being, but perceived social support significantly positively mediated religiosity and well-being with an effect size of 0.079. The findings reveal that factors, such as religiosity and social support could thus aid in the mental well-being of future challenging times such as the pandemic.

The development and validation of a new resilience inventory based on inner strength

There are a number of resilience scales with good psychometric properties. However, the various scales differ in their item content in accordance with the model of resilience the developer had in mind. Culture is one of the reasons for the difference. Thailand, one of the Buddhist cultures, has a different view on resilience compared with Western culture. This study aimed to develop and validate a resilience inventory created based on the inner strength concept using a confirmatory factor analysis (CFA) and Rasch measurement model. The resilience inventory (RI) was developed by creating new items representing inner strengths attributed to resilience. The inner strength was adopted to form the resilience construct, including perseverance, wisdom, patience, mindfulness, loving-kindness and equanimity. In addition, face and content validity were examined by experts in both mental health and Buddhism. The final RI comprised nine items with a 5-point Likert-type scale. The RI-9 was completed by 243 medical students who participated in the study, along with other measurements, i.e., Inner Strength-Based Inventory (iSBI), measuring the ten characteristics of perfection or inner strength, and the Core Symptom Index, measuring anxiety, depression and somatization symptoms. CFA, internal consistency and the Polytomous Rasch rating model were used to investigate the RI-9 construct validity. The mean age of the participants was 22.7 years (SD, 0.8); one-half were male (50%). The RI-9 construct demonstrated item hierarchy as follows: perseverance, patience (tolerance), mindfulness and equanimity, wisdom and loving-kindness. CFA showed that the unidimensional model fitted the data well. Rasch analysis showed no misfitting items and local dependence. The reliability of the person and item was good, and no disordered threshold was observed. Two items were found to exhibit differential item functioning due to sex. RI-9 scores were significantly related to all ten strengths from the iSBI, whereas they were negatively related to depression, anxiety, somatization and interpersonal difficulties. The RI-9 demonstrated validity and reliability. It constitutes a promising tool for outcome assessment in nonclinical populations. Further investigation on external validity as well as psychometric validation in other different cultures, should be encouraged.

"Faith Is Not Enough?" Ego-Resiliency and Religiosity as Coping Resources with Pandemic Stress-Mediation Study

Based on the concepts of Pargament's adaptational functions of religiosity, Huber's centrality of religiosity, and Block's conceptualisation of ego-resiliency as psychosocial resources, a nonexperimental, moderated mediation project was designed for a group of 175 women and 57 men who voluntarily participated in an online study to determine whether and to what extent religiosity mediated or moderated the relationship between ego-resiliency and the severity of PTSD and depression during the COVID-19 epidemic. The analyses carried out showed that the studied variables, ego-resiliency and centrality of religiosity, were predictors of the intensity of some psychopathological reactions caused by the COVID-19 pandemic but were not connected via a mediation relationship. Therefore, one question remains open: what is the role of ego-resiliency and the nature of the stated immunogenic effect of the centrality of religiosity in dealing with the critical threat to mental health that is the COVID-19 pandemic?

Association between Experiences in Life and Quality of Life among Lebanese University Students in a Collapsing Country: The Moderating Role of Religious Coping and Positivity

(1) Background: No goal can be more important than optimal individual quality of life (QOL); life experiences, religious coping, and positivity play pivotal roles in achieving this goal. The aim is to assess the correlation between positive/negative experiences in life and QOL, taking into consideration the moderating role of positivity and positive/negative religious coping among a sample of Lebanese university students. (2) Methods: This cross-sectional study was carried out between November and December 2021, and enrolled 333 university students, aged between 18 and 30 years, from various areas in Lebanon’s governorates. The 12-item Short Form Health Survey, the brief religious coping methods scale, and the Scale of Positive and Negative Experience were included in the questionnaire. Forward linear regressions were conducted to check for correlates associated with physical and mental QOL scores. All variables that showed a correlation or effect size > |0.24| were entered in the multivariable and moderation models as independent ones. Significance was set at a p < 0.05. (3) Results: A linear regression, taking the physical QOL score as the dependent variable, showed that living in rural areas compared to urban and more positivity were significantly associated with a better physical QOL, whereas more negative religious coping was significantly associated with a lower physical QOL. More positivity and more positive religious coping were significantly associated with a better mental QOL. The moderation analysis showed that in people with high positive experiences, those with higher negative religious coping had lower mental QOL. (4) Conclusions: In a society as deeply religious as Lebanon, it is crucial to organize awareness programs to help in discriminating between religious coping mechanisms. Across order to stop further detrimental effects on QOL, our findings may serve as a solid foundation for future studies of QOL with additional variables, in other groups and nations.

An Analysis of the Relationship Between Religiosity and Psychological Well-Being in Chilean Older People Using Structural Equation Modeling

Using a representative sample, we explored the relationship of organizational (ORA), non-organizational (NORA), and intrinsic religiosity (IR) with depressive and anxious symptomatology and loneliness in Chilean older people, and examined mediating mechanisms. Structural Equation Modeling showed a direct effect between ORA and reduced depressive symptomatology and between IR and anxious symptomatology; for indirect effects, the relationship between ORA and depressive and anxious symptomatology was mediated by friends' social support network, while that between IR and the three outcomes studied was mediated by the family support network and resilience. NORA was not associated with any of the outcomes or mediating variables.

Factors Associated With Hope and Quality of Life in Patients With Coronary Artery Disease

BACKGROUND

Psychological resources such as hope have been suggested to affect quality of life (QoL) positively in patients with heart disease. However, little information regarding the relationship between these two constructs is available.

PURPOSE

This work was aimed at examining the factors associated with hope and QoL in patients with coronary artery disease.

METHODS

In this descriptive work, perceived QoL and hope were assessed in 500 patients with heart disease. The information was collected using the McGill QoL Questionnaire, demographic variables, and the Herth Hope Index. The Pearson correlation test and general linear model were used to examine correlations through SPSS Version 22.

RESULTS

A considerable correlation was discovered between QoL and hope (r = .337, p < .001). Multivariate analyses with regression revealed that religious beliefs and social support both had significant and positive effects on the total perceived hope of patients and that patient age had a considerable negative impact on QoL (p < .05). None of these factors had a significant impact on hope (p < .05). In addition, the total QoL had a significant and positive effect on patient feelings and thoughts, whereas the physical problems component of QoL had a significant and negative effect on hope (p < .05). Participants with higher levels of education reported more hope.

CONCLUSIONS

QoL relates significantly to self-perceived hope in patients. Understanding QoL and hopefulness in patients with coronary artery disease has implications for nurses and other healthcare professionals.

Religious coping in the time of COVID-19 Pandemic in India and Nigeria: Finding of a cross-national community survey

BACKGROUND

Religious and spiritual coping strategies is one of the possible tools that can be used to deal with stress and the negative consequences of life problems and illnesses. The study aims to assess religious coping in the time of the COVID-19 pandemic.

METHODOLOGY

It was an online survey. The sample was collected using a snowball sampling technique as the data were collected through Google forms. The survey started on 22 April 2020 and was closed on 28 May 2020. The participants were from two countries, India and Nigeria. The inclusion criteria were age between 18 and 60 years, having completed at least 10 years of formal education, and have internet access. For data collection, Semi-structured proforma (demographic and personal characteristics) and Brief RCOPE was used to see the extent to which individuals engage in positive and negative forms of religious coping.

RESULTS

A total of 647 individuals (360 from Nigeria and 287 from India) participated in the survey. A total of 188 (65.5%) participants in India reported no change in their religious activities since they heard about COVID-19, while, 160 (44.4%) in Nigeria reported a decrease in religious activities. Positive religious coping in the Nigerian population was significantly higher than the Indian population. Similarly, negative religious coping was significantly higher (for most of the items in the brief RCOPE) in the Indian population than the Nigerian population.

CONCLUSION

Significant percentages of people after the COVID-19 pandemic took religious coping steps to overcome their problems. During this pandemic, positive religious coping among the Indian and Nigerian communities is more prevalent than negative religious coping. There is a substantial cross-national difference between Indians and Nigerians in the religious coping modes.

Resilience in severe mental disorders: correlations to clinical measures and quality of life in hospitalized patients with major depression, bipolar disorder, and schizophrenia

PURPOSE

To evaluate resilience in severe mental disorders and correlate it with clinical measures and quality of life.

METHODS

Resilience (Resilience Scale, RS) and quality of life (WHOQOL-BREF questionnaire) were prospectively evaluated in a sample of 384 hospitalized patients diagnosed with severe mental disorders (depression, bipolar disorder and schizophrenia). Clinical outcomes were measured using the Global Assessment of Functioning Scale (GAF), Clinical Global Impression (CGI), Cumulative Illness Rating Scale (CIRS), Hamilton Scale-Depression (HAM-D), Young Mania Rating Scale (YMRS), and Brief Psychiatric Rating Scale (BPRS).

RESULTS

Resilience measure showed a difference between the three clinical groups analyzed in the study, with lower scores in depressed patients than in bipolar disorder or schizophrenia patients. There was a trend toward a correlation between resilience and depressive symptoms (Hamilton Scale-Depression; P = 0.052; r_s = - 0.163). The scores in the resilience scale's personal competence domain presented a tendency of association with general psychiatric symptoms (Brief Psychiatric Rating Scale; P = 0.058; r = - 0.138). There was a significantly positive association between resilience and all domains of quality of life (r = 0.306-0.545; P < 0.05). Sociodemographic data like age, education, intelligence quotient, sex, and marital status were associated with resilience.

CONCLUSION

Depressive patients had low scores on the resilience scale compared to patients with other disorders. Resilience was positively associated with quality of life. Therefore, it deserves special attention, as it promotes more positive outcomes and improves patients' quality of life with severe mental disorders.

Spirituality and religiosity are associated with physical and psychological status in patients with chronic obstructive pulmonary disease

BACKGROUND

Management strategies that incorporate spirituality and religiosity (S/R) have been associated with better health status in clinical populations. However, few data are available for patients with chronic obstructive pulmonary disease (COPD) to improve the traditional disease-model treatment.

AIMS

The objectives of this study were to evaluate the association between S/R and physical and psychological status in patients with stable COPD.

DESIGN

This is a cross-sectional study.

METHODS

Religiosity, spiritual well-being and S/R Coping were measured. Physical status was evaluated with the activity of daily living, dyspnoea and the impact of the disease. Psychological status was assessed with anxiety and depression symptoms and quality of life. Spearman correlation coefficients were calculated, multivariate linear regression was applied in the analyses. This study is reported following the STROBE recommendations.

RESULTS

Seventy-two patients with stable COPD (male 58%, aged 68 ± 9 years, forced expiratory volume in 1s (FEV₁ ) of 49.2 ± 19.6% predicted) were included. There was no association between S/R and activity of daily living. However, higher spiritual well-being and lower Negative S/R Coping was associated with reduced dyspnoea and burden of the disease. Increased S/R and lower Negative S/R Coping was also associated with less anxiety, depression and better quality of life. Multivariate linear regression showed that S/R variables explained the physical and psychological health status in people with stable COPD.

CONCLUSIONS

Higher spirituality and less negative S/R Coping are associated with reduced dyspnoea, the burden of the disease, anxiety and depression symptoms, and better quality of life in patients with stable COPD.

RELEVANCE TO CLINICAL PRACTICE

Understanding how religiosity and spirituality are associated with physical and psychological features in patients with COPD may contribute to the long-term management of this patient population.

Religiosity, Emotions, Resilience, and Wellness during the COVID-19 Pandemic: A Study of Taiwanese University Students

One hard fact of COVID-19 is the uncertainty of all things. Anchoring on the assumption that the religiosity of an individual has a profound impact on their emotions, resilience, and wellness, this study investigated the levels of the centrality of religiosity, emotions towards God, resilience, and wellness among 399 Taiwanese university students. Data analysis included descriptive statistics, factor analysis, group comparisons, multiple regression, and mediation analysis. Findings showed that most of the participants were religious. Furthermore, the 16 emotions towards God were successfully factored into three distinct sub-groups, namely: pleasant, unpleasant, and moral valence, which were later found to be quite related to Asian religions. More importantly, the results suggested that the resiliency of an individual can be attributed to their belief in the existence of God or the Divine, while the wellness indicators of security and satisfaction were related to one’s religiosity. Lastly, structural equation modeling showed that resilience fully mediated the relationship between the ideology dimension of religiosity and the security and satisfaction component of wellness. In addition to discussing these significant results, this paper also included some implications of the study results, particularly the importance of religiosity and emotions toward God or the Divine in sustaining resilience and promoting wellness, especially in the context of crisis, such as the current COVID-19 pandemic.

Is there a relationship between spirituality/religiosity and resilience? A systematic review and meta-analysis of observational studies

Resilience is the ability to recover or cope with adverse situations. Spiritual and religious beliefs may be associated with important "resilience resources." To investigate whether there is a relationship between spirituality/religiosity (S/R) and resilience. This is a systematic review (observational studies) with meta-analysis following the PRISMA guidelines. From a total of 2468 articles, 34 observational studies were included. We identified a moderate positive correlation between S/R and resilience (r = 0.40 (95% CI, 0.32-0.48], p < 0.01). When only high-quality articles were included, the results were maintained. Conclusion: A moderate positive correlation was found between S/R and resilience.

Religiosity, spirituality, suicide risk and remission of depressive symptoms: a 6-month prospective study of tertiary care Brazilian patients

Religiosity and spirituality (R/S) are increasingly recognized as significant aspects in the evaluation of depressed patients. Limited research, however, has investigated the impact of R/S on outcomes of more severe or chronic depressed patients. The present study investigated the impact of different religiosity dimensions in tertiary care Brazilian depressed patients over suicide risk scores measured at baseline and remission of depressive symptoms in a 6-month prospective follow-up. In 277 individuals interviewed, 226 presented a diagnosis of depressive episode and 192 were assessed in the follow-up. Religiosity was evaluated using the Duke University Religion Index, comprising three dimensions of religiosity (organizational religiosity, non-organizational religiosity, intrinsic religiosity). Other potential predictors of outcomes included the Childhood Trauma Questionnaire (CTQ), Maudsley Staging of illness (MSM), Medical Outcomes Study Social Support Survey (MOS), World Health Organization Spirituality, Religiousness and Personal Beliefs instrument (WHOQOL-SRPB) and Hamilton Depression Scale (HAM-D). Results showed that almost half (46.1%) of the patients reported previous suicide attempts. Linear regression models identified that religious attendance (t-statistic -2.17, P=0.03), intrinsic religiosity (t-statistic -2.42, P=0.01) and WHOQOL-SRPB (t-statistic -3.67, P=0.00) were inversely correlated to suicide risk scores. In a prospective follow-up 16.7 % of patients (n=32/192) achieved remission of depressive symptoms (HAM-D scores ≤7). Religious attendance (OR 1.83, P=0.02) was identified as the main predictor of remission. Findings reinforce the importance of attending to religiosity/spirituality in order to improve outcomes and promote the recovery especially among severely depressed patients with increased suicide risk.

Religiousness, meaning, and quality of life: Test of a mediational model among adults seeking a spiritually integrated inpatient program

OBJECTIVE

Religious beliefs and practices may augment a sense of meaning in life that could support quality of life (QOL) in physical, social, and emotional domains amid mental health crises. However, these associations have not been thoroughly tested among persons with serious mental illness (SMI).

METHODS

Focusing on 248 adults who had recently enrolled in a spiritually integrated acute psychiatric hospitalization program, we incorporated structural equation modeling to examine whether (1) religiousness would be associated with better overall QOL; and (2) inpatients' sense of meaning in life would at least partially account for the religiousness-QOL link.

RESULTS

Religiousness was linked indirectly with QOL at the time of admission: religiousness was associated with greater meaning in life, and a higher degree of meaning in life was associated with QOL.

CONCLUSIONS

Findings underscore the crucial role of religiousness for meaning and wellness among many individuals with SMI who seek stabilization and healing.

Religious Coping, Hopelessness, and Suicide Ideation in Subjects with First-Episode Major Depression: An Exploratory Study in the Real World Clinical Practice

BACKGROUND

This study aimed to evaluate the potential relationships between religious coping, hopelessness, and suicide ideation in adult outpatients with the first episode of major depressive disorder (MDD).

METHODS

Ninety-four adult outpatients with MDD were assessed through the Hamilton Depression Rating Scale (HAM-D), the Beck Hopelessness Scale (BHS), and the Scale of Suicide Ideation (SSI). Religious coping was assessed with the Italian version of the Brief RCOPE scale, consisting of seven positive coping items (PosCop) and seven negative coping items (NegCop).

RESULTS

The results showed that the Brief RCOPE PosCop scale exhibited a strong inverse correlation with HAM-D, BHS, and SSI, whereas HAM-D and BHS were positively correlated with SSI. Brief RCOPE NegCop scores were positively correlated only with SSI. Regression analysis with SSI as the dependent variable showed that higher Brief RCOPE PosCop scores were associated with lower suicide ideation, whereas higher HAM-D and BHS scores were associated with higher suicide ideation.

CONCLUSION

Positive religious coping may be a protective factor against the development of suicide ideation, perhaps counteracting the severity of depressive symptoms and hopelessness. The evaluation of religious coping should be performed in all subjects with MDD in everyday clinical practice. However, this study was preliminary, and limitations must be considered.

The association between religious orientation and life satisfaction in older adults living with morbidity and multimorbidity: a gender perspective in Malaysia

BACKGROUND

Little is known about gender differences in the relationship between religious orientation and life satisfaction in older adults living with chronic disease(s). Therefore, the purpose of this article was to examine the moderating effect of gender on the association between religious orientation and life satisfaction in older adults living with morbidity and multimorbidity.

METHODS

The study involved 1790 community-dwelling older adults aged 60 and above living with at least one chronic medical condition. The Satisfaction with Life Scale and Revised Intrinsic/Extrinsic Religious Orientation Scale were used to measure life satisfaction and religious orientation. Moderated hierarchical multiple regression was used to test the moderation effect.

RESULTS

Results showed that while intrinsic religiosity was positively associated with life satisfaction, extrinsic religiosity was found to have a negative relationship with life satisfaction. Gender moderated the association between intrinsic religiosity and life satisfaction.

CONCLUSIONS

The findings suggested that the positive impact of intrinsic religiosity on life satisfaction was stronger in older women living with morbidity and multimorbidity. Healthcare practitioners can help disadvantaged older women in identifying their religious values and practices to improve their subjective wellbeing.

Religiosity and depressive symptoms among older adults in Colombia

Objective: The objective of this study was to examine the relationship between depressive symptoms and religiosity among older adults in Colombia.Methods: Data are drawn from the SABE (Salud, Bienestar y Envejecimiento) Colombia Study, a cross-sectional survey conducted in 2015 involving 19,004 community-dwelling adults aged 60 years and older living in urban and rural areas of Colombia. Depressive symptoms were measured using the Geriatric Depression scale (GDS; range 0-15), examined both as a continuous and categorical variable. Religiosity was assessed by self-rated religiosity and comfort derived from religion. Logistic and linear regression analyses were used to assess the association adjusting for confounders.Results: Multivariate logistic regression analyses demonstrated that being more religious (OR = 0.90, 95% CI = 0.85-0.95, p < .001) or perceiving greater strength or comfort from religion (OR = 0.88, 95% CI = 0.82-0.93, p < .001) was associated with a lower likelihood of scoring above the cutoff on the GDS for significant depressive symptoms (≥6). Similarly, linear regression analyses indicated that being more religious (unstandardized beta coefficient B = -0.16, p < .001) or perceiving greater strength or comfort from religion (B = -0.20, p < .001) was associated with a significantly lower score on the GDS assessed on a continuous scale.Conclusion: Being more religious or perceiving greater strength or comfort from religion is associated with fewer depressive symptoms among older adults in Colombia.

Espiritualidade e resiliência na atenção domiciliar

Introdução: A atenção domiciliar (AD) caracteriza-se por práticas de cuidado que realizam abordagem integral do paciente em seu contexto familiar, socioeconômico e cultural. Religiosidade e espiritualidade atuam como mecanismos de fortalecimento da resiliência. Objetivo: Avaliar a relação entre religiosidade e espiritualidade com resiliência em pacientes em AD de Unidades de Saúde de Atenção Primária à Saúde (US-APS) de Porto Alegre (RS), Brasil. Métodos: estudo quantitativo transversal e descritivo, incluindo 44 adultos de quatro US-APS em AD por condições crônicas e problemas de saúde controlados/compensados com alguma dependência para atividades da vida diária. Foram utilizadas escalas de religiosidade (DUREL), espiritualidade (ARES), resiliência (RS-14), funcionalidade (Katz), sintomas depressivos (PHQ-2), suporte social (mMOS-SS), classificação econômica (ABEP 2016) e grau de severidade das condições clínicas (CIRS-G). Resultados: Pacientes avaliados são majoritariamente de sexo feminino (72,7 %), idosas (média 74 anos), viúvas, brancas, de baixo estrato socioeconômico, baixa escolaridade, aposentadas, com tempo médio de 7,5 anos de restrição domiciliar e grau moderado de resiliência. Os entrevistados apresentam altos índices de religiosidade e espiritualidade, sendo que 90,9% apresentam alta religiosidade intrínseca e 79,6% realizam práticas religiosas privadas uma ou mais vezes ao dia. A maioria (88,6%) considera importante que sua religiosidade e espiritualidade seja abordada em seus atendimentos de saúde, mas somente 20,5% já foram questionados sobre tal temática. Resiliência associou-se à maior espiritualidade (B=0,44; p=0,02), controlando-se este efeito para suporte social e sintomas depressivos; e à maior idade (B=0,18; p=0,02). Conclusão: O estudo corrobora a relevância da dimensão de religiosidade e espiritualidade e indica seu papel na promoção de resiliência nesta população em AD. Recomenda-se a abordagem da religiosidade e espiritualidade com esses indivíduos, fortalecendo o cuidado integral preconizado pela APS.

[The influence of religiosity on depressive disorders and suicidal behavior]

This review of the literature is focused on the positive influence of religiosity on recovery after depression and on the protective role of religiosity against suicidal activity. Despite the inconsistent results on the role of religiosity in treatment of mental diseases, to date there is a sufficiently large body of literature showing the beneficial effect of religiosity and describing specific therapeutic approaches and suicide prevention programs.

The Association of Religion and Spirituality with Postpartum Mental Health in Women with Childhood Maltreatment Histories

OBJECTIVES

Although the associations between religion and spirituality and mental health and trauma have been studied extensively across various populations, relatively few studies have focused on the postpartum period. This study aimed to shed light on specific domains of religiosity and spirituality that may be resiliency factors for positive postpartum adjustment defined as low depression and high quality of life in mothers oversampled for childhood trauma histories.

METHODS

We examined several religion and spirituality variables among 108 women at 6 months postpartum as well as prospective relations from religion and spirituality to postpartum depression and quality of life at 12 and 15 months postpartum.

RESULTS

We found that the personal aspects of self-forgiveness and forgiveness for others were most relevant as resiliency factors predicting lower postpartum depression and better quality of life even when controlling for other risks (trauma and demographics). Surprisingly, no other religion and spirituality domain had associations with postpartum depression or quality of life, with the exception of a significant negative association for organizational religiousness with quality of life at 12 months postpartum.

CONCLUSIONS

Our findings suggest that forgiveness, especially to self and to others, in women who have been physically and mentally hurt as children may be associated with mental wellness and quality of life in the late postpartum period. Further, our results point to the need to study specific religion and spirituality aspects in the context of specific populations and conditions instead of generally studying religion and spirituality as a common marker for coping.

Tentativa de suicídio, transtorno de estresse pós-traumático e fatores associados em mulheres do Recife

RESUMO: Objetivo: Investigar a associação da tentativa de suicídio (TS) com o transtorno de estresse pós-traumático (TEPT), a violência por parceiro íntimo (VPI) e variáveis relacionadas aos aspectos socioeconômicos e demográficos em uma coorte de mulheres cadastradas na Estratégia Saúde da Família do Recife. Métodos: Foi realizado um estudo transversal, aninhado em um estudo de coorte prospectivo, com 644 mulheres de 18 a 49 anos, cadastradas na Estratégia Saúde da Família do Distrito Sanitário II da cidade do Recife (PE), entre julho de 2013 e dezembro de 2014. A TS foi avaliada pela pergunta “Já tentou pôr fim à sua vida?”, e o TEPT, diagnosticado por meio do Post-traumatic Stress Disorder Checklist - Civilian Version (PCL-C). Foram realizadas uma modelagem hierarquizada, a aplicação do teste χ2 e a análise de resíduos padronizados. A associação das variáveis independentes com a TS foi estimada por meio de regressão logística simples e ajustada. Resultados: A prevalência da TS foi de 10,9%, e a frequência de TEPT, de 16%. As mulheres que tinham TEPT e também as que não possuíam religião tiveram maior chance de tentar o suicídio (odds ratio - OR = 5,11, intervalo de confiança de 95% - IC95% 2,9 - 8,7; OR = 1,76, IC95% 1,0 - 2,9, respectivamente). Conclusões: Houve maior risco de TS nas mulheres que tiveram TEPT e baixa adesão a uma religião. Sendo assim, compreendeu-se que o enfrentamento do TEPT se dá prevenindo esse transtorno, tratando dele e promovendo mais conhecimentos sobre ele, além do efeito agregador e protetor social que a religiosidade promove, que também podem ser estratégias de redução e prevenção da TS.

Resilience, quality of life and symptoms of depression among elderlies receiving outpatient care

Objective:

to analyze the relation between resilience and demographic variables, quality of life and symptoms of depression in elderlies attended at a Geriatric Outpatient Clinic.

Method:

analytical cross-sectional study, conducted with 148 elderlies, with a questionnaire of sociodemographic and health characterization, the Resilience Scale, the World Health Organization Quality of Life Bref, the World Health Organization Quality of Life Old, and the Center for Epidemiologic Survey - Depression Scale. Descriptive statistics, Student’s t-test and Pearson correlation were used for data analysis.

Results:

there was a positive correlation between resilience and schooling (r = 0.208; p = 0.010), income (r = 0.194; p = 0.017), the World Health Organization Quality of Life Bref (r = 0.242; p = 0.003), and the World Health Organization Quality of Life Old (r = 0.522; p <0.001), and negative correlation regarding symptoms of depression (r = -0.270; p = 0.001).

Conclusion:

Resilience presented relation to schooling, income, quality of life and symptoms of depression in the elderly. These results are expected to help the multidisciplinary team plan actions aimed at developing resilience towards the promotion of health and good quality of life in old age.

Perspectives on Suicide Prevention Amongst Members of Christian Faith-Based Organizations

The purpose of this study was to explore perspectives on suicide prevention held by members of Christian faith-based organizations (FBOs). Eight focus groups were facilitated, and five major themes were identified: perceptions of responsibility, connection to suicidal persons, equipping for suicide prevention, collaboration with professional services, and hope. Overall, Christian FBO members considered suicide prevention to be an important demonstration of their faith and values. They perceived themselves to be currently adding to suicide prevention efforts through spiritual practices and interpersonal skills, but regarded these as insufficient if considered stand-alone responses. They recognized the receipt of suicide prevention training and collaboration with professional services as necessary to be fittingly engaged as a resource for suicide prevention.

Longitudinal Investigation of Psychotherapy Outcomes (LIPO): Description of the Study Protocol

Background: Despite extensive research in the field of psychotherapies, few studies have compared the primary psychotherapies of naturalistic design, which represents real-life situations. Objective: The objectives of this study were to evaluate three modalities of evidence-based psychotherapy for clinical, psychosocial, and biological outcomes and to identify the mediators and confounders of this process. Our primary hypothesis is that all psychotherapies will improve clinical and psychosocial outcomes and will increase BDNF levels. Methods: Design: longitudinal, naturalistic. Participants: One hundred twenty-six patients who underwent one of three evidence-based modalities of individual psychotherapy [psychodynamic psychotherapy (PDT), interpersonal psychotherapy (IPT), and cognitive-behavioral psychotherapy (CBT)] were included. Measure: Primary outcomes are divided into three domains of variables: clinical (general psychiatric symptoms), biological (serum BDNF levels), and psychosocial (resilience, quality of life, coping strategies, social support, and quality of life-adjusted years of life). Confounding/mediator variables included clinical (personality traits, type of psychotherapy, number of sessions, concomitant use of pharmacological treatment, history of previous psychotherapeutic treatment, medical and psychiatric comorbidities, and psychiatric diagnosis), psychosocial (psychosocial stressors, therapeutic alliance, and defense mechanism style), and other (religiosity) factors. Procedure: The follow-up period will be baseline and 6 months and 1 year after entering the study. The study will include 42 controls for biological variables only. Sample size calculation considered a significance level of 5% and a power of 80% to detect a difference of 0.22 with a standard deviation of 0.43, assuming losses of 20-30% of patients. The comparison between the modalities of psychotherapy will be by generalized estimating equations (GEE) model, the analysis of mediators by the Hayes method, and confounders by multivariate logistic regression. Discussion: The findings of this study are intended to demonstrate the outcomes of evidence-based psychotherapies for clinical, psychosocial, and biological parameters and to understand the mediators and confounders of this process in a real-life setting for patients with severe mental illness, thus contributing to the establishment of evidence-based public health policies in the field of psychological interventions.

Increased Levels of Brain-Derived Neurotrophic Factor Are Associated With High Intrinsic Religiosity Among Depressed Inpatients

Recognition of the importance of religion and spirituality in psychiatry is increasing, and several studies have shown a predominantly inverse relationship between religiosity and depression. Brain-derived neurotrophic factor (BDNF) is a widely studied brain neurotrophin responsible for synaptic plasticity, dendritic and neuronal fiber growth, and neuronal survival. The objective of the present study was to evaluate BDNF levels across high and low intrinsic religiosity (IR) in depressed inpatients. Serum BDNF levels were evaluated from 101 depressed inpatients at hospital admission and 91 inpatients at discharge. Religiosity was assessed using a validated version of the Duke University Religion Index. High IR patients had significantly higher serum BDNF at discharge than do low IR (52.0 vs. 41.3 ng/mL, P = 0.02), with a Cohen's d effect size difference of 0.56. High IR patients had a statistically significant increase in BDNF levels from admission to discharge (43.6 ± 22.4 vs. 53.8 ± 20.6 ng/mL, -1.950 (paired t-statistic), P = 0.05). The relationship between IR and BDNF levels (F = 6.199, P = 0.00) was controlled for the effects of depressive symptoms ( β = 2.73, P = 0.00) and psychiatric treatments, including selective serotonin reuptake inhibitors (SSRIs) (β = 0.17, P = 0.08), serotonin and norepinephrine reuptake inhibitors (SNRIs) ( β = -0.23, P = 0.02), tricyclic antidepressants (TCAs) ( β = -0.17, P = 0.10), lithium ( β = 0.29, P = 0.00), anticonvulsants ( β = 0.22, P = 0.03), antipsychotics ( β = -0.05, P = 0.61), and electroconvulsive therapy ( β = 0.00, P = 0.98). The current findings suggest a potential pathway to help understand the protective effect of religiosity in depressive disorders.

Religious and Spiritual Salience, Well-Being, and Psychosocial Functioning Among Psychotherapy Clients: Moderator Effects for Humility

A number of studies have examined the mediating factors in the relationship between religion and spirituality (R/S) and psychological health. Humility is a virtue that has been positively correlated with R/S variables, measures of well-being, and indicators of psychosocial functioning. In this study, we investigate dispositional humility as a potential moderator in the relationship between religious and spiritual salience and (1) well-being and (2) psychosocial functioning outcomes in a clinical sample. Results indicated that dispositional humility significantly moderated the relationships tested. Implications for future research and clinical practice are discussed.

Religion and Suicide: New Findings

Suicide rates and risk and protective factors vary across religions. There has been a significant increase in research in the area of religion and suicide since the article, "Religion and Suicide," reviewed these issues in 2009. This current article provides an updated review of the research since the original article was published. PsycINFO, MEDLINE, SocINDEX, and CINAHL databases were searched for articles on religion and suicide published between 2008 and 2017. Epidemiological data on suicidality and risk and protective factors across religions are explored. Updated general practice guidelines are provided, and areas for future research are identified.

Parallels between research in mental health in Brazil and in the field of Global Mental Health: an integrative literature review

Global Mental Health is a field of teaching, research, and practice whose goal is to improve access to mental health and reduce inequalities in mental health outcomes for all people worldwide, especially proposing action in low- and middle-income countries like Brazil. Given this global scenario and Brazil's progress in health and psychiatric reforms, it is important to investigate the current status of the Brazilian mental health literature and its relationship to Global Mental Health, describing how Brazilian research deals with key topics in the Global Mental Health field. The authors performed an integrative literature review using a qualitative and descriptive approach. The article search was performed for the years 2014 and 2015 in Portuguese and English, using the terms "mental health" and "Brazil", combined with key words corresponding to the principal themes addressed by authors in Global Mental Health. The search yielded 88 articles, which were analyzed according to authorship, periodicals and regions, and the analytical categories of access, primary care, community mental health services, social determinants of health, human rights, and equity. Brazil's mental health research revealed a rich and diverse body of studies, showing parallels with the literature on global mental health, but with limited systematization. Although the review revealed efforts to generate knowledge in this field within Brazil, some barriers may be limiting Brazil's participation in the international debate on Global Mental Health.

The Role of Religious Behavior in Health Self-Management: A Community-Based Participatory Research Study

Prevalence of chronic disease, mental health problems, and risk behaviors in San Bernardino (SB) County reflect some of the worst health outcomes in the State of California and the United States. Using the Integrated Theory of Health Behavior Change (ITHBC) as the theoretical framework, this community-based participatory research (CBPR) study aimed to determine how religious self-regulation skills and ability, and religious behaviors, jointly affect health promotion behaviors among socio-economically challenged residents of southwest SB County, California. A convenience sample of adult residents (N = 261) completed a series of inventories to measure the relationship between modified ITHBC constructs of religious self-regulation skills, religious self-management behaviors, and health outcomes. Structural Equation Modeling (SEM) analysis was conducted to validate the strong positive effect of religious self-regulation skills and ability on how frequently individuals engage in both organized and non-organized religious activities. Results also indicated a significant positive impact of religious behaviors towards healthy eating behaviors. However, without the engagement in religious activities, high religious self-regulation skills and ability inhibited the likelihood of healthy food intake. This faith-related theoretical model provides an avenue for faith-based organizations’ capacity for contributing to community health promotion.

Caregiver depression: The contributing role of depression in patients, stigma, social support and religiosity

BACKGROUND

Depression has been well studied as part of caregiver burden among patients with severe mental illnesses. Curiously, though, there has been little data in terms of caregiver burden with specific focus on depression among caregivers of patients with major depressive disorder (MDD).

AIM

This study aims to determine the rate of depression among caregivers of person with depression and its psychosocial correlates, which include stigma, perceived social support, religious commitment and the severity of the patient's symptoms.

METHODS

A cross-sectional study was conducted among 165 patients diagnosed with MDD using the Mini-International Neuropsychiatric Interview (M.I.N.I.) together with their caregivers. Apart from gathering social demographic data, patients were administered the 16-item Quick Inventory of Depressive Symptomatology-Self-Rated Version (QIDS-SR 16), whereas the caregivers were required to answer Patient Health Questionnaire-9 (PHQ-9), Multidimensional Scale of Perceived Social Support (MSPSS), Duke University Religion Index (DUREL) and Depression Stigma Scale (DSS). Those who scored ⩾5 on PHQ-9 were further assessed with interviewer-rated M.I.N.I. to diagnose the presence of depression.

RESULTS

A total of 47 (28.5%) caregivers were found to have depressive symptoms. Out of that total, 13 (7.9%) were diagnosed to have MDD using M.I.N.I. From univariate analysis, factors associated with depression in caregivers were the severity of symptoms in patients ( p < .001), personal stigma in caregivers ( p = .037), the patients' current depressive episode ( p = .026) and lower perceived social support from friends ( p = .048). From multivariate analysis, only the patients' severity of depressive symptoms ( p < .001) and personal stigma in caregivers ( p = .048) were significantly associated with the caregivers' depressive symptoms.

CONCLUSION

Our findings suggested that the severity of patient depression and personal stigma of the caregivers were significant factors correlated with caregiver depression. Therefore, beyond optimizing the treatment of depression in patients, the issue of stigma among caregivers also needs to be addressed as a potential target of intervention.

Religiosity, depression, and quality of life in bipolar disorder: a two-year prospective study

OBJECTIVE

Few quantitative studies have examined the effect of religious involvement on the course of bipolar disorder (BD). We investigated the effects of religious activity and coping behaviors on the course of depression, mania, and quality of life (QoL) in patients with BD.

METHODS

Two-year longitudinal study of 168 outpatients with BD. Linear regression was used to examine associations between religious predictors and outcome variables (manic symptoms, depression, QoL), controlling for sociodemographic variables.

RESULTS

Among the 158 patients reassessed after 2 years, positive religious coping at T1 predicted better QoL across all four domains: physical (β = 10.2, 95%CI 4.2 to 16.1), mental (β = 13.4, 95%CI 7.1 to 19.7), social (β = 10.5, 95%CI 3.6 to 17.33), and environmental (β = 11.1, 95%CI 6.2 to 16.1) at T2. Negative religious coping at T1 predicted worse mental (β = -28.1, 95%CI -52.06 to -4.2) and environmental (β = -20.4, 95%CI -39.3 to -1.6) QoL. Intrinsic religiosity at T1 predicted better environmental QoL (β = 9.56, 95%CI 2.76 to 16.36) at T2. Negative religious coping at T1 predicted manic symptoms (β = 4.1) at T2.

CONCLUSION

Religiosity/spirituality (R/S) may influence the QoL of patients with BD over time, even among euthymic patients. Targeting R/S (especially positive and negative religious coping) in psychosocial interventions may enhance the quality of recovery in patients with BD.

Resilience and spirituality in patients with depression and their family members: A cross-sectional study

OBJECTIVE

The degree and quality of resilience in patients with depression have never been investigated in the context of remission status, spirituality/religiosity, and family members' resilience levels, which was addressed in this study.

METHODS

This cross-sectional study recruited Japanese outpatients with depressive disorder according to ICD-10 and cohabitant family members who were free from psychiatric diagnoses. Resilience was assessed using the 25-item Resilience Scale (RS). Other assessments included the Montgomery-Asberg Depression Rating Scale (MADRS); the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT) and Kasen et al.'s (2012) scale for spirituality/religiosity; and the Rosenberg Self-Esteem Scale (RSES).

RESULTS

One hundred outpatients with depression (mean±SD age, 50.8±14.5years; 44 men; MADRS total score 9.8±9.0) and 36 healthy family members (mean±SD age, 56.5±15.0years; 18 men) were included. Symptom severity, attendance at religious/spiritual services, and self-esteem were significantly associated with RS scores in the patient group. RS total scores were significantly higher in remitted patients compared to non-remitted patients (mean±SD, 112.3±17.1 vs. 84.8±27.7, p<0.001). No correlation was found in RS total scores between patients and their family members (p=0.265), regardless of patients' remission status.

CONCLUSIONS

Resilience may be influenced by individual characteristics rather than familial environment; furthermore, self-esteem or spirituality/religiosity may represent reinforcing elements. While caution is necessary in extrapolating these findings to other patient populations, our results suggest that resilience may be considered a state marker in depression.

Suicidality associated with PTSD, depression, and disaster recovery status among adult survivors 8 years after the 2008 Wenchuan earthquake in China

It has been eight years since the Wenchuan earthquake. We don't know how the lives of those affected by the disaster may remain blighted by its effects, or how many remain thus affected. The aim of the present study was to examine the relationship of disaster exposure, PTSD, depression and suicidal behaviors, using data from a cross-sectional survey conducted in earthquake-affected areas of China. 1369 participants were recruited from two different sites that were severely affected by the Wenchuan earthquake. The survey assessed suicidality (suicidal ideation, plans and attempts) and other mental health issues. Probable PTSD was assessed using the Impact of Event Scale-Revised (IES-R). The Center for Epidemiologic Studies Depression Scale (CES-D) Chinese edition was used to assess depressive symptoms. The results showed that 11.2% of participants felt that their lives had not yet recovered from the effects of the Wenchuan earthquake, even after eight years. Suicidal ideation, plans, and attempts were reported by 9.1%, 2.9%, and 3.3%, respectively, of the respondents. PTSD, depression, and perceived non-recovery were highly associated with suicidality. These results indicate that suicidality can be a long-term mental health sequela of disaster. Targeted, long-term suicide prevention programs for adult survivors should be further developed.

Resilience and attempted suicide in depressed patients

Introduction

Among the patients, 6.6% with past-year major depressive disorders attempt suicide in their life. Resilience (the ability to respond positively to adversity) and coping strategies (the ability to manage living stresses) may be protective factors against suicide ideation and behavior. A study conducted on 100 abstinent substance dependent patients suggested that suicide attempters had significantly lower resilience scale scores. Other authors demonstrated that intrinsic religiosity, resilience, quality of life were associated with previous suicide attempts in depressed patients.

Aim

To examine the correlation among resilience, coping strategies and sociodemographic and clinical characteristics in depressed patients.

Methods

From December 1st 2014 to December 31st 2015 we recruited inpatients and outpatients aged > 18 years with a diagnosis of depression (current or past). At baseline, patients were assessed with Montgomery Asberg Depression Rating Scale, Resilience Scale for Adult and Brief-COping with problems experienced; sociodemographic and clinical characteristics were gathered. Follow-up was conducted after 1 year in order to assess the possible presence of further depressive episodes and suicide attempts. Analysis was performed with SPSS.

Results and discussion

Data collection are still ongoing; results and implications will be discussed. We expect to find higher attempted suicide rates in patients with lower resilience and less coping strategies.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Factors Affecting Disability-Related Depression in Patients with Lost Limbs: A Mediational Model

The objective of the present study was to determine the mediating role of self-efficacy between religiosity, social support, and depression in patients with lost limbs. We sampled 67 male and 33 female disabled patients who had lost limbs in accidents or amputations from four public hospitals in Lahore, Pakistan, and used Religiosity Index (Farooq and Imam, in The effect of religiosity on locus of control. Department of Psychology, Govt College University, Lahore, 1997), General Self-efficacy Scales (Tabassum et al., in Urdu adaptation of the general self-efficacy scale. Retrieved from http://userpage.fu-berlin.de/~health/urdu.htm , 2003), Berlin Social Support Scale (Schwarzer and Schulz, in Berlin Social Support Scales. Retrieved online from http://userpage.fuberlin.de/~gesund/skalen/Language_Selection/Turkish/BerlinSocialSupportScales/berlin_social_support_scales.htm , 2000), and Siddiqui-Shah Depression Scale (Siddiqui and Shah, in Pychol Dev Soc 9(2):245-262, 1997), and used a correlation matrix and mediational analyses along with other inferential statistics to develop a model that suggested self-efficacy mediated between religiosity, social support, and depression with negative correlations that partially mediated this relationship. The findings suggest that low level of religiosity, social support, and self-efficacy may play a role in the onset and continuation of depression or its symptoms. We found no significant differences in gender, education, and cause of disability in patients with lost limbs. Results have implications for clinical psychologists, counselors, and health psychologists to develop a treatment plan for such patients with depression focusing on the factors implicated above.

Religiosity and Health-Related Quality of Life: A Cross-Sectional Study on Filipino Christian Hemodialysis Patients

This study aimed to measure the religiosity and health-related quality of life of Filipino Christian HD patients. A cross-sectional study of 100 HD patients was conducted. The Duke University Religion Index and the Ferrans and Powers QLI Dialysis Version-III were used. Data were analyzed using descriptive statistics and Pearson r correlation. Attendance to organizational religious activities and NORA were found to be correlated with some of the dimensions of HRQoL. Intrinsic religiosity showed a strong, positive correlation with HRQoL. It is essential to attend to and nourish their religious needs. Holistic approach in providing care to HD patients, with emphasis on spiritual care, is encouraged to improve their total health.

Is religiosity a protective factor against suicidal behavior in bipolar I outpatients?

BACKGROUND

Several risk factors have been associated with suicidal behavior (SB) in bipolar disorder (BD), but little is known regarding possible protective factors. Religiosity has been related to favorable outcomes in mental health and to a reduction in the risk of SB, although the relation between BD, religiosity and SB remains under-investigated. The objective of this study was to evaluate the association between religiosity and SB in euthymic bipolar I outpatients.

METHOD

In this study, 164 outpatients with BD type I with and without a history of suicide attempts were assessed and compared using a questionnaire to collect clinical and sociodemographic characteristics, the Structured Clinical Interview for DSM-IV, the Hamilton Depression Rating Scale, the Young Mania Rating Scale, the Duke Religious Index, and the Barratt Impulsivity Scale.

RESULTS

The suicide attempters (SA) group had more psychiatric comorbidity (p=0.007), more rapid cycling (p=0.004), higher levels of impulsivity in all domains (p=0.000), and less religious affiliation (p=0.006) compared with the non-SA group. In the multivariate analysis, after controlling for covariates, non-organizational religious activities (OR, 0.66; 95% CI, 0.50-0.86) and intrinsic religiosity (OR, 0.70; 95% CI, 0.60-0.81) were associated with less SB.

LIMITATIONS

A small sample size, the cross-sectional design that precluded the possibility of assessing cause and effect relationships, and the infeasibility of determining the time lapse between the last suicide attempt and the period when the patients were evaluated.

CONCLUSION

Non-organizational religious activities and intrinsic religiosity dimensions exert a protective effect against SB in bipolar I outpatients, even when controlling for variables that may affect the outcome in question.