Health care workers and researchers are increasingly recognizing the religiosity/spirituality great dimension in health

Cruz Caldas Lins, Hellen LÃºcia

de AraÃºjo Neto, EmÃ­dio Antonio

de Carvalho Ferreira, Alberto Gorayeb

de MacÃªdo Melo, Rafaela

dos Santos Rocha, Susanne

Fernandes da Silva, Arthur

Rolim Neto, Modesto Leite

Soares Feitosa, Uilna NatÃ©rcia

English

International Medical Publisher Journals (iMedPub)

InternatIonal archIves of MedIcIneSection: PSychiatry and Mental healthIssn: 1755-7682 12015Vol. 8 No. 116doi: 10.3823/1715iMedPub Journalshttp://journals.imed.pub© Under License of Creative Commons Attribution 3.0 License This article is available at: www.intarchmed.com and www.medbrary.com AbstractHealth care workers and researchers are increasingly recognizing the religiosity/spirituality (R/S) great dimension in health. It is important to note that investigations had pointed studies which found spirituality as a significant positive factor on physical health, subjective wellbeing and life satisfaction. Others also evidenced a negative burden of spirituality in mental health, through negative religious coping, negative beliefs and miscommunication. In 2008, The World Psychiatric Association (WPA) declared the spiritual wellbeing as an important health aspect, reinforcing the R/S valuation of the patients with mental disorders. Noticing the necessity of more knowledge about the subject the Diag-nostic and Statistical Manual of Mental Disorders (DSM-IV) introduced a new category called "Religious and Spiritual Problems" to angle the diagnostic attention, justifying the evaluation of religious and spiritual experiences as a constituent part. Patients want the assistance team to demonstrate a holistic interest during interventions, including spiritual support during illness. Visualizing mental health assistance's future as a continuous path towards a better understanding of men's com-plexity and integrated health care, it seems appropriate to say that spirituality/religiosity will play a great role in this direction.The Influence of Religiosity/Spirituality on Mental Health  oPInIon Arthur Fernandes da Silva1, Alberto Gorayeb de Carvalho Ferreira2, Rafaela de Macêdo Melo1, Hellen Lúcia Cruz Caldas Lins3,Uilna Natércia Soares Feitosa3,Emídio Antonio de Araújo Neto3,Susanne dos Santos Rocha4,Modesto Leite Rolim Neto11  Medicine School, Federal University of Cariri –UFCA, Barbalha, Ceará, Brazil.2  Health School Pernambuco –FPS, Recife, Pernambuco, Brazil.3  Postgraduate Program in Health Sciences, FMABC, Santo André, São Paulo, Brazil.4  Medicine and Specialties Dr. Emidio, Cajazeiras, Paraíba, Brazil.Contact information:Modesto Leite Rolim Neto.modestorolim@yahoo.com.brKeywordsReligiosity, Spirituality, Physical Health.Health care workers and researchers are increasingly recognizing the importance of the religiosity/spirituality (R/S) dimension in health. Pro-perly correlate and present the influence of R/S on mental health is a challenge due to the difficulty to establish the direction of that rela-tionship and to the deep commitment that religion has with several di-mensions of human structure, such as emotional, behavioral, cognitive and motivational what translate into multiple effects on health statues and, notwithstanding, vary according to the definition of R/S used. According to analysis [1], R/S was inversely correlated with the prevalence of any mental disorders. A narrative literature review by Agoorastos, Demiralay and Huber [2] pointed studies which found InternatIonal archIves of MedIcIneSection: PSychiatry and Mental healthIssn: 1755-7682 2015Vol. 8 No. 116doi: 10.3823/1715This article is available at: www.intarchmed.com and www.medbrary.com 2spirituality as a significant positive factor on physical health, subjective well-being and life satisfaction. Stressful life situations, such as immune, endocrine and cardiovascular diseases, pain, cancer and ter-minal illness are some examples of circumstances in which religion and spirituality importance were emphasized [3]. However, it is important to note that investigations had also evidenced a negative burden of spirituality in mental health, for example, being associated with higher risk for most psychia-tric disorders in general [4]. Weber and Pargament [5] listed positive beliefs, community, support and positive religious coping as ways in which religion and spirituality can increase mental health levels; they also noted that religion and spirituality can damage mental health through negative religious coping, negative beliefs and miscommunication. A 30 year follow-up study [6] of 754 individuals, evaluating their religious frequency and depressive symptoms at four moments in time, evidenced that the religiosity contributed importantly for symptom reduction. Despite that, was also found an inverse correlation between the reduction of symptom sco-res and the religious participation (yearly, monthly or weekly). Evaluating depressive women and their offspring in a ten-year follow-up, Miller et al [7] were able to conclude that those women who re-ferred religion or spirituality as greatly importance to them had less than one-tenth the risk of recu-rrence or incidence of major depression over the previous 10-year period in comparison to those who did not consider religion or spirituality as greatly importance. On the other hand, in a 10-year pros-pective study, Miller et al [8] found a longstanding protective effect of significant personal judgment of religion or spirituality against major depressive disorder. Comparing with other study participants, those with high personal importance of R/S had one-fourth the risk of having a depressive episode in the period. Greater spirituality is associated with less severe depression, as it is suggested by Peselow et al [9] . They also evidenced that the spirituality level of a patient may indicate his or her capacity to improve measures of depressive symptom seve-rity, hopelessness, and cognitive distortions after a selective serotonin reuptake inhibitors treatment for eight weeks. Another study [10], this time using data from the Canadian National Population Health Survey, examined the effect of religious attendance, self-declared importance of spiritual values, and self identification as a spiritual person on major depres-sion in a 14 year follow-up (1994-2008). After the control for confounding factors, the investigators found a 22% lower risk of major depression among the monthly attenders (mostly female, older and married at baseline) compared with non-attenders. In fighting depression resulting from death of be-loved ones, some strategies that also hold spiritua-lity can be used. The Bereavement Life Review, for example [11], has been put as an effective resource to support and reduce depression among bereaved relatives of individuals who died in non-palliative care settings, improving their spirituality at the same time. A research [12] which aimed to determine if the attendance to religious services influenced the mor-tality by suicide of an American population analyzed data from a USA nationally representative sample (n = 20,014) and found, even after accounting for the effects of other relevant risk factors, that highest frequencies to religious services contributed to the mortality reduction in that population. According to Koenig et al [13], that is one of the two only pros-pective or longitudinal studies which evaluated the relationship between religion and suicide to date. Nevertheless much is discussed about [14] the boun-daries of the physician intervention using spirituality with the patient, the Royal College of Psychiatrists suggests [15] some generic strategies to assure a good quality caregiving. Most of the data from epidemiologic studies indi-cate a positive association between the relation R/S and health indicators. Although, the patients beliefs may influence the medical decision and induce spi-InternatIonal archIves of MedIcIneSection: PSychiatry and Mental health Issn: 1755-7682 2015Vol. 8 No. 116doi: 10.3823/1715© Under License of Creative Commons Attribution 3.0 License 3ritual conflicts that creates stress, interfering at the resolution of pathologies [16]. Accordingly to this, the World Psychiatric Association (WPA) declared [17], in 2008, the spiritual wellbeing as an impor-tant health aspect, reinforcing the importance of the R/S evaluation of the patients with mental disor-ders. Despite the evidences and recommendations about the relevance of this approach, still there is no correct adequacy of the mental health assistance to this reality [18]. A brazilian cross-sectional study, developed by Lucchetti [19] aimed to evaluate the relation between R/S and elderly mental health in outpatient rehabilitation, it evidenced that 87% of them would like their doctors to approach their reli-giosity and spirituality during their clinical treatment, but only 8% referred already had been questioned about this aspects. From the clinical point of view, more knowledge about the subject is necessary. Due to this facts the Diagnostic and Statistical Manual of Mental Di-sorders, fourth Edition (DSM-IV), introduced a new category called “Religious and Spiritual Problems” to angle the diagnostic attention, justifying the eva-luation of religious and spiritual experiences as a constituent part. In the United Kingdom, a clinical sample of pa-tients with psychotic disorder was compared to a non-clinical population of people with a history of psychotic experiences and it was evidenced that, despite both groups had the same score of psy-chotic perceptions, the clinical sample had grea-ter index of cognitive impairment, depressive and anxious. About the psychotic experiences, the cli-nical population had a higher propensity regard them as dangerous, negative and anxiogenic. The non-clinical sample, moreover, tended to unders-tand these experiments as positive and normal [20]. Other authors evidenced that diagnosed patients with different mental disorders are different to sub-jects with a history of variable psychotic experien-ces, such as controlling the experience and absence of psychological suffer [21]. Reckon this experience as normal part of human experiences, therefore, appears to be an adaptive measure [22] .Considering spirituality as a universal phenome-non, representing a very personal dimension of a subject’s life, it is possible to comprehend how patients want their health assistance team to treat it: not necessarily giving them a spiritual guidance, but demonstrating a holistic interest during their relationship and interventions, what includes spiri-tual support during illness [23]. Today it is possi-ble to evaluate and recognize the positive effects of spirituality from a private perspective [24] to its workplace dimension [25] i.e., spirituality has been proved as a resource widely available for individuals to cope with negative life events [26], such as men-tal illnesses. Visualizing mental health assistance’s future as a continuous path towards a better understanding of men’s complexity and integrated health care, it seems appropriate to say that R/E ill play a great role in this direction, especially with a growing evi-dence basis [27] of its impact in mental health study focuses like depression, substance abuse, suicide, stress-related disorders and dementia.References 1. King M, Marston L, McManus S, Brugha T, Meltzer H, Bebbington P. Religion, spirituality and mental health: results from a national study of English households. Br J Psychiatry. 2013; 202(1): 68-73.  2. Agorastos, A., Demiralay, C., Huber, C.G. Influence of religious aspects and personal beliefs on psychological behavior: Focus on anxiety disorders Psychology Research and Behavior Management. 2014; 7: 93-101.  3. Koenig HG. Religion, spirituality, and health: the research and clinical implications. ISRN Psychiatry. 2012; 2012: 278730.  4. Baetz M, Bowen R, Jones G, Koru-Sengul T. How spiritual values and worship attendance relate to psychiatric disorders in the Canadian population. Can J Psychiatry. 2006; 51(10): 654-661.  5. Weber, S.R., Pargament, K.I. The role of religion and spirituality in mental health. Current Opinion in Psychiatry. 2014; 27(5): 358-363. 6. Zou, J., Huang, Y., Maldonado, L., Kasen, S., Cohen, P., Chen, H. The efficacy of religious service attendance in reducing depressive symptoms. Social Psychiatry and Psychiatric Epidemiology. 2014; 49(6): 911-918. InternatIonal archIves of MedIcIneSection: PSychiatry and Mental healthIssn: 1755-7682 2015Vol. 8 No. 116doi: 10.3823/1715This article is available at: www.intarchmed.com and www.medbrary.com 4 7. Miller L, Warner V, Wickramaratne P, Weissman M: Religiosity and depression: ten-year follow-up of depressed mothers and offspring. J Am Acad Child Adolesc Psychiatry. 1997; 36: 1416-1425. 8. Miller, L., Wickramaratne, P., Gameroff, M.J., Sage, M., Tenke, C.E., Weissman, M.M. Religiosity and major depression in adults at high risk: A ten-year prospective study. American Journal of Psychiatry. 2012; 169(1): 89-94.  9. Peselow, E., Pi, S., Lopez, E., Besada, A., Ishak, W.W. The impact of spirituality before and after treatment of major depressive disorder. Innovations in Clinical Neuroscience. 2014; 11(3-4): 17-23.  10. Balbuena, L., Baetz, M., Bowen, R. Religious attendance, spirituality, and major depression in Canada: A 14-year follow-up study. Canadian Journal of Psychiatry. 2013; 58(4): 225-232.  11. Ando, M., Sakaguchi, Y., Shiihara, Y., Izuhara, K. Universality of Bereavement Life Review for Spirituality and Depression in Bereaved Families. American Journal of Hospice and Palliative Medicine. 2014; 31(3): 327-330. 12. Kleiman, E.M., Liu, R.T. Prospective prediction of suicide in a nationally representative sample: Religious service attendance as a protective fator. British Journal of Psychiatry. 2014; 204(4): 262-266.  13. Koenig HG, King DE, Carson VB. Handbook of Religion and Health (2nd edn).Oxford University Press, 2012.  14. Cook CCH (ed.). Controversies on the place of spirituality and religion in psychiatric practice. In Spirituality, Theology and Mental Health. SCM Press, 2013.  15. Cook CCH. Recommendations for Psychiatrists on Spirituality and Religion (Position Statement PS03/2013). Royal College of Psychiatrists, 2013.  16. Koening HG. Religion, Spirituality, and Medicine: Research Findings and Implications for Clinical Practice. South Med J. 2004; 97: 1194-200.  17. Verhagen PJ, Cook CCH. Epilogue: Proposal for a World Psychiatric Association Consensus or Position Statement on Spirituality and Religion in Psychiatry. In: Verhagen PJ, Van Praag HM, López-Ibor JJ, Cox JL, Moussaoui D (editors). Religion and Psychiatry: Beyond Boundaries. Chicester: Wiley-Blackwell. 2010: 615-631.  18. Tostes JSRM, Pinto AR, Moreira-Almeida A. Religiosidade/espiritualidade na prática clínica: o que o psiquiatra pode fazer? Debates em Psiquiatria. 2012 14(x): 20-16.  19. Lucchetti G, Lucchetti AG, Badan-Neto AM, Peres PT, Peres MF, MoreiraAlmeida A et al. Religiousness affects mental health, pain and quality of life in older people in an outpatient rehabilitation setting. J Rehabil Med. 2011; 43(4): 316-22.  20. Lovatt A, Mason O, Brett C, Peters E. Psychotic-like experiences, appraisals, and trauma. J Nerv Ment Dis. 2010; 198(11): 813-9.  21. Menezes Junior A, Moreira-Almeida, A. O diagnóstico diferencial entre experiências espirituais e transtornos mentais de conteúdo religioso. Rev Psiquiatr Clín. 2009; 36(2): 75-82.  22. Almeida AAS. Uma fábrica de loucos: psiquiatria x espiritismo no Brasil (1900- 1950) [dissertação]. Departamento de História do Instituto de Filosofia e Ciências Humanas da Universidade Estadual de Campinas (Unicamp); 2007. Available from: http://www.hoje.org.br/bves. 23. Best, M., Butow, P., Olver, I. Spiritual support of cancer patients and the role of the doctor. Supportive Care in Cancer. 2014; 22(5); 1333-1339.  24. Lee, K.H., Hwang, M.J. Private religious practice, spiritual coping, social support, and health status among older korean adult immigrants. Social Work in Public Health. 2014; 29(5): 428-443. 25. Kumar, V., Kumar, S. Workplace spirituality as a moderator in relation between stress and health: An exploratory empirical assessment. International Review of Psychiatry. 2014; 26(3): 344-351.  26. Kidwai, R., Mancha, B.E., Brown, Q.L., Eaton, W.W. The effect of spirituality and religious attendance on the relationship between psychological distress and negative life events. Social Psychiatry and Psychiatric Epidemiology 2014; 49(3): 487-497. 27. Bonelli R, Koenig H. Mental disorders, religion and spirituality 1990 to 2010: a systematic evidence-based review. Journal Of Religion And Health. 2013; 52(2): 657-673.Where Doctors exchange clinical experiences,review their cases and share clinical knowledge.You can also access lots of medical publications forfree. Join Now!http://medicalia.org/Comment on this article:International Archives of Medicine is an open access journal publishing articles encompassing all aspects of medical scien-ce and clinical practice. IAM is considered a megajournal with independent sections on all areas of medicine. IAM is a really international journal with authors and board members from all around the world. The journal is widely indexed and classified Q1 in category Medicine.Publish with iMedPubhttp://www.imed.pub

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