Rosmarin David H, Malloy Mary C, Forester Brent P
Department of Psychiatry, McLean Hospital/Harvard Medical School, Belmont, MA, USA.
Int J Geriatr Psychiatry. 2014 Jun;29(6):653-60. doi: 10.1002/gps.4052. Epub 2013 Dec 6.
We explored relationships between general religiousness, positive religious coping, negative religious coping (spiritual struggle), and affective symptoms among geriatric mood disordered outpatients, in the northeastern USA.
We assessed for general religiousness (religious affiliation, belief in God, and private and public religious activity) and positive/negative religious coping, alongside interview and self-report measures of affective functioning in a diagnostically heterogeneous sample of n = 34 geriatric mood disordered outpatients (n = 16 bipolar and n = 18 major depressive) at a psychiatric hospital in eastern Massachusetts.
Except for a modest correlation between private prayer and lower Geriatric Depression Scale scores, general religious factors (belief in God, public religious activity, and religious affiliation) as well as positive religious coping were unrelated to affective symptoms after correcting for multiple comparisons and controlling for significant covariates. However, a large effect of spiritual struggle was observed on greater symptom levels (up to 19.4% shared variance). Further, mean levels of spiritual struggle and its observed effects on symptoms were equivalent irrespective of religious affiliation, belief, and private and public religious activity.
Previously observed effects of general religiousness on (less) depression among geriatric mood disordered patients may be less pronounced in less religious areas of the USA. However, spiritual struggle appears to be a common and important risk factor for depressive symptoms, regardless of patients' general level of religiousness. Further research on spiritual struggle is warranted among geriatric mood disordered patients.
我们探讨了美国东北部老年情绪障碍门诊患者的一般宗教信仰、积极宗教应对、消极宗教应对（精神挣扎）与情感症状之间的关系。
我们评估了一般宗教信仰（宗教归属、对上帝的信仰以及私人和公共宗教活动）以及积极/消极宗教应对，同时在马萨诸塞州东部一家精神病院对n = 34名诊断异质性的老年情绪障碍门诊患者（n = 16名双相情感障碍患者和n = 18名重度抑郁症患者）进行访谈和自我报告情感功能测量。
除了私人祈祷与较低的老年抑郁量表得分之间存在适度相关性外，在进行多重比较校正并控制显著协变量后，一般宗教因素（对上帝的信仰、公共宗教活动和宗教归属）以及积极宗教应对与情感症状无关。然而，观察到精神挣扎对更高的症状水平有很大影响（高达19.4%的共享方差）。此外，无论宗教归属、信仰以及私人和公共宗教活动如何，精神挣扎的平均水平及其对症状的观察影响都是相当的。
先前观察到的一般宗教信仰对老年情绪障碍患者（较少）抑郁的影响在美国宗教性较低的地区可能不太明显。然而，精神挣扎似乎是抑郁症状的一个常见且重要的风险因素，无论患者的一般宗教水平如何。有必要对老年情绪障碍患者的精神挣扎进行进一步研究。
