Spirituality In Psychiatry Research Articles

Psychiatry Residents’ Attitudes towards Spirituality in Psychiatric Practice in Saudi Arabia

Objectives: This study examined residents’ attitudes and practices regarding the relevance of spirituality in psychiatry within Saudi residency training programs; their experiences and comfort levels in addressing patients’ spiritual concerns; and their interest and past learning experiences in this area of training and practice. Methods: This cross-sectional study targeted trainees and recent graduates of residency programs across Saudi Arabia. The study materials consisted of an electronic questionnaire that was adapted with permission. Results: The total number of respondents was 71 out of 180 potential participants (39.44%). Most residents (64.8%) felt that it was appropriate to inquire about the spiritual aspects of patients’ lives and that it was essential to address spiritual problems or needs that patients may have within the clinical setting (71.8%). Many participants (40.80%) described themselves as being both religious and spiritual. Most respondents (94.4%) did not receive any training on spirituality and psychiatry, and 80.3% said they would like to learn more about the subject. Conclusions: Our findings indicate that residents have an overall high level of personal spirituality and that they feel it is relevant in clinical practice. However, they have not had much training in this area and are interested in learning more. Educational initiatives would be beneficial for improving the effectiveness of residents and patient care in this untapped area of spirituality in psychiatry.

Spirituality in Moroccan Psychiatric Context

Objective: Assessing the place of spirituality in psychiatry seems interesting, since the spiritual life influences the psychological experience of patients, and sometimes a defense deal with life frustrations. Studies are rare in this field. Methods: We evaluate the role of spirituality in psychiatry in the moroccaon context: its palce in the lives of patients followed in psychiatry and its place in the practice of psychiatrists. We have evaluated patient socio-demographic and medical characteristics, the importance of spirituality in their life, its importance to deal with their disease. We have also evaluated the importance of spirituality in the psychiatrists practice, and if it has or not a paradox with their medical interventions. Results: The results showed that 56 % of patients were men. Patients with schizophrenia represented 37%, and 28% had a depression. Religious practices were present in 87% of patients. Religion had an important place in the life of 71% of patients and 61 % had mentioned their faith in God to deal with the disease. The majority of patients (83%) do not find a conflict between spirituality and the psychiatric cares. The majority of practitioners (90%) accept receiving a spiritual request from their patients. Conclusion: Spirituality has an important place in psychiatry in Moroccan context. Patients and practitioners consider it an important side of life, and do not find any paradox between it and psychiatric cares.

Position Statement on Religion and Spirituality in Psychiatry: Seven Recommendations

Background: in December 2015 the Executive Committee of the World Psychiatric Association approved a Position Statement on religion, spirituality in psychiatry. Since then, the World Psychiatric Association Section of Religion, Spirituality and Psychiatry has committed to publicizing the Position Statement worldwide. Aim: to bring this statement, especially the seven recommendations, to the attention of the international psychiatric community, in particular the Russian psychiatric community. Method: a narrative review and the seven recommendations in the Position Statement are explained, thus demonstrating its importance. Conclusion: religion and spirituality in psychiatry are part of daily psychiatric practice, scientific research, residency training and continuous medical education, and the political and public realm. With the publication of the Position Statement, the Executive Committee of the World Psychiatric Association has made a major accomplishment that benefits psychiatry around the world.

Spiritual competence in psychiatry and psychotherapy-Barriers and success factors

HintergrundEbenso wie die World Psychiatric Association (WPA) und andere nationale psychiatrische Fachgesellschaften hat auch die Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde (DGPPN) ein Positionspapier zu Religiosität und Spiritualität (R/Sp) in Psychiatrie und Psychotherapie veröffentlicht, in dem sie Patientenzentrierung und spirituelle Kompetenz (SpK) der psychiatrischen Berufe fordert. Es ist bekannt, dass Kompetenzmangel das wichtigste Hindernis für die Implementierung von Spiritual Care (SpC) in die klinische Praxis darstellt.FragestellungZiel der vorliegenden Studie ist die praxisnahe Untersuchung der SpK in Psychiatrie und Psychotherapie. Wie schätzen psychiatrisch Tätige die SpK ihrer eigenen Berufsgruppe ein und welche Variablen beeinflussen dieses Urteil?Material und MethodenInsgesamt 391 psychiatrische Pflegekräfte, 75 Psychiater, 119 Therapeuten verschiedener Professionen und 62 andere (n = 647) aus Krankenhäusern in Deutschland und Österreich füllten den SpC Competency Questionnaire (SCCQ) aus.ErgebnissePflegekräfte, ältere und spirituell erfahrenere Personen schätzen die SpK der eigenen Berufsgruppe vergleichsweise höher ein und meinen seltener, diesbezüglich nicht zuständig zu sein. Pflegende nennen häufiger als andere Berufsgruppen das Fehlen geeigneter Räumlichkeiten als Hindernis für die Implementierung von SpC. Höhere Einschätzung der SpK der eigenen Berufsgruppe geht mit höheren Werten in den SCCQ-Faktoren „Selbsterfahrung und proaktive Öffnung“, „Team-Spirit“, „Wahrnehmungs‑/Dokumentationskompetenz“ einher.DiskussionDie Zuständigkeit der Gesundheitsberufe für SpC in Psychiatrie und Psychotherapie wird unter den deutschsprachigen psychiatrischen Berufsgruppen noch kontrovers diskutiert. Dies hängt mit mangelnder Kompetenz in diesem Feld zusammen.

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.

The free spirit: spiritualism meanings by a Nursing team on psychiatry.

To analyze the meanings attributed by nursing professionals in psychiatry to spirituality and its relationship with care. Clinical-qualitative, with appreciation of symbolic meanings. We interviewed 18 individuals for a semi-structured script of open questions and the data were analyzed in the light of psychoanalytic hermeneutics. The discussion was undertaken with the overlap of understanding of the sacred symbol, psychological and the meaning of life. Different spiritualities are interposed by personal restlessness and the experience of transience. Spirituality aids in social functions, personal balance and commitment to endure the anguish of transience. Among professionals, it has been shown as an ethical-combative attitude to evil forms, but there is a restriction in dealing with patients' spirituality. The meanings pointed to the limits of human reason, resembling caregivers and patients in subjective conditions by which they avoid spirituality in psychiatry. It is suggested that spiritual attention be given to professionals.

Psychiatry and religion: a perspective on meaning

ABSTRACTA Position Statement on Spirituality and Religion in Psychiatry was issued by the World Psychiatric Association in 2016. Among many recommendations, this statement underscores the need for research on both religion and spirituality in psychiatry, especially on their clinical applications. In this contribution we will put light on the issue of meaning and meaning-making, i.e., an important field for every human, Particularly for individuals suffering from severe mental disorders. After an introduction about meaning in its religious/spiritual dimension, we will describe what needs to be studied in order to get a better knowledge as to how patients cope with meaning, and how they process (in terms of meaning-making) the outburst of a severe mental disorder such as schizophrenia.

Role of Spirituality in Mental Health Practice

Most modern medical disciplines adopt biomedical and positivistic corners while viewing and interpreting various events and phenomena related to living and physical worlds. But in case of mental health the dimension is much complicated and full of abstract elements and relativism; all these areas can be expressed or enumerated what can be possible in other steams of physical and biological sciences. Factors like socio-cultural and human factors, spirituality and religiosity have some definite association with various aspects of mental health and illness. Spirituality in recent times has been entertained as a major factor in determining the course of mental health and illness; it drew the attention of mental health clinicians and researchers to find out its temporal relationship with mental illness and psychological wellbeing. Many authentic literatures came up with the view that positive spirituality does have some potentialities to enhance as well as protect the positive mental health and psychological well-being of the people. Spirituality can also lower the distress level and increase the positive coping ability of people. The aim of this article is to explore the role of spirituality in psychiatry in terms of evolution of psychopathology, understanding of the illness and finally, its role in treatment of the psychiatric settings. This article also aims to sensitize mental health clinicians to remain positive towards the religious and spiritual beliefs of patients and to use those things in the therapeutic process.
 Keywords: Spirituality, mental health, psychiatry, psychopathology

Does psychiatry need religion and spirituality in its treatment approach? Narcissism as an example.

BackgroundAlthough religion and spirituality are increasingly recognised as important in the understanding and treatment of patients, there are also concerns about their role in psychiatry. The recommendation for the integration of spirituality in the approach to psychiatric practice highlights the importance to further think about this practice.ObjectiveTo contribute to the debate on the role of spirituality in psychiatry by considering the opinions of two prominent thinkers in this field, the theologian Tillich, and the psychoanalyst Symington.MethodThe approach of Tillich and Symington to mental health problems are compared. Narcissism is focussed on, since Symington describes narcissism as the core of all pathology and states that the prime aim of psychoanalysis is the transformation of narcissism. The contributions of Kohut and Kernberg are also briefly discussed.ResultsIn Symington’s opinion more than psychoanalysis is needed to help those in the grip of narcissism. Tillich emphasises the difference between existential anxiety and anxiety due to psychopathology. Psychotherapy can only heal the latter. Yet he also states that we are incapable of change without self-acceptance. For this a larger experience of acceptance or grace is needed, since we are incapable of offering ourselves this type of acceptance.ConclusionIn the struggle to get a grip on narcissism, good nurturing experiences, transformative selfobjects, a confrontation with the darker sides of the self and the message of ultimate acceptance are needed. Religion and spirituality have an important contribution to make to psychiatric or psychotherapeutic treatment.

WPA Position Statement on Spirituality and Religion in Psychiatry

WPA Position Statement on Spirituality and Religion in Psychiatry

Learning About Spirituality Improves Competency

A “process” approach allowing residents to reflect on their own responses to the subject matter appears to be crucial.

Psychiatry Residents' Attitudes Toward Spirituality in Psychiatry

There is increasing recognition of the importance of addressing spirituality in psychiatry. Studies report that religiosity correlates with greater well-being and social support, and lower rates of depression, anxiety, and substance abuse (1). Leading authorities in psychiatric diagnosis and training have recognized these findings as reflected in diagnostic nosology and training standards. The Diagnostic and Statistical Manual of Mental Disorders, 4th Edition introduced a category for religious and spiritual problems (2). Spirituality is mentioned in the training requirements of the Royal College of Physicians and Surgeons of Canada (3) and the practice guidelines of the American Psychiatric Association (4). Studies suggest that training on spirituality improves residents’ attitudes (5), comfort levels, competency (6), and knowledge (7) in this area. Despite these findings, a survey of Canadian psychiatry residency programs showed that most did not offer any didactic teaching, and those that did offered no more than 4 hours (8). This study aimed to explore the attitudes, experiences, and comfort levels of psychiatry residents at McGill University regarding spirituality in psychiatry, and to examine residents’ interest and past learning experiences in this area. An IRB-approved anonymous, paper-based survey was distributed to the residents in the 201022011 academic year. The questionnaire items were generated based on the specific research questions of this study, and a literature review of previous related work. The questionnaire was further developed by consulting two psychiatrists involved in resident education and by having two medical students who had graduated complete it and provide feedback on clarity and length. Most questions were quantitative, providing response options on a Likert scale. Items were conceptually grouped into the following domains with respect to spirituality in psychiatry: self-reported attitudes, experiences in practice, influence on practice, comfort level, relation to CanMEDS (Canadian Medical Education Directives for Specialists) roles, and barriers to discussing spirituality in practice. For the latter two questions, residents were simply asked to select all the items deemed true for them. A few questions addressed demographics and personal spirituality, and two qualitative short-answer questions addressed learning in the area of spirituality and psychiatry. Quantitative data were analyzed, using SPSS GradPack 17 for Windows, to yield descriptive frequencies. Qualitative data were analyzed with a framework-analysis approach, a type of thematic analysis used in research that aims to provide outcomes or recommendations (9). After a general familiarization process, a framework of three themes was identified: knowledge, skills, and attitudes. Data were then coded under these headings by two researchers, and percentage agreement in coding was calculated to ensure reliability. The response rate was 64% (45/70) with 43% male and 57% female respondents. Residents identified as Christian (37%), Jewish (25.9%), Atheist (7.4%) and Muslim (3.7%), and 25.9% were categorized as “other, ”“ unknown,” or “none.” Many considered themselves spiritual-only (37%), whereas very few (5%) reported being religious-only. Many (37.5%) were neither spiritual nor religious, and 20% were both. Only 38.6% of residents had received training on spirituality, but 81.3% of those who did found it beneficial. Further quantitative results are summarized in Table 1. Qualitative data explored the impact of previous training in spirituality and psychiatry on residents and their learning interests for the future. In terms of knowledge, residents reported that training “introduced the topic” and “increased awareness” of the relationship between spirituality and mental health. An important attitudinal change was that residents reported an increase in “comfort approaching the topic” and in the “initiative to question” patients on it. Residents’ skills improved through “coaching on sensitive questioning,” and having the patients’ spiritual history made “more accessible.” Residents were interested in acquiring knowledge and skills that would help them in their “day-to-day care of patients.” They wanted to learn specifically about “different spiritual/religious affiliations/belief systems”, as well as gain a broader understanding of “their potential impact on mental health.” They were also eager to develop skills in taking a “spiritual history” and in integrating spirituality into their conceptualization of cases.

Competence of Medical Students and Residents in Psychiatry regarding Spirituality, at a South African School of Clinical Medicine

Elsewhere, curricula for undergraduate and postgraduate psychiatry have been extended to include the role of spirituality. It has also become important to establish how, within accepted professional boundaries, spirituality should be incorporated appropriately into the current model for South African practice and training. The objectives included exploring, analyzing, and describing the views and experience of local academic psychiatrists on this topic. This study was designed as an explorative, descriptive, phenomenological qualitative investigation. In-depth, semi-structured interviews were conducted with individual academic specialist psychiatrists as the primary data source. Data saturation was achieved after 13 interviews. "Training of spirituality in psychiatry" emerged as one of six main themes from the integrated interview and literature content. All participants proposed that spirituality must be included in undergraduate medical and specialist psychiatric training. They have suggested that a mentorship model should be considered, which implies the reorientation of the teachers of psychiatry in this regard. This view concurred with the international medical literature, recommending that spirituality has to be incorporated into specialist psychiatric practice and training, but within professional boundaries and with all faith traditions and belief systems considered equally.

Religion and Spirituality in Psychiatry

Religion and Spirituality in Psychiatry

Religion and spirituality in psychiatry

Religion and spirituality in psychiatry

P02-273 - Religion in psychiatry? The pilot study in Freiburg, Germany: the meaning of religion / spirituality in psychiatry from staff's perspective

ObjectivesIn the context of a growing body of international research though not in German-speaking countries, this study examines1)the extent of spirituality of staff in a psychiatric hospital,2)their relationship to staff's attitudes towards religion / spirituality (ReS) of patients3)and the integration of religious and spiritual contents to the patient's therapy.MethodsAn anonymous survey distributed to the staff in the department of psychiatry and psychotherapy of the Freiburg university hospital in 2009. Main predictor variable was the extent of spirituality using DRI. Main criterion variables were the relevance of ReS of patients and staff's attitudes towards ReS during their therapies using the questionnaire of Curlin et al.(2007).ResultsThe response rate was 44.16% (n=197). The extent of spirituality of staff is 6.89 on a scale of 12.0. Although there is no significant relationship between the extent of spirituality and staff's attitudes towards ReS as well as their integration of religious and spiritual contents to therapies, staff regard the influence of ReS generally positive to patients. 95.4% endorse ReS as coping strategy. However staff do not integrate religious and spiritual practices in their therapies. The most frequent reasons are insufficient time/occasion, insufficient knowledge and concern about offending patients.ConclusionsReligious and spiritual contents have not been integrated yet in psychiatric therapy methods, although they are regarded as important for patients. Further studies and discussion about religious and spiritual matters are essential for their integration into psychiatric therapies to overcome these problems for patients and staff.

Integrated Perspectives

This column discusses the concepts of an integrated psychotherapeutic approach to patient care and explores some of the underlying principles that make it beneficial. Using the terms spirituality and psychotherapy in the same sentence may seem strange because there has been a long history of mutual skepticism, if not antagonism, between the two. In the past, mental health professionals and ministers have seen science and religion as separate, and attempts to connect them have been dismissed as disruptive and unhealthy (Fallot, 2001). We only need to go back to Freud (1927/1964) to see how this attitude of separateness and disconnection has been perpetuated. He characterized religion as an illusion, and connected it with pathology such as obsessive compulsive behavior. This attitude fostered the view that spirituality was irrelevant at best and indicative of pathological thinking at worst, encouraging many therapists to avoid the topic altogether. In sessions, then, any discussion of experiences was often viewed as regressive and dysfunctional (Fallot). Over the years, however, there have been attempts by noted therapists such as Jung and others to integrate these two aspects of spirituality and psychotherapy. In the last 20 years, a growing number of voices have joined in the discussion (Fallot, 2001). Many therapists now are beginning to consider the healing opportunities available when incorporating a more holistic view of mind, body, and spirit. Even the American Psychiatric Association (APA) has begun to consider the of religion and spirituality in psychiatry. For example, the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) (APA, 1994) includes a category, religious and spiritual which, while it focuses on problems, separates spiritual issues from psychological problems for the first time. In addition, a model curriculum is being presented to the APA to help train psychiatric residents in issues (Fallot). These moves signal a shift in thinking by the psychiatric community away from separation toward integration, as therapists begin to speak of the major role spirituality and religion can play in our modern world (Lukoff, 2000). Such a dramatic shift in thinking is easy to understand when looking at the growing sense of isolation and alienation present in the patient population, which the psychiatric community can no longer ignore. With families eroding and communities no longer available to provide support, there is a growing sense of confusion and conflict about values, standards, and priorities (Aponte, 1996). People who come into therapy today are looking for something more. As Nicholas (1994) states, Patients not only are coming into therapy with confusion about their own individual morality but are seeking to compensate for the lack of reliable and humane guideposts that are available in society as a whole (p. 5). In this atmosphere, therapists are looked to for support as clients struggle with a loss of meaning and a sense of emptiness. A therapist who focuses on traditional therapies can provide only transitory relief for the emptiness and is limited because the process speaks primarily to individual pathology rather than the wider aspect of humankind (Karasu, 1999). Practicing psychotherapy with a wider inclusion of spiritual issues involves a willingness to explore one's own attitudes and beliefs. This may be a difficult task for therapists who may feel unprepared both educationally and experientially. Studies have shown that mental health professionals tend not to be involved in practices and beliefs, seeing them as a small part of their life (Lukoff, Lu, & Turner, 1992; Shafranske, 1996). They may see themselves as spiritual but not (Fallot, 2001). This difference in self-image may make it difficult for therapists to explore traditions with their clients or to see the value of doing so. …

Notes on a few issues in the philosophy of psychiatry.

The first part called the Preamble tackles: (a) the issues of silence and speech, and life and disease; (b) whether we need to know some or all of the truth, and how are exact science and philosophical reason related; (c) the phenomenon of Why, How, and What; (d) how are mind and brain related; (e) what is robust eclecticism, empirical/scientific enquiry, replicability/refutability, and the role of diagnosis and medical model in psychiatry; (f) bioethics and the four principles of beneficence, non-malfeasance, autonomy, and justice; (g) the four concepts of disease, illness, sickness, and disorder; how confusion is confounded by these concepts but clarity is imperative if we want to make sense out of them; and how psychiatry is an interim medical discipline.The second part called The Issues deals with: (a) the concepts of nature and nurture; the biological and the psychosocial; and psychiatric disease and brain pathophysiology; (b) biology, Freud and the reinvention of psychiatry; (c) critics of psychiatry, mind-body problem and paradigm shifts in psychiatry; (d) the biological, the psychoanalytic, the psychosocial and the cognitive; (e) the issues of clarity, reductionism, and integration; (f) what are the fool-proof criteria, which are false leads, and what is the need for questioning assumptions in psychiatry.The third part is called Psychiatric Disorder, Psychiatric Ethics, and Psychiatry Connected Disciplines. It includes topics like (a) psychiatric disorder, mental health, and mental phenomena; (b) issues in psychiatric ethics; (c) social psychiatry, liaison psychiatry, psychosomatic medicine, forensic psychiatry, and neuropsychiatry.The fourth part is called Antipsychiatry, Blunting Creativity, etc. It includes topics like (a) antipsychiatry revisited; (b) basic arguments of antipsychiatry, Szasz, etc.; (c) psychiatric classification and value judgment; (d) conformity, labeling, and blunting creativity.The fifth part is called The Role of Philosophy, Religion, and Spirituality in Psychiatry. It includes topics like (a) relevance of philosophy to psychiatry; (b) psychiatry, religion, spirituality, and culture; (c) ancient Indian concepts and contemporary psychiatry; (d) Indian holism and Western reductionism; (e) science, humanism, and the nomothetic-idiographic orientation.The last part, called Final Goal, talks of the need for a grand unified theory.The whole discussion is put in the form of refutable points.

What is Spirituality?

<P>Welcome to March and the stirrings of Spring, the rebirth of hope and the time of renewal. This month’s issue of <cite>Psychiatric Annals</cite>, guest edited by Len Sperry, MD, has spirituality in psychiatry as its focus.</P>

Religion, spirituality and psychiatry: conceptual, cultural and personal challenges.

Recent psychiatric literature and contemporary sociopolitical developments suggest a need to reconsider the place of religion and spirituality in psychiatry. This paper was written with the aim of encouraging dialogue between the often antithetical realms of religion and science. Material from psychiatric, sociological and religious studies literature was reviewed, with particular emphasis on New Zealand sources. Despite the secularising effects of science, the presence and influence of 'religiosity' remains substantial in Western culture. The literature emphasises the central importance of religion and spirituality for mental health, and the difficulty of integrating these concepts with scientific medicine. Psychiatric tradition and training may exaggerate the 'religiosity gap between doctors and patients. In New Zealand, the politically mandated bicultural approach to mental health demands an understanding of Maori spirituality. Intellectual, moral and pragmatic arguments all suggest that psychiatry should reconsider its attitude to religion and spirituality. There are many opportunities for research in the field. Psychiatry would benefit if the vocabulary and concepts of religion and spirituality were more familiar to trainees and practitioners. Patients would find better understanding from psychiatrists, and fruitful interdisciplinary dialogue about mutual issues of 'ultimate concern' might ensue.