Depression in the Medically Ill: Evidence for the Important Role of Chaplains in Medical Settings
Issue: Vol 1 No. 2 (2013)
Journal: Health and Social Care Chaplaincy
Subject Areas: Healthcare Communication
Health professionals often underestimate the power that religious faith plays in the healing of the whole person (emotional, social, and psychological), especially when that person becomes physically ill. This article examines the role of religion in coping with stress and medical illness, reviews new research on the relationship between religious involvement and mental health, and explores how religious psychotherapy can speed the treatment of depression and other emotional conditions. A growing research base is now beginning to document the wide prevalence of spiritual and religious needs of patients in health care settings, the importance that addressing those needs plays in the patient’s mental and physical health, and the key role that chaplains play in this regard (as the only health professionals who are trained to address these areas). That research base includes studies from the United Kingdom. We are now developing and testing new psychotherapeutic methods at Duke University for therapists, including chaplains, that will provide tools to address the emotional and religious needs of Christian, Muslim, Buddhist, Jewish, and Hindu patients with medical illness.
Author: Harold G. Koenig, Faten N. Al Zaben
Azhar, M. Z., and S. L. Varma (1995a) “Religious Psychotherapy as Management of Bereavement”. Acta Psychiatrica Scandinavica 91: 233–35. http://dx.doi.org/10.1111/j.1600-0447.1995.tb09774.x
—(1995b) “Religious Psychotherapy in Depressive Patients”. Psychotherapy & Psychosomatics 63: 165–73. http://dx.doi.org/10.1159/000288954
Azhar, M. Z., S. L. Varma and A. S. Dharap (1994) “Religious Psychotherapy in Anxiety Disorder Patients”. Acta Psychiatrica Scandinavica 90: 1–3. http://dx.doi.org/10.1111/j.1600-0447.1994.tb01545.x
Balboni, T., M. Balboni, M. E. Paulk, A. Phelps, A. Wright, J. Peteet, S. Block, C. Lathan, T. VanderWeele and H. Prigerson (2011) “Support of Cancer Patients’ Spiritual Needs and Associations with Medical Care Costs at the End of Life”. Cancer 117(23): 5383–391. http://dx.doi.org/10.1002/cncr.26221
Beck, A. T., J. Rush, B. F. Shaw and G. Emery (1979) Cognitive Therapy of Depression. New York: Guilford Press.
Borowasky, S. J., L. V. Rubenstein, L. S. Meredith, P. Camp, M. Jackson-Triche and K. B. Wells (2000) “Who Is At Risk of Nondetection of Mental Health Problems in Primary Care?” Journal of General Internal Medicine 15: 381–88. http://dx.doi.org/10.1046/j.1525-1497.2000.12088.x
Bostwick, J. M., and V. S. Pankratz (2000) “Affective Disorders and Suicide Risk: A Re-examination”. American Journal of Psychiatry 157: 1925–932. http://dx.doi.org/10.1176/appi.ajp.157.12.1925
Evans, D. L., T. R. Ten Have, S. D. Douglas et al. (2002) “Association of Depression with Viral Load, CD8 T Lymphocytes, and Natural Killer Cells in Women with HIV Infection”. American Journal of Psychiatry 159: 1752–759. http://dx.doi.org/10.1176/appi.ajp.159.10.1752
Frodl, T. S., N. Koutsouleris, R. Bottlender, C. Born, M. Jager, I. Scupin, M. Reiser, H. J. Moller and E. M. Meisenzahl (2008) “Depression-related Variation in Brain Morphology Over 3 Years”. Archives of General Psychiatry 65(10): 1156–165. http://dx.doi.org/10.1001/archpsyc.65.10.1156
Gehi, A., D. Haas, S. Pipkin and M. A. Whooley (2005) “Depression and Medication Adherence in Outpatients with Coronary Heart Disease: Findings From the Heart and Soul Study”. Archives of Internal Medicine 165: 2508–513. http://dx.doi.org/10.1001/archinte.165.21.2508
Kessler, R. C., O. Demler, R. G. Frank, M. Olfson, H. A. Pincus, E. E. Walters, P. Wang, K. B. Wells and A. M. Zaslavsky (2005) “Prevalence and Treatment of Mental Disorders, 1990–2003”. New England Journal of Medicine 352: 2515–523. http://dx.doi.org/10.1056/NEJMsa043266
Koenig, H. G. (1998) “Religious Beliefs and Practices of Hospitalized Medically Ill Older Adults”. International Journal of Geriatric Psychiatry 13: 213–24. http://dx.doi.org/10.1002/(SICI)1099-1166(199804)13:4<213::AID-GPS755>3.0.CO;2-5
—(2007) “Religion and Remission of Depression in Medical Inpatients with Heart Failure/Pulmonary Disease”. Journal of Nervous and Mental Disease 195: 389–95.
—(2012) “Religious vs. Conventional Psychotherapy for Major Depression in Patients with Chronic Medical Illness: Rationale, Methods, and Preliminary Results”. Depression Research and Treatment. Article ID 460419.
Koenig, H. G., D. B. Larson and S. S. Larson (2001) “Religion and Coping with Serious Medical Illness”. Annals of Pharmacotherapy 35: 352–59. http://dx.doi.org/10.1345/aph.10215
Koenig, H. G., D. E. King and V. B. Carson (2012) “Depression”. In Handbook of Religion and Health, 145–73. New York: Oxford University Press, 2nd edn.
Koenig, H. G., F. Shelp, V. Goli, H. J. Cohen and D. G. Blazer (1989) “Survival and Healthcare Utilization in Elderly Medical Inpatients with Major Depression”. Journal of the American Geriatrics Society 37: 599–606.
Koenig, H. G., L. K. George, B. L. Peterson and C. F. Pieper (1997) “Depression in Medically Ill Hospitalized Older Adults: Prevalence, Correlates, and Course of Symptoms Based on Six Diagnostic Schemes”. American Journal of Psychiatry 154: 1376–383.
Lavender, H., A. H. Khondoker and R. Jones (2006) “Understandings of Depression: an Interview Study of Yoruba, Bangladeshi and White British People”. Family Practice 23(6): 651–58. http://dx.doi.org/10.1093/fampra/cml043
Loewenthal, K. M., M. Cinnirella, G. Evdoka and P. Murphy (2001) “Faith Conquers All? Beliefs About the Role of Religious Factors in Coping with Depression Among Different Cultural-religious Groups in the UK”. British Journal of Medical Psychology 74: 293–303. http://dx.doi.org/10.1348/000711201160993
Lutgendorf, S. K., D. M. Lamkin, K. DeGeest, B. Anderson, M. Dao, S. McGinn, et al. (2008) “Depressed and Anxious Mood and T-cell Cytokine Expressing Populations in Ovarian Cancer Patients”. Brain, Behavior, & Immunity 22(6): 890–900. http://dx.doi.org/10.1016/j.bbi.2007.12.012
Lutgendorf, S. K., K. DeGeest, C. Y. Sung, J. M. Arevalo, F. Penedo and J. Lucci 3rd (2009) “Depression, Social Support, and Beta-adrenergic Transcription Control in Human Ovarian Cancer”. Brain, Behavior, & Immunity 23(2): 176–83. http://dx.doi.org/10.1016/j.bbi.2008.04.155
McIllmurray, M. B., B. Francis, J. C. Harman, S. M. Morris, K. Soothill and C. Thomas (2003) “Psychosocial Needs in Cancer Patients Related to Religious Belief”. Palliative Medicine 17(1): 49–54. http://dx.doi.org/10.1191/0269216303pm660oa
Pearce, M. J., and H. G. Koenig (2012) “Cognitive Behavioral Therapy for the Treatment of Depression in Christian Patients with Medical Illness”. Mental Health, Religion and Culture (August 28) [E-pub ahead of print].
Pew Research Center (2012) The Global Religious Landscape: A Report On the Size and Distribution of the World’s Major Religious Groups As of 2010 (United Kingdom). See website: http://www.pewforum.org/global-religious-landscape.aspx (accessed 13/06/13).
Propst, L. R. (1980) “The Comparative Efficacy of Religious and Nonreligious Imagery for the Treatment of Mild Depression in Religious Individuals”. Cognitive Therapy and Research 4: 167–78. http://dx.doi.org/10.1007/BF01173648
Propst, L. R., R. Ostrom, P. Watkins, T. Dean and D. Mashburn (1992) “Comparative Efficacy of Religious and Nonreligious Cognitive-behavior Therapy for The Treatment of Clinical Depression in Religious Individuals”. Journal of Consulting and Clinical Psychology 60: 94–103. http://dx.doi.org/10.1037/0022-006X.60.1.94
Razali, S. M., C. I. Hasanah, K. Aminah and M. Subramaniam (1998) “Religious – Sociocultural Psychotherapy in Patients with Anxiety and Depression”. Australian & New Zealand Journal of Psychiatry 32: 867–72. http://dx.doi.org/10.3109/00048679809073877
Rosemann, T., M. Backenstrass, K. Joest, A. Rosemann, J. Szecsenyi and G. Laux (2007) “Predictors of Depression in a Sample of 1,021 Primary Care Patients with Osteoarthritis”. Arthritis & Rheumatism 57(3): 415–22. http://dx.doi.org/10.1002/art.22624
Rosmarin, D. H., K. I. Pargament, S. Pirutinsky and A. Mahoney (2010) “A Randomized Controlled Evaluation of a Spiritually Integrated Treatment for Subclinical Anxiety in the Jewish Community”, Delivered via the Internet. Journal of Anxiety Disorders 24: 799–808. http://dx.doi.org/10.1016/j.janxdis.2010.05.014
Scobie, G., and C. Caddell (2005) “Quality of Life at End of Life: Spirituality and Coping Mechanisms in Terminally Ill Patients”. Internet Journal of Pain, Symptom Control & Palliative Care 4(1). See website: http://ispub.com/IJPSP/4/1/6121 (accessed 13/06/13).
Sodergren, S. C., M. E. Hyland, A. Crawford and M. R. Partridge (2004) “Positivity in Illness: Self-delusion or Existential Growth?” British Journal of Health Psychology 9(2): 163–74. http://dx.doi.org/10.1348/135910704773891023
Stanley, M. A., A. L. Bush, M. E. Camp, J. P. Jameson, L. L. Phillips, C. R. Barber, D. Zeno, J. W. Lomax and J. A. Cully (2011) “Older Adults’ Preferences For Religion/Spirituality in Treatment of Anxiety and Depression”. Aging and Mental Health 15: 334–43. http://dx.doi.org/10.1080/13607863.2010.519326
Thaker, P. H., S. K. Lutgendorf and A. K. Sood (2007) “The Neuroendocrine Impact of Chronic Stress on Cancer”. Cell Cycle 6: 430–33. http://dx.doi.org/10.4161/cc.6.4.3829
Voas, D. (2006) “Religious Decline in Scotland: New Evidence on Timing and Spatial Patterns”. Journal for the Scientific Study of Religion 45: 107–18. http://dx.doi.org/10.1111/j.1468-5906.2006.00009.x
Walsh, K., M. B. King, L. Jones, A. Tookman and R. Blizard (2002) “Spiritual Beliefs May Affect Outcome of Bereavement: Prospective Study”. British Medical Journal 324(7353): 1551. http://dx.doi.org/10.1136/bmj.324.7353.1551
World Health Organization (2006) Preventing Suicide: A Resource for Counselors. Department of Mental Health and Substance Abuse: World Health Organization, Geneva.
World Values Survey (2006) Great Britain. See: http://www.wvsevsdb.com/wvs/WVSAnalize.jsp (accessed 13/06/13).
Worth, A., T. Irshad, R. Bhopal, D. Brown, J. Lawton, E. Grant, S. Murray, M. Kendall, J. Adam, R. Gardee and A. Sheikh (2009) “Vulnerability and Access to Care for South Asian Sikh and Muslim Patients with Life Limiting Illness in Scotland: Prospective Longitudinal Qualitative Study”. British Medical Journal 338: b183. http://dx.doi.org/10.1136/bmj.b183
Wulsin, L. R., G. E. Vailant and V. E. Wells (1999) “A Systematic Review of The Mortality of Depression”. Psychosomatic Medicine 61: 6–17. http://dx.doi.org/10.1097/00006842-199901000-00003
Zautra, A. J., D. C. Yocum, I. Villanueva et al. (2004) “Immune Activation and Depression in Women with Rheumatoid Arthritis”. Journal of Rheumatology 31: 457–63.