Functional disability and death wishes in older Europeans: results from the EURODEP concerted action

Functional disability was independently associated with death wishes in older adults. Results can help inform clinicians who care for older persons with functional impairment.</p

Spiritual belief, social support, physical functioning and depression among older people in Bulgaria and Romania

Objectives: An exploratory investigation is reported into the role of spirituality and religious practice in protecting against depression among older people living in rural villages in Bulgaria and Romania, two neighbouring countries with similar cultural, political and religious histories, but with differing levels of current religiosity. Methods: In both countries, interviews were conducted with samples of 160 persons of 60 years and over in villages of similar socio-economic status. The Hospital Anxiety and Depression-D scale and the Royal Free Interview for Religious and Spiritual Beliefs were used to assess depression and spiritual belief and practice respectively. In addition social support, physical functioning and the presence of chronic diseases were assessed. One year later, follow-up interviews were conducted with 58 of the original sample in Bulgaria, in which additional measures of depression and of spiritual belief and practice were also included. Results: The study demonstrates, as expected, significantly lower levels of spiritual belief in the Bulgarian sample (Bulgarian mean 29.7 (SD = 19.1), Romanian mean 47.6 (SD = 11.2), t = 10.2, p &lt; 0.001), as well as significantly higher levels of depression (Bulgarian mean 12.0 (SD = 4.9), Romanian mean 7.3 (SD = 4.1), t = 9.3, p &lt; 0.001), the latter attributable in large part to higher morbidity and disability rates, but less evidently to differences in strength of belief. However, analyses from both the cross-sectional study and the one-year follow-up of the Bulgarian sample do suggest that spiritual belief and practice may both influence and reflect physical and mental illness. Conclusions: Much of Eastern Europe displays high rates of depression among its older population and provides opportunities for investigation of the role of religious belief and practice in preventing and coping with depression. Further research is encouraged in populations of diverse religiosity

De beoordeling van vignetten van psychiatrische problematiek met religieuze inhoud door GGZ-medewerkers.

Objective The aim of the study was to gain insight into how mental health professionals (MHPs) assess psychiatric and psychological problems with religious content. Method MHPs (social psychiatric nurses, psychologists, trainee psychiatrists and psychiatrists evaluated four vignettes: a psychotic state, a religious experience, a mourning reaction and a psychotic depressive state. The participants evaluated the religious etiology, helpfulness of psychiatric medication, the severity of the presenting problems and the recommendation of mental health care assistance. Results The trainee psychiatrists (TPs) and social psychiatric nurses (SPNs) view the psychosis vignette more as a religious or spiritual problem compared to the psychiatrists and psychologists. The non-medical professionals more frequently consider the melancholia vignette a religious or spiritual problem, which differs significantly from the response of the medical professionals. The medical professionals considered medication more useful, and mental health care more desirable in the case of the melancholia vignette, statistically significantly different compared to the non-medical professionals. Conclusions In this article the results are presented of a study conducted among MHPs and based on vignettes of psychiatric problems

Religiositeit en stemming in de laatste levensweek Een exploratieve benadering aan de hand van nabestaandeninterviews

In de huidige bijdrage wordt onderzocht wat de rol is van religiositeit voor de stemming in de laatste levensweek. Aan de hand van interviews bij nabestaanden van 270 overleden respondenten van de Longitudinal Aging Study Amsterdam zijn gegevens verkregen over depressieve stemming en angst in de laatste levensweek, alsook over vrede met het naderend levenseinde. Verder maakten de nabestaanden inschattingen over ernstige lichamelijke verschijnselen, cognitieve achteruitgang, het belang van geloof voor de respondent, en of deze over geloof had gesproken. Uit eerdere interviews met de respondenten zelf zijn gegevens verkregen over eerdere depressieve symptomen, kerkelijke gezindte, kerkbezoek, orthodoxie, belang van geloof, en kosmische transcendentie. Kenmerken van religiositeit hingen niet samen met depressieve stemming of angst (zoals ingeschat door de nabestaanden), maar wel met vrede met het naderend levenseinde. Meer vrede werd gevonden bij respondenten die vroeger geregeld de kerk bezochten, protestanten (in vergelijking met onkerkelijken), en degenen voor wie werd ingeschat dat het geloof belangrijk was. Religiositeit heeft geen aanwijsbare invloed op depressieve stemming of angst in de laatste levensweek. Mogelijk werkt religiositeit wel steunend voor een meer existentieel facet van de stemming, namelijk het vrede hebben met het naderend levenseinde, een gegeven dat in de literatuur over palliatieve zorg met regelmaat terugkeert

Recognition of psychopathology with religious content by clergy members: a case vignette study

Clergy members (CMs) frequently offer support and counselling for people with mental health problems. The current study aims to obtain insight into the ability among CMs to recognise psychopathology and need for psychiatric treatment. A random sample of CMs (N ¼ 143) and a control sample of mental health professionals (MHPs, N ¼ 73), were compared as to their evaluations of four vignettes. CMs considered the psychiatric states to be related to religious or spiritual problems to a similar degree as they did for the non-psychiatric states. Sensitivity of CMs with regard to the need of psychiatric care for the psychiatric states was modest (66%) and differed significantly from MHPs (96%). Specificity of the CMs was 89%, which was significantly lower than the MHPs (97%). The CMs did recognise psychopathology with religious content but clearly to a lower extent than MHPs. Requests by CMs for education about recognising psychopathology may be considered as justified