Key words: Religious Attitude Depression College students. INTRODUCTION ... groups as everything from evil sorcerers to conduits of between 5 and 12% of ...
World Applied Sciences Journal 22 (10): 1449-1452, 2013 ISSN 1818-4952 © IDOSI Publications, 2013 DOI: 10.5829/idosi.wasj.2013.22.10.461
Relation Between Religious Attitude and Depression Among Medical Students 1
Ali Sahraian, 2Arash Mani, 3Vala Rezaee, 4Ali javadpour and 5Amir Ashkan Mahjoor Research Centre for Psychiatry and Behavioral Sciences, Shiraz University of Medical Sciences, Shiraz, Iran 3 Shiraz University of Medical Sciences, Shiraz, Iran 5 Islamic Azad university, Zahedshar brnach, Zahedshar, Iran 1,2,4
Abstract: Background: religious attitudes and behaviors have significant effects on life meaning. Behaviors such as praying may relax the person via hope. Secure relation to GOD and having goals and meanings in life may be a supportive way in problematic life events, so religious people can handle life stress more effective than others. The aim of current study was to explore the association between religious attitude and depressive symptoms among undergraduate medical students. Methods: This descriptive-analytical, cross-sectional research was carried out to evaluate the relation between religious attitudes and depression among 750 students of Shiraz University of Medical Science who were selected by stratified sampling method and completed Ghubari religious attitude scale and Beck depression index. Results: descriptive analyses showed that the mean of depression and religious attitude were 9.03 and 107.59 respectively. Female participants had significant higher religious attitude than male. Co relational analyses revealed a significant negative correlation between depression and religious attitude among sample (r= - 0.157). Conclusion: religious attitude could be a protective factor against depression. Applied programs are recommended to reinforce the religious beliefs and convictions among the students. Key words: Religious
Attitude
Depression
College students
INTRODUCTION The relationship between religion and health care has cycled between cooperation and antagonism throughout history. Among this paradigm psychology of religion is the discipline that studies religion and religious phenomena using psychological theories, concepts and methods. Some of the most advanced ancient civilizations (Assyrian, Chinese, Egyptian, Mesopotamian and Persian) equated physical illnesses with evil spirits and demonic possessions and treatment was aimed at banishing these spirits. Since then, physicians and other health-care providers have been viewed by religious groups as everything from evil sorcerers to conduits of God’s healing powers. Similarly, physicians’, scientists’ and health-care providers’ views of religion have ranged from interest to disinterest to disdain [1]. Despite this controversy, there are many signs that the role of religion in health care is increasing.
For instance, the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, recognizes religion and spirituality as relevant sources of either emotional distress or support [2-4]. Also, the guidelines of the Joint Commission on Accreditation of Healthcare Organizations require hospitals to meet the spiritual needs of patients [5]. The literature reflects this trend as well. The frequency of studies on religion and spirituality and health has increased over the past decade [6]. Depression is one of the most common mental disorders. Within their lifetime, between 10 and 25% of women and 5-12% of men will meet the criteria for major depressive disorder; while at any given point in time between 5 and 12% of women and 2–3% of men meet the criteria for major depressive disorder [7]. Depression is expensive both financially and in terms of human life. It appears that medical care for depression is on the rise [8]. Review evidence indicating that visits to physicians for depression increased from 11 million in
Correspondign Author: Amir Ashkan Mahjoor, Islamic Azad University, Kazeroon Branch, Kazeroon, Iran. Tel: +98-9173150962.
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1985 to 20.4 million in 1993-1994 and visits that included treatment with an antidepressant medication increased from 5.3 million to 12.4 million in the same time frame. In addition, people with major depression have a substantially increased risk for use of hospital and medical services, suicide attempts and early death [9]. Koenig and colleagues found that among 87 clinically depressed elder adults who were followed for one year beyond the onset of depression; intrinsic religiosity was directly proportional to the speed in which their depressive episodes abated. This association appeared to be stronger amongst those subjects whose physical disabilities did not improve over the follow-up period [10]. Several recent studies have pointed out that certain aspects of religiousness (public religious involvement, intrinsic religious motivation) are inversely related to the incidence of depressive symptoms [11, 12] Bram et al., (2001) found public religious involvement (church attendance) was inversely related to rates of depression amongst elderly individuals from several European countries. Depression rates were lower among regular church attendees, most prominently among Roman Catholics. In a study of clinically depressed adults [11]. Murphy et al., 2000 found that the incidence of depressive symptoms was inversely correlated with religious beliefs after controlling for age, race, marital status, gender and educational level. In a representational longitudinal study of 2,836 adults from the general population [1]. Schnittker (2001) examined the relation between religious involvement and the frequency of symptoms of depression and found a curvilinear relationship [13]. Although religious attendance was found to have little relationship with symptoms of depression, once demographic and physical health variables were controlled, there was a significant correlation between religious ‘salience’ and symptoms of depression. Individuals who did not consider themselves as religious and individuals who saw themselves as extremely religious had more frequent symptoms of depression than those who considered themselves moderately religious. It should be considered that religion is a variable that is not commonly discussed in standard epidemiological conceptualizations of depression. Several RCTs(Randomized clinical traials) have been performed. A study demonstrated that directed and nondirected intercessory prayer correlated favorably with multiple measures of self-esteem, anxiety and depression
but did not clearly state the randomization technique and did not account for multiple confounders [14]. Another study suggested that using religion-based cognitive therapy had a favorable impact on Christian patients with clinical depression but may have contained too many comparison groups for strong cause-and-effect relationships to be established [15]. Three RCTs suggested that religious (Islamic-based) psychotherapy appeared to speed recovery from anxiety and depression in Muslim Malays but did not control for the use of antidepressants and benzodiazepines [16-18]. For nearly half a century, stress in medical training has been a topic of concern. Trainees’ stress during medical school and residency training has been well documented in the literature. Common stressors include heavy workload, sleep deprivation, difficult patients, poor learning environments, financial concerns, information overload and career planning. These stressors often exert negative effects on students’ and residents’ academic performance, physical health and psychological well-being, making them more susceptible to depression [19]. So it is concluded that depression is pervasive mental disorder among medical student, besides they should equipped with coping strategy, one of the best of them are religious activity which can support the person and decrease depressive symptom. Accordingly; the goal of the present study is to evaluate the relationship between religious attitude and depressive symptom among Shiraz University of Medical Sciences. MATERIALS AND METHODS Sample: The sample for the present research consisted of 750 of SUMS student who were selected according to stratified random sampling from eight different colleges. The respondents were between 19 and 28 years of age with the mean of 21.17. Sixty three percent were women. All of the respondents who were affiliated Muslim. Respondents were obtained from a number of universities class in the south of Iran. Tools: Ghobari’s Religious Attitude Scale (GRAS) which is prepared in Persian language and after that the validity and reliability were checked respectively; responses to items are scored on a 5-point Likert-type scale: Strongly Disagree (0) to Strongly Agree (5)). High scores on the scale indicates favorable attitude and low scores unfavorable attitude.)
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World Appl. Sci. J., 22 (10): 1449-1452, 2013 Table 1: Comparison of GRAS and BDI among male and female subjects
P
Female ----------------------------------------------Std. Deviation Mean N
Male -----------------------------------------------Std. Deviation Mean N
Total ---------------------------------------------Std. Deviation Mcean N
Variables
0.01 0.01
24.57 8.4
28.70 9.8
26.87 8.93
GRAS BDI
112.48 8.53
474 474
99.17 9.97
Beck Depression Scale I (BDI) which had been translated to Persian language and has well psychometric characteristics was used to evaluate depression symptom among the subjects). High scores on the scale indicate more symptom and low scores less symptom.) RESULTS AND DISCUSSION According to our results; the correlation coefficients obtained between Religious attitude and BDI were found to be significant, in other words when the religious attitude and activity increased, the depression symptom decreased. In the case of females religious attitude were significantly higher than male; besides depressive symptom in male is significantly higher than female (Table 1). This study highlights the importance of continual assessment of the mental health of medical students. Access to mental health care deserves further consideration. Students are concerned that treatment for depression could jeopardize their career. The study influence on the fact that religious factors might protect against the influence of negative life events suggests a possible need to incorporate religious perspectives into mental health care and for psychiatrists to include a brief religious assessment as part of their everyday working practices. At the least, mental health professionals should inquire about religious or spiritual faith and the role it plays in a person’s life and whether they have appealed to their religious beliefs and practices as a mode of coping with current stressors. In terms of religious therapies, there is emerging evidence that religious or spiritual activities may lead to a reduction in the frequency of depressive symptomatology and that religiously accommodative psychotherapy is as effective as secular therapy for the treatment of depression among those who are religious and may be more highly valued by them, which was highlighted via the result of this study that person who has high level of Islamic religious attitude has lower level of depress mood. The findings of the present study are in agreement with several studies
275 271
107.59 9.03
725 750
done earlier, where persons with high religiosity were found to be happier than persons with lower levels of religiosity [20]. In general, clinical studies are fraught with challenges. Designing ones that are able to establish cause-and-effect relationships is difficult. This is especially true in the study of religion and health, where confounding factors abound. However, there is evidence that something about religion can provide health benefits. Religion brings many things including social and emotional support, motivation and health-care resources and it promotes healthy lifestyles. Moreover religion is clearly important to many students and their religious concerns could be better addressed in the health-care setting. Health-care providers should be aware of how religious involvement can affect symptoms, quality of life and patients’ willingness to receive treatment. Religious and spiritual activities may serve as adjunct therapy in various disease and addiction treatment programs. In the future, additional specific spiritual interventions may prove beneficial. REFERENCES 1.
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14. O’Laoire, S., 1997. An Experimental Study of the Effects of Distant, Intercessory Prayer on SelfEsteem, Anxiety and Depression. Alternative Therapies in Health and Medicine, 3(6): 38-53. 15. Propst, L.R., R. Ostrom, P. Watkins, T. Dean and D. Mashburn, 1992. Comparative Efficacy of Religious and Nonreligious Cognitive-Behavioral Therapy for the Treatment of Clinical Depression in Religious Individuals.” Journal of Consulting and Clinical Psychology, 60: 94-103. 16. Azhar, M.Z. and S.L. Varma, 1995. Religious Psychotherapy in Depressive Patients. Psychotherapy and Psychosomatics, 63: 165-168. 17. Azhar, M.Z., S.L. Varma and A.S. Dharap, 1994. Religious Psychotherapy in Anxiety Disorder Patients. Acta Psychiatry Scandinavia, 90: 1-3. 18. Razali, S.M., C.I. Hasanah, K. Aminah and M. Subramaniam, 1998. Religious-Sociocultural Psychotherapy in Patients with Anxiety and Depression. Australian and NewZealand Journal of Psychiatry, 32: 862-867. 19. Goebert, D., D. Thompson, J. Takeshita, C. Beach, et al., 2009. Depressive symptoms in Medical Students and Residents: A Multischool Study. Academic Medicine, 84(2): 236-241. 20. Abdel-Khalek, A.M., 2006. Happiness, health and religiosity: Significant relations. Mental Health, Religion and Culture, 9(1): 85-97.
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