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Spirituality, Religion, and Depression in the Terminally Ill

Received July 2, 2001; revised November 27, 2001; accepted December 7, 2001. From the Department of Psychology, Long Island University, Brooklyn, New York; Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, Department of Psychology, Fordham University, Bronx, New York. Address for correspondence and reprints: Dr. Barry Rosenfeld, Department of Psychology, Fordham University, 441 East Fordham Road, Bronx, NY 10458. E-mail; rosenfeld{at}fordham.edu

OBJECTIVE: This study examined the impact of spirituality and religiosity on depressive symptom severity in a sample of terminally ill patients with cancer and AIDS.METHODS: One hundred sixty-two patients were recruited from palliative-care facilities (hospitals and specialized nursing facilities), all of whom had a life expectancy <6 months. The primary variables used in this study were the FACIT Spiritual Well-Being Scale, a religiosity index similar to those used in previous research, the Hamilton Depression Rating Scale (HDRS), the Karnofsky Performance Rating Scale, the Memorial Symptom Assessment Scale, and the Duke-UNC Functional Social Support Questionnaire.RESULTS: A strong negative association was observed between the FACIT Spiritual Well-Being scale and the HDRS, but no such relationship was found for religiosity, because more religious individuals had somewhat higher scores on the HDRS. Similar patterns were observed for the FACIT subscales, finding a strong negative association between the meaning and peace subscale (which corresponds to the more existential aspects of spirituality) and HDRS scores, whereas a positive, albeit nonsignificant, association was observed for the faith subscale (which corresponds more closely to religiosity).CONCLUSIONS: These results suggest that the beneficial aspects of religion may be primarily those that relate to spiritual well-being rather than to religious practices per se. Implications for clinical interventions and palliative-care practice are discussed.

Key Words: Spirituality • Religion • Depression • Terminally Ill

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