title: Spiritual struggle and affective symptoms among geriatric mood disordered patients.
abstract: OBJECTIVE
  We explored relationships between general religiousness, positive religious coping, negative religious coping (spiritual struggle), and affective symptoms among geriatric mood disordered outpatients, in the northeastern USA.
  
  
  METHODS
  We assessed for general religiousness (religious affiliation, belief in God, and private and public religious activity) and positive/negative religious coping, alongside interview and self-report measures of affective functioning in a diagnostically heterogeneous sample of n = 34 geriatric mood disordered outpatients (n = 16 bipolar and n = 18 major depressive) at a psychiatric hospital in eastern Massachusetts.
  
  
  RESULTS
  Except for a modest correlation between private prayer and lower Geriatric Depression Scale scores, general religious factors (belief in God, public religious activity, and religious affiliation) as well as positive religious coping were unrelated to affective symptoms after correcting for multiple comparisons and controlling for significant covariates. However, a large effect of spiritual struggle was observed on greater symptom levels (up to 19.4% shared variance). Further, mean levels of spiritual struggle and its observed effects on symptoms were equivalent irrespective of religious affiliation, belief, and private and public religious activity.
  
  
  CONCLUSIONS
  Previously observed effects of general religiousness on (less) depression among geriatric mood disordered patients may be less pronounced in less religious areas of the USA. However, spiritual struggle appears to be a common and important risk factor for depressive symptoms, regardless of patients' general level of religiousness. Further research on spiritual struggle is warranted among geriatric mood disordered patients.
authors: Department of Psychiatry, McLean Hospital/Harvard Medical School, Belmont, MA, USA.
authors: David H
authors: DH
authors: Rosmarin
authors: Mary C
authors: MC
authors: Malloy
authors: Brent P
authors: BP
authors: Forester
mesh_terms: D000223:Adaptation, Psychological; D000342:Affective Symptoms / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001714:Bipolar Disorder / Q000523:psychology*; D003865:Major Depressive Disorder / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008404:Massachusetts; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012067:Religion; D012307:Risk Factors; D029181:Spirituality
keywords: depression; mania; negative religious coping; spirituality