New research reveals spiritual belief not linked to depression

by Dr Louise Jones Head of the Marie Curie Palliative Care Research Unit, UCL dr-louise-jones

Our new research paper, Spiritual beliefs near the end of life (PDF 200KB), has found that terminally ill patients' levels of religious and spiritual belief do not affect their levels of anxiety or depression.
Our finding that spiritual belief is not linked to psychological well-being has important implications for both spiritual and psychological care. We interviewed a total of 170 terminally ill patients – almost all with cancer – to establish their level of spiritual belief. We asked them a set of standard questions about their spiritual beliefs and values. We used a scale that we developed at the Marie Curie Hospice, Hampstead, which measures spiritual belief. It doesn’t matter what people believe in – it’s designed to cover all kinds of belief – and it’s more about patients’ core beliefs than religious practice. We also used a standard questionnaire to measure the patients' levels of anxiety and depression, looking at their medication for pain control, anxiety and depression. The patients were interviewed three times – at the point they became involved in the study, three weeks later and finally 10 weeks later. We found that spiritual belief was unrelated to patients' levels of anxiety and depression and their need for psychotropic (anti-anxiety) drugs. There was a trend for belief to go up as death got nearer, and this approaches statistical significance. We also found that patients with a strong level of spiritual belief use less analgesia (although the finding is not statistically significant), and people with a lower level of spiritual belief died more quickly. A lot of people talk about spiritual belief as being the same as or similar to well-being. We think that they are not the same thing. If you have a strong sense of well-being, then your scores for anxiety and depression are good. But they don’t bear any relationship to your spirituality score. So spiritual care is not just about the psychological welfare of the patient. It’s about something else, and if someone has spiritual welfare needs, we need to think beyond anxiety and depression.  It’s about some other existential dimension, and strong spiritual belief may make people more reflective. That might not calm you down – it could make you question things. Our study was funded by Marie Curie and Cancer Research UK. Researchers worked with 170 patients living at home in North London who accessed specialist palliative care services, 97% of whom had cancer. Download the research (PDF 200KB)