Pourquoi et comment aborder la spiritualité et la religiosité des patients souffrant de troubles mentaux sévères : une étude de terrain |
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Institution: | 1. Département de santé mentale et de psychiatrie, hôpitaux universitaires de Genève, 8, rue du 31-Decembre, 1207 Genève, Suisse;2. Faculty of Theology, Lausanne University, BFSH 2, 1015 Lausanne, Suisse;1. Centre hospitalier universitaire de Lille (CHRU), 59000 Lille, France;2. Université de Lille, 59000 Lille, France;3. Clinique médicale du Château-de-Garches, 92380 Garches, France;4. Service S.H.U., hôpital Sainte-Anne, 1, rue Cabanis, 75004 Paris, France;5. Inserm, U1144, 75006 Paris, France;6. Université Paris Descartes, UMR-S 1144, 75006 Paris, France;7. Université Paris Diderot, Sorbonne Paris Cité, UMR-S 1144, 75013 Paris, France;8. Pôle de psychiatrie et de médecine addictologique, groupe hospitalier Saint-Louis–Lariboisière–F.-Widal, AP–HP, 75475 Paris cedex 10, France;9. Fondation FondaMental, 94000 Créteil, France;1. Service de pharmacologie clinique, CAP-TV, hôpital Sainte-Marguerite, AP–HM, 270, boulevard Sainte-Marguerite, 13271 Marseille, France;2. Aix-Marseille université, Inserm, Sesstim U912, 13006 Marseille, France;3. SHU Psychiatrie adultes, hôpital Sainte-Marguerite, 13274 Marseille cedex 9, France;1. Octogone, Centre d’études et de recherches en psychopathologie, université de Toulouse II-Le Mirail, pavillon de la recherche, bureau R31, 5, allées Antonio-Machado, 31058 Toulouse cedex, France;2. Laboratoire de psychologie des Pays-de-la-Loire, université de Nantes, 44300 Nantes, France;3. Department of Counseling and Applied Educational Psychology, Northeastern University, MA 02115, Boston, États-Unis;4. Laboratoire stress traumatique (EA 4560), université de Toulouse-Paul Sabatier, 31062 Toulouse, France |
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Abstract: | ObjectivesThere is evidence that psychiatrists are rarely aware of how religion may intervene in their patient's life. That is particularly obvious concerning patients with psychosis. Yet, even for patients featuring delusions with religious content, religious activities and spiritual coping may have a favourable influence. Indeed, patients with psychosis can use religion to cope with life difficulties related to their psychotic condition, in a social perspective but also in order to gain meaning in their lives. Also, religion may be part of explanatory models about their disorder with, in some cases, a significant influence on treatment adhesion.Patients and methodsThis paper describes a prospective randomized study about a spiritual assessment performed by the psychiatrists of patients with schizophrenia. The outpatient clinics in which the sample was collected are affiliated with the department of psychiatry at the university hospitals of Geneva. Eighty-four outpatients with psychosis were randomized into two groups: an experimental group receiving both traditional treatment and spiritual assessment with their psychiatrist and a control group of patients receiving only their usual treatment. Psychiatrists were supervised by a clinician (PH) and a psychologist of religions (PYB) for each patient in the spiritual assessment group. Data were collected from both groups before and after 3 months of clinical follow-up.ResultsSpiritual assessment was well-tolerated by all patients. Moreover, their wish to discuss religious matters with their psychiatrist persisted following the spiritual assessment. Even though clinicians acknowledged the usefulness of the supervision for some patients, especially when religion was of importance for clinical care, they reported being moderately interested in applying spiritual assessments in clinical settings. Compared to the control group, there were no differences observed in the 3 months’ outcome in terms of primary outcome measures for satisfaction with care, yet the attendance at the appointments was significantly increased in the group with spiritual assessment. The same result was found when restricting analyses to patients for whom an intervention was suggested or patients who invested more in religion. Areas of potential intervention were frequent both in a psychiatric and psychotherapeutical perspective.ConclusionsSpiritual assessment appears to be useful for patients with psychosis. This is in accordance with the recommendations of the World Psychiatric Association which promotes considering the whole person in clinical care. Spiritual assessment is quite simple to perform, providing that clinicians do not prescribe or promote religion, and that no critical comments are made concerning religious issues. Clinicians do not need to know in depth the religious domains of each of their patients, as it appears that each patient accommodates his/her religious background his/her own way. |
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Keywords: | Psychosis Schizophrenia Religion Spirituality |
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