Keywords
factors protecting from suicide
suicide and depression
How to Cite
Abstract
According to the WHO, over 700,000 people commit suicide annually. Their main cause is clinical depression. It is predicted that by 2030 it will become the most diagnosed ailment among people. In the face of the pandemic of depression and suicidal behaviour, it is important to establish the so-called protective factors. Aim of the study: The main aim of the study was to analyse the relationship between protective factors (spirituality, religiosity) and suicidal risk factors (mental pain, depression, anxiety, fascination with death, coexistence of Borderline Personality Disorder BPD, self-harm) in people with a clinical depression. Methodology: The study was conducted from November 2022 to March 2023 using standardized tools and clinical scales to assess the above-mentioned variables. A total of 167 people were examined, while 96 people were qualified for the study, including 46 patients with depression and 50 people from the control group. Results: A significant number of subjects from the control group declaring mental health showed features of depressive disorders (27%), anxiety disorders (45%) and BPD (31.5%). Depressed participants compared to the control group, showed a lower level of spirituality and religiosity and a higher level of suicidal risk factors. Among people with depression, a positive effect of spirituality on lowering the fascination with death was shown, while religiosity correlated negatively with self-harm. In addition, psychological pain and fascination with death increased with the severity of anxiety, depression, self-harm, and BPD. In the examined group, the level of suicidal risk factors increased along with the religious crisis. Conclusions: The study partially confirmed the protective effect of spirituality and religiosity on people with depression in the context of suicidal risk. Religious crisis turned out to be a significant predictor of suicide risk
References
American Psychiatric Association. (2018). Kryteria Diagnostyczne Zaburzeń Psychicznych DSM-5, P. Gałecki, M. Pilecki, J. Rymaszewska, A. Szulc, S. Sidorowicz, J. Wciórka, (eds.). Edra Urban & Partner.
Bloo, J., Arntz, A., Schouten, E. (2017). Lista Kontrolna Zaburzenia Osobowości z Pogranicza (BPD): ocena psychometryczna i struktura czynnikowa w próbie klinicznej i nieklinicznej. Roczniki Psychologiczne, 20(2), 281-336.
Borowicz, M., Rybka, M. (2016). Wybrane aspekty jakości życia pacjentów z depresją. Innowacje w Pielęgniarstwie i Naukach o Zdrowiu, 1. https://doi.org/10.21784/iwp.2016.004
Braam, A.W., Koenig, H.G. (2019a). Religion, spirituality and depression in prospective studies: A systematic review. Journal of Affective Disorders, 257, 428-438. https://doi.org/10.1016/J.JAD.2019.06.063
Campos, R.C., Holden, R.R., & Gomes, M. (2019). Assessing psychache as a suicide risk variable: Data with the Portuguese version of the psychache scale. Death Studies, 43(8), 527-533. https://doi.org/10.1080/07481187.2018.1493002
CBOS. (2020). Religijność Polaków w ostatnich 20 latach. https://cbos.pl/SPISKOM.POL/2020/K_063_20.PDF
Cheng, Y., Zhao, W.W., Chen, S.Y., & Zhang, Y.H. (2021). Research on Psychache in Suicidal Population: A Bibliometric and Visual Analysis of Papers Published During 1994-2020. Frontiers in Psychiatry, 12. https://doi.org/10.3389/fpsyt.2021.727663
Chodkiewicz, J. (2013). Ból psychiczny – konceptualizacja i narzędzia pomiaru. Psychiatria, 10(3-4), 109-115. https://journals.viamedica.pl/psychiatria/article/view/36415/32089
Chodkiewicz, J., Miniszewska, J., Strzelczyk, D., & Gąsior, K. (2017). Polska adaptacja Skali Bólu Psychicznego Ronalda Holdena i współpracowników. Psychiatria Polska, 51(2), 369-381. https://doi.org/10.12740/pp/onlinefirst/59448
Cole-Lewis, Y.C., Gipson, P.Y., Opperman, K.J., Arango, A., & King, C.A. (2016). Protective Role of Religious Involvement Against Depression and Suicidal Ideation Among Youth with Interpersonal Problems. Journal of Religion and Health, 55(4), 1172-1188. https://doi.org/10.1007/s10943-016-0194-y
Czerwiński, S.K., Mackiewicz, J.J., Mytlewska, W.M., & Atroszko, P.A. (2020). Factorial validity, measurement invariance and concurrent validity of Hospital Anxiety and Depression Scale in a sample of Polish undergraduate students. Psychiatria i Psychologia Kliniczna, 20(1), 13-18. https://doi.org/10.15557/pipk.2020.0002
Dervic, K., Carballo, J.J., Baca-Garcia, E., Galfalvy, H.C., Mann, J.J., Brent, D.A., Oquendo, M.A. (2011). Moral or religious objections to suicide may protect against suicidal behavior in bipolar disorder. The Journal of Clinical Psychiatry, 72(10), 1390-1396. https://doi.org/10.4088/jcp.09m05910gre
Dinis, J., Bragança, M. (2018). Quality of Sleep and Depression in College Students: A Systematic Review. Sleep Science, 11(4), 290-301. https://doi.org/10.5935/1984-0063.20180045
Dong, M., Wang, S. Bin, Li, Y., Xu, D.D., Ungvari, G.S., Ng, C.H., Chow, I.H. I., Xiang, Y.T. (2018). Prevalence of suicidal behaviors in patients with major depressive disorder in China: A comprehensive meta-analysis. Journal of Affective Disorders, 225, 32-39. https://doi.org/10.1016/j.jad.2017.07.043
Dong, M., Wang, S.B., Wang, F., Zhang, L., Ungvari, G.S., Ng, C.H., Meng, X., Yuan, Z., Wang, G., Xiang, Y.T. (2019). Suicide-related behaviours in schizophrenia in China: A comprehensive meta-analysis. Epidemiology and Psychiatric Sciences, 28(3), 290-299. https://doi.org/10.1017/S2045796017000476
Dugiel, G. (2018). Zaburzenia depresyjne – ujęcie teoretyczne. Polish Journal of Health and Fitness, 1, 36-46.
Dziwota, E., Żmuda, D., Dubiel, R., Dziwota, K., Markiewicz, R., Makara-Studzińska, M., & Olajossy, M. (2016). On the border of deep spirituality and psychosis… A case study. Current Problems of Psychiatry, 17(3), 183-197. https://doi.org/10.1515/cpp-2016-0020
Frumkin, M.R., Robinaugh, D.J., LeBlanc, N.J., Ahmad, Z., Bui, E., Nock, M.K., Simon, N.M., & McNally, R.J. (2021). The pain of grief: Exploring the concept of psychological pain and its relation to complicated grief, depression, and risk for suicide in bereaved adults. Journal of Clinical Psychology, 77(1), 254-267. https://doi.org/10.1002/jclp.23024
Gałecki, P., Szulc, A. (2018). Psychiatria. Edra Urban & Partner.
Glenn, C.R., Klonsky, E.D. (2011). One-year test-retest reliability of the Inventory of Statements about Self-Injury (ISAS). Assessment, 18(3), 375-378. https://doi.org/10.1177/1073191111411669
Grzywa, A., Kucmin, A., Kucmin, T. (2009). Samobójstwa – epidemiologia, czynniki, motywy i zapobieganie. Część I. Polski Merkuriusz Lekarski, 27 (161), 432-436. https://www.academia.edu/541572
Hook, J.N., Captari, L.E., Hoyt, W., Davis, D.E., McElroy, S.E., & Worthington, E.L. (2019). Religion and Spirituality. Psychotherapy Relationships that Work, 212-263. https://doi.org/10.1093/med-psych/9780190843960.003.0008
Ibrahim, N., Che Din, N., Ahmad, M., Amit, N., Ghazali, S.E., Wahab, S., Abdul Kadir, N.B. Y., Halim, F.W., & Halim, M.R. T.A. (2019). The role of social support and spiritual wellbeing in predicting suicidal ideation among marginalized adolescents in Malaysia. BMC public health, 19 (Suppl 4). https://doi.org/10.1186/s12889-019-6861-7
Isometsä, E. (2014). Suicidal behaviour in mood disorders – who, when, and why? Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie, 59(3), 120-130. https://doi.org/10.1177/070674371405900303
Klimkiewicz, A., Jakubczyk, A., Mach, A., Abramowska, M., Szczypiński, J., Berent, D., Skrzeszewski, J., Witkowski, G., & Wojnar, M. (2021). Psychometric properties of the polish version of the Alcohol Use Disorders Identification Test (AUDIT). Drug and Alcohol Dependence, 218, 108427. https://doi.org/10.1016/j.drugalcdep.2020.108427
Koenig, H.G., Al-Zaben, F., VanderWeele, T.J. (2020). Religion and psychiatry: recent developments in research. BJPsych Advances, 26(5), 262-272. https://doi.org/10.1192/BJA.2019.81
Komenda Główna Policji. (2023). Zamachy samobójcze. (From:) https://statystyka.policja.pl/st/wybrane-statystyki/zamachy-samobojcze (access: 3.09.2023).
Krawczyk, J., Gmitrowicz, A. (2014). Analiza czynników chroniących przed samobójstwem. Psychiatria i Psychologia Kliniczna, 14(1), 43-49. https://doi.org/10.15557/pipk.2014.0005
Kubiak, A. (2013). Mechanizm radzenia sobie z napięciem u osób podejmujących nawykowe samouszkodzenia. Poznań: Uniwersytet im. Adama Mickiewicza.
Kyle, J. (2013). Spirituality: Its Role as a Mediating Protective Factor in Youth at Risk for Suicide. Journal of Spirituality in Mental Health, 15(1), 47-67. https://doi.org/10.1080/19349637.2012.744620
Lawrence, R.E., Oquendo, M.A., & Stanley, B. (2016). Religion and Suicide Risk: A Systematic Review. Archives of Suicide Research, 20(1), 1-21. https://doi.org/10.1080/13811118.2015.1004494
Lee, S.A., Piotrowski, J.P., Rózycka, J., Żemojtel-Piotrowska, M.A. (2013). Associations Between Death Fascination, Death Anxiety and Religion among Polish College Students. Polish Psychological Bulletin, 44(4), 439-448. https://doi.org/10.2478/ppb-2013-0047
Lerman, S., Jung, M., Arredondo, E.M., Barnhart, J.M., Cai, J., Castañeda, S.F., Daviglus, M.L., Espinoza, R.A., Giachello, A.L., Molina, K.M., Perreira, K., Salgado, H., Wassertheil-Smoller, S., & Kaplan, R.C. (2018). Religiosity prevalence and its association with depression and anxiety symptoms among Hispanic/Latino adults. PLOS ONE, 13(2), e0185661. https://doi.org/10.1371/journal.pone.0185661
Linehan, M.M. (2016). Terapia Dialektyczno-Behawioralna (DBT)–trening umiejętnosci. Wydawnictwo Uniwersytetu Jagiellońskiego.
Makara-Studzińska, M. (2013). Reasons for suicide attempts in young people aged 14-18. Psychiatria, 10(2), 76-83. https://journals.viamedica.pl/psychiatria/article/view/35886
Makara-Studzińska, M., Koślak, A. (2009). Severity of depressive symptoms in adolescents after attempted suicide. Postepy Psychiatrii i Neurologii, 18(3), 243-245. https://www.ppn.ipin.edu.pl/archiwum/2009-zeszyt-3/nasilenie-objawow-depresji-u-mlodziezy-po-probach-samobojczych.html
Makara-Studzińska, M., Łopuszanska, U., Sidor, K., Świder, K., & Pac-Kozuchowska, E. (2017). Violence, suicidal attempts and relationships with parents in a group of adolescent girls. Pilot studies. Psychiatria i Psychologia Kliniczna, 17(3), 172-178. https://doi.org/10.15557/pipk.2017.0019
Masters, K.S., Hooker, S.A., & Emerson, R.W. (2022). Effects of Devotional Prayer and Secular Meditation on Cardiovascular Response to a Faith Challenge Among Christians. Psychology of Religion and Spirituality, 14(2), 251-259. https://doi.org/10.1037/rel0000369
Mee, S., Bunney, B.G., Bunney, W.E., Hetrick, W., Potkin, S.G., & Reist, C. (2011). Assessment of psychological pain in major depressive episodes. Journal of Psychiatric Research, 45(11), 1504-1510. https://doi.org/10.1016/j.jpsychires.2011.06.011
Mee, S., Bunney, B.G., Fujimoto, K., Penner, J., Seward, G., Crowfoot, K., Bunney, W.E., & Reist, C. (2019). A study of psychological pain in substance use disorder and its relationship to treatment outcome. PLOS ONE, 14(11), e0216266. https://doi.org/10.1371/journal.pone.0216266
Mee, S., Bunney, B.G., Reist, C., Potkin, S.G., Bunney, W.E. (2006). Psychological pain: a review of evidence. Journal of Psychiatric Research, 40(8), 680-690. https://doi.org/10.1016/j.jpsychires.2006.03.003
Mento, C., Silvestri, M.C., Muscatello, M.R. A., Rizzo, A., Celebre, L., Bruno, A., & Zoccali, A.R. (2020). Psychological pain and risk of suicide in adolescence. International Journal of Adolescent Medicine and Health. https://doi.org/10.1515/ijamh-2019-0270
Mihalca, A.M. & Pilecka, W. (2015). Struktura czynnikowa oraz walidacja polskiej wersji Szpitalnej Skali Lęku i Depresji (HADS) dla młodzieży. Psychiatria Polska, 49(5), 1071-1088. http://dx.doi.org/10.12740/pp/38139
Młodożeniec, A. (2008). Uwarunkowania kliniczne obecności i nasilenia myśli i tendencji samobójczych u chorych leczonych z powodu schizofrenii paranoidalnej. Nieopublikowana rozprawa doktorska. Warszawa: Instytut Psychiatrii i Neurologii.
Montemarano, V., Troister, T., Lambert, C.E., Holden, R.R. (2018). A four-year longitudinal study examining psychache and suicide ideation in elevated-risk undergraduates: A test of Shneidman’s model of suicidal behavior. Journal of Clinical Psychology, 74(10), 1820-1832. https://doi.org/10.1002/jclp.22639
Myers, D.G., Diener, E. (2018). The Scientific Pursuit of Happiness. Perspectives on Psychological Science, 13(2), 218-225. https://doi.org/10.1177/1745691618765171
Orbach, I., Mikulincer, M., Sirota, P., Gilboa-Schechtman, E. (2003). Mental pain: a multidimensional operationalization and definition. Suicide & Life-threatening Behavior, 33(3), 219-230. https://doi.org/10.1521/suli.33.3.219.23219
Pečečnik, T.M., Gostečnik, C. (2022). Use of Spirituality in the Treatment of Depression: Systematic Literature Review. Psychiatric Quarterly, 93(1), 255-269. https://doi.org/10.1007/s11126-020-09881-9
Piotrowski, J.P., Żemojtel-Piotrowska, M., Piedmont, R.L., & Baran, T. (2019). The Assessment of Spirituality and Religious Sentiments (ASPIRES) Scale: Examining a Spiritual Transcendence Nomological Net in Polish Context. Psychology of Religion and Spirituality. https://doi.org/10.1037/rel0000273
Radziwiłłowicz, W. (2020). Autoagresja – samobójstwa i samookaleczenia. (In:) I. Grzegorzewska, L. Cierpiałkowska, A.R. Borkowska (eds.), Psychologia kliniczna dzieci i młodzieży, 559-570. Warszawa: Wydawnictwo Naukowe PWN.
Rodziński, P., Rutkowski, K., Ostachowska, A. (2017). Progression of suicidal ideation to suicidal behavior from a perspective of selected suicidological models. Psychiatria Polska, 51(3), 515-530. https://doi.org/10.12740/PP/63984
Ronneberg, C.R., Miller, E.A., Dugan, E., & Porell, F. (2016). The Protective Effects of Religiosity on Depression: A 2-Year Prospective Study. The Gerontologist, 56(3), 421-431. https://doi.org/10.1093/geront/gnu073
Ruszkiewicz, M., Eldridge, E. (2015). Rola duchowości i poczucia koherencji jako czynników chroniących przed wypaleniem zawodowym wśród wolontariuszy opieki paliatywnej. Psychoonkologia, 2, 64-73.
Rzecznik Praw Dziecka. (2023). Badanie jakości życia dzieci i młodzieży, perspektywa dzieci (2021) i ich rodziców (2022). Samopoczucie psychiczne. (From:) https://brpd.gov.pl/wp-content/uploads/2023/04/Załącznik-nr-4.-Raport-z-badania-jakości-życia-dzieci-i-młodzieży-pespektywa-dzieci-i-ich-rodziców.-Obszar-samopoczucie-psychiczne.pdf (access: 3.09.2023).
Shneidman, E.S. (1993). Commentary: Suicide as psychache. Journal of Nervous and Mental Disease, 181(3), 145-147. https://doi.org/10.1097/00005053-199303000-00001
Shneidman, E.S. (1998). The suicidal mind. New York, Oxford: Oxford University Press.
Sikora, A., Majda, A., Kurowska, A. (2021). Religijność i zachowania zdrowotne pacjentów z depresją. Pielęgniarstwo Polskie, 79(1), 11-18. https://doi.org/10.20883/pielpol.2021.1
Smith, T.B., McCullough, M.E., Poll, J. (2003). Religiousness and Depression: Evidence for a Main Effect and the Moderating Influence of Stressful Life Events. Psychological Bulletin, 129(4), 614-636. https://doi.org/10.1037/0033-2909.129.4.614
Surmacz, N., Tylec, A., Ryś, M., Kucharska, K. (2021). Assessment of selected suicide risk factors and the level of spirituals transcendence and religiosity. Kwartalnik Naukowy Fides et Ratio, 47(3), 357-374. https://doi.org/10.34766/fetr.v47i3.917
Szewczuk-Bogusławska, M., Kaczmarek-Fojtar, M., Halicka-Masłowska, J., Misiak, B. (2021). Self-injuries and their functions with respect to suicide risk in adolescents with conduct disorder: findings from a path analysis. Journal of Clinical Medicine 2021, Vol. 10, Page 4602, 10(19), 4602. https://doi.org/10.3390/jcm10194602
Tae, H., Chae, J.H. (2021). Factors related to suicide attempts: the roles of childhood abuse and spirituality. Frontiers in Psychiatry, 12, 338. https://doi.org/10.3389/fpsyt.2021.565358
Tanrıverdi, D., Bekircan, E., Koç, Z. (2022a). The relationship between psychache and suicide risk with spiritual well-being levels of patients diagnosed with depression. Journal of the American Psychiatric Nurses Association. https://doi.org/10.1177/10783903221079796
Trevino, K.M., Balboni, M., Zollfrank, A., Balboni, T., Prigerson, H.G. (2014). Negative religious coping as a correlate of suicidal ideation in patients with advanced cancer. Psycho-Oncology, 23(8), 936-945. https://doi.org/10.1002/pon.3505
Vitorino, L.M., Lucchetti, G., Leão, F.C., Vallada, H., Peres, M.F.P. (2018). The association between spirituality and religiousness and mental health. Scientific Reports, 8, 1-9. https://doi.org/10.1038/s41598-018-35380-w
Warzocha, D., Gmitrowicz, A., Pawełczyk, T. (2008). Self-harm done by young patients during their psychiatric hospitalization in relation to the presence of specific mental disorders and chosen environmental factors. Psychiatria Polska, 42(5), 659-669. (From:) https://www.researchgate.net/publication/24430337_Self-harm_done_by_young_patients_during_their_psychiatric_hospitalization_in_relation_to_the_presence_of_specific_mental_disorders_and_chosen_environmental_factors (access: 3.09.2023).
WHO. (2021). Suicide. Newsrooom. (From:) https://www.who.int/news-room/fact-sheets/detail/suicide (access: 19.01.2022)
Wu, A., Wang, J.Y., Jia, C.X. (2015). Religion and Completed Suicide: a Meta-Analysis. PLOS ONE, 10(6), e0131715. https://doi.org/10.1371/journal.pone.0131715
Zhang, Y., Li, J., Hu, X. (2022). The effectiveness of dignity therapy on hope, quality of life, anxiety, and depression in cancer patients: A meta-analysis of randomized controlled trials. International Journal of Nursing Studies, 132. https://doi.org/10.1016/j.ijnurstu.2022.104273
Zuchowicz, P., Bliźniewska, K., Talarowska, M., Gałecki, P. (2018). Personality disorders in depression. Neuropsychiatria i Neuropsychologia, 13(1), 25-30. https://doi.org/10.5114/nan.2018.77451
Żemojtel-Piotrowska, M., Piotrowski, J. (2009). Skala lęku i fascynacji śmiercią. Polskie Forum Psychologiczne, 14(1), 90-109.