Espiritualidade, depressão e qualidade de vida no transtorno bipolar do humor: um estudo prospectivo de dois anos

Abstract

Background: Although several studies have examined the relationship between religiosity/spirituality and depression, there is little research examining the effect of religious involvement on the course of bipolar disorder. This study investigated the effects of religious activity and coping behaviors on the course of depression, mania and quality of life in patients with bipolar disorder. Methods: Two-year longitudinal study of 168 outpatients with bipolar disorder. Linear regression was used to examine associations between religious predictors and outcome variables (manic symptoms, depression, and quality of life), controlling for sociodemographic variables. Results: Among the 158 patients reassessed after two years, positive religious coping at T1 (baseline) predicted better quality of life across all four domains: physical (β 10.2, 95%CI, 4.2 - 16.1), mental (β 13.4; 95%CI; 7.1–19.7), social (β 10.5; 95%CI; 3.6–17.33) and environmental (β 11.1; 95%CI; 6.2–16.1) at T2 (2-years later). Negative religious coping at T1 predicted worse mental (β -28.1; 95%CI; -52.06– -4.2) and environmental (β -20.4; 95%CI; -39.3– -1.6) quality of life. Intrinsic religiosity at T1 predicted better environmental quality of life (β 9.56; 95%CI; 2.76–16.36) at T2. Negative religious coping at T1 predicted manic symptoms (β 4.1) at T2. In the qualitative research, 88.2% of the subjects reported that their faith helped to cope with their illness and the support of their religious community regarding the treatment was pointed out by 35.3%, there was no report of opposition of religious leaders to the treatment. Limitations: This is an observational study, causal inferences must be made cautiously. Conclusions: religiosity/spirituality may influence the quality of life of patients with bipolar disorder over time, even among euthymic patients. Targeting religiosity/spirituality (especially positive and negative religious coping) in psychosocial interventions may enhance the quality of recovery in patients with bipolar disorder.