On July 27, 2017, Howard Koh and colleagues from Harvard University, Boston, in the prestigious Journal of the American Medical Association (JAMA), highlighted the importance of spirituality and religiosity for the health of humans in their article entitled “Health and Spirituality” (VanderWeele et al., JAMA online 27.7.2017, here free online access).
They write: “Patients often discover strength and solace in their spirituality, both informally through deeper connections with family and friends, and formally through religious communities and practices. However, modern day clinicians regularly overlook dimensions of spirituality when considering the health of others—or even themselves.” In fact, spirituality plays virtually no role in modern medicine any more – and this also applies to psychiatry.
In their article, the authors cite studies suggesting that religiosity and spirituality are associated with reduced mortality rates. There are even indications that this relationship is causal. Particularly interesting for psychiatry are findings from the “Nurses’ Health Study”, according to which the participation in a religious community leads to a reduced risk of depression. Suicide rates are even drastically reduced sixfold (from 6.5 per 100,000 to 1.0). In palliative medicine, spirituality is one of the core dimensions of treatment. Therapists themselves experience more work satisfaction and have a lower “burn out” risk, if they attach a spiritual meaning to their work.
This above-mentioned article gets particular relevance by a publication just published in JAMA Psychiatry. In this article, Kim and colleagues, also from Harvard University, show that with the experience of “purpose” of one’s own life, the risk of physical impairment associated with aging decreases (Kim et al., JAMA Psychiatry, online 16.8.2017).
The researchers measured walking speed and grip strength in a sample of about 4500 people over the age of 50 years. In addition, with a scale developed by the Harvard psychologist Carol Ryff, the experience of the purpose of one’s own life was measured (Ryff, J Pers Soc Psychol 1989, 57: 1069-1081). After four years of follow-up, purpose of life was associated with a lesser decrease in the two parameters assessing physical fitness.
The “Purpose in Life” scale developed by Carol Ryff is part of the Ryff Psychological Well-being Scales. It consists of seven items that can have a score of 1 to 6. In the study by Kim et al. a mean value over all seven items was calculated, so that finally a single score between 1 and 6 depicted the purpose of one’s own life. What does the scale measure (Ryff CD. Happiness is everything, or is it? Explorations on the meaning of psychological well-being. J Pers Soc Psychol 1989;57:1069-1081)?
“Purpose in life: Mental health is defined to include beliefs that give one the feeling there is purpose in and meaning to life. The definition of maturity also emphasizes a clear comprehension of life’s purpose, a sense of directedness, and intentionality. The life span developmental theories refer to a variety of changing purposes or goals in life, such as being productive and creative or achieving emotional integration in later life. Thus, one who functions positively has goals, intentions, and a sense of direction, all of which contribute to the feeling that life is meaningful.”
High scorers on this scale are characterized as follows:
has goals in life and a sense of directedness
feels there is meaning to present and past life
holds beliefs that give life purpose
has aims and objectives for living.
Low scorer, on the other hand, are described as follows:
lacks a sense of meaning in life
has few goals or aims
lacks sense of direction
does not see purpose of past life
has no outlook or beliefs that give life meaning.
Does your life have purpose?
VanderWeele et al. close their article with the following remarkable conclusion:
More attention to such spiritual matters could bring medicine closer to the World Health Organization’s longstanding definition of health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”