Bipolar disorder patients in mixed states appear to have more active private religious lives, including prayer or meditation, compared with their counterparts in depressed, manic, or euthymic states, US researchers report.

This finding supports the theory that being both depressed and manic poses a greater level of distress than being depressed or manic alone, say Mario Cruz, from Western Psychiatric Institute and Clinic in Pittsburgh, Pennsylvania, and colleagues. This in turn could prompt individuals in mixed states to increase the frequency of their religious behaviors.

The researchers note that, although some studies have suggested potential beneficial effects of different forms of religious coping for patients with psychiatric illness, others have found spiritual beliefs conflict with illness models and medical advice.

They therefore recommend that “providers should assess the religious activities of individuals with bipolar disorder in mixed states and how they may complement/deter ongoing treatment.”

A total of 334 patients receiving care for bipolar disorder at an urban Veterans Affairs mental health clinic were surveyed to assess their public (frequency of church attendance), private (frequency of prayer/meditation), and subjective forms (influence of beliefs on life) of religious involvement.

Among the patients, 73 were currently manic/hypomanic, 96 were in a mixed episode, 62 were in a depressed episode, and 103 were euthymic.

The results of multivariate analyses, controlling for functional disability, anxiety, and binge drinking, showed that patients in a mixed state had a significantly higher rate of prayer/meditation than other patients, at an odds ratio of 1.29.

Conversely, the rate of prayer/meditation was significantly lower in patients who were euthymic, compared with other patients, at an odds ratio of 0.84.

Depression and mania were not associated with religious involvement and no significant associations were found between church attendance and influence of beliefs and participants’ bipolar state.

“We recommend to mental health providers that if an individual suffering from bipolar disorder is religious, his/her religious activities should be explored to assess the presence of a mixed state and to determine how his/her religious activities influence treatment-seeking behaviors,” Cruz et al conclude in the journal Bipolar Disorders.

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

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