Study Links Spiritual Struggle With Death Risk

Older patients wrestling with religious beliefs during an illness may have an increased risk of dying, according to a new study.

Patients who said they felt "abandoned or punished by God," during an illness were said to have a 19 percent to 28 percent increase in risk of dying during an approximate two-year follow-up period.

The study sample consisted of 595 people aged 55 or older who were hospitalized at either Duke University Medical Center or the Veteran's Administration Medical Center in Durham, N.C., between January 1996 and March 1997. The group was almost entirely Christian (about 95 percent), with a majority of patients representing conservative or mainline Protestant denominations.

The results of the study appear in the Archives of Internal Medicine.

Religious Feelings, Predictor of Mortality

"This study reminds us that religion is a rich, complex process, one that represents a potent resource for people facing problems and one that can, at times, be a source of problems in itself," said Kenneth Pargament, professor of psychology at Bowling Green State University and lead author of the study.

Several studies have demonstrated a reduced risk of death with more frequent church visits, but this study is a first to examine negative associations with religion as a predictor or mortality.

"The finding of a link between religious struggles and increased risk of mortality was, in some ways, surprising to us," Pargament said. "Preliminary analyses among the survivors of this cohort suggest that patients who 'stay stuck' in their struggles over time may be more likely to suffer declines in their physical and mental health than those who are able to resolve their struggles more quickly."

The study, Pergament said, underscores the need for spiritual assessment and intervention for patients experiencing chronic religious struggle in the face of major medical illnesses.

Doctors Should Track Spiritual Concerns

"Those people are in trouble — and doctors need to know about it," said Dr. Harold Koenig, one of the authors of the study and an associate professor of psychiatry at Duke University Medical Center. "This study is important because it identifies specific religious conflicts that may lead to poorer health and greater risk of death."

Feeling abandoned by God and not loved when faced with a serious illness is normal, the researchers say. But doctors should assess their patients' feelings and beliefs.

"Whenever anyone becomes suddenly ill with a disease that threatens life, or a way of life, they ask 'why?' or 'why me?'" said Koenig, who has conducted several studies on the link between health and religion.

"It's not so much a question as it is a release of frustration. Some people experience anger at God for not protecting them or not answering their prayers for healing. Some feel as though God is punishing them and they question God's love for them, and sometimes they feel like others have deserted them as well."