Supplementary Material for: Varieties of Religious and Spiritual Struggles by Type of Mental Disorder: A Qualitative Approach

Introduction: Little is known about types of religious/spiritual (R/S) struggles with regard to various diagnostic groups in mental health care. The current qualitative study aims to give an impression of R/S struggles as observed in six diagnostic groups in clinical mental health care. Methods: Inductive thematic content analysis was applied to 34 semi-structured interviews. The interviews were performed among (day) clinical mental health care patients in two institutions. Results: Among patients with depression, a lack of positive R/S experiences, isolation, and feelings of guilt and shame were present. Those with cluster C and anxiety disorders reported uncertainty toward God and faith and R/S reticence. Psychotic disorders were accompanied by impressive R/S experiences, reticence to share these, and mistrust toward health professionals. Patients with bipolar disorder struggled with the interpretation of their R/S experiences and with both attraction and distance toward R/S. Cluster B patients showed ambivalence and anger toward God and others, and some reported existential tiredness. Patients with autism mentioned doubts and troubles with religious beliefs. In all groups, many patients had questions like “why?” or “where is God?” Conclusion: R/S struggles to some extent may be the language of the illness. Mental health professionals are recommended to take this into account, taking heed of the content of individual R/S struggles and considering using R/S interventions.

引言：目前学界对精神卫生照护中不同诊断群体所面临的宗教与灵性（Religious/Spiritual，R/S）困境类型尚缺乏充分认知。本项质性研究旨在呈现临床精神卫生照护中六类诊断群体所观察到的R/S困境的具体样貌。研究方法：本研究采用归纳式主题内容分析法，对34份半结构化访谈资料开展分析。访谈对象为两家机构的临床精神卫生照护（日间）患者。研究结果：抑郁障碍患者群体中，可见缺乏积极R/S体验、社交孤立以及内疚与羞耻感等表现。C群人格障碍与焦虑障碍患者则表现出对上帝与信仰的不确定感，以及不愿谈及R/S议题的缄默态度。精神病性障碍患者伴随极具冲击力的R/S体验，不愿分享此类经历，且对医疗专业人员存在不信任感。双相障碍患者在解读自身R/S体验以及对R/S既向往又疏离的矛盾心态中饱受困扰。B群人格障碍患者表现出对上帝与他人的矛盾心态与愤怒情绪，部分患者还存在存在主义倦怠感。孤独症谱系障碍患者则提及对宗教信仰的质疑与相关困扰。在所有诊断群体中，诸多患者都曾提出诸如“为何如此？”或“上帝何在？”这类问题。结论：在一定程度上，R/S困境或许可被视为疾病的表达性语言。建议精神卫生专业人员将这一点纳入考量，关注个体R/S困境的具体内容，并可考虑采用R/S相关干预手段。