Letters to the Editor
Reply: Canadian Psychiatric Inpatient Religious Commitment:
An Association With Mental Health
Dr Watters raises some interesting issues, on which we are happy to expand. He also provides data on which we are unable to comment, because they involve economics, politics, history, and the law.
The question of social support as a possible confound was certainly considered in this study and controlled for in the analysis. As to undue reliance on studies of inpatients, we agree that this has often produced a distorted view, and we acknowledge this in our paper. We have collected population and outpatient data that we are now analyzing, and preliminary results support our conclusions. One of the article’s main findings—the correlation between worship attendance and religious coping and length of stay—could by definition only be studied in inpatients. It would be peculiar if, as Dr Watters asserts, religious involvement played a part in hospitalization and was also associated with reduced length of stay.
Dr Watters mistakenly attributes to us a finding that is actually a quote from a study by Neeleman and Lewis: “The intensity of religious beliefs was more pronounced among the more severely ill subjects” (1). We note that in general our population had a high incidence of comorbidity and psychiatric hospitalizations, but in this study we did not compare the intensity of belief with the severity of illness.
The most interesting proposed “head-to-head” study is actually between 2 religious positions. Sellars, the author of the Humanist Manifesto I (1933), states elsewhere that humanism is really a nontheistic religion (2), perhaps making it an ideal choice for one of these positions. Such a study would not necessarily be definitive: it would just add to other studies like it.
The reference to Batson and others (3) is 20 years old. Since then, there has been a large increase in research on spirituality and mental health, with increasingly stringent methodology and controls for potential confounding variables. Batson and others (3,4), however, do note that religiousness has different components and that there are different ways to measure these aspects and mental health and types of mental illness. They actually conclude that findings depend on the way one measures religiousness and mental health and the confounders, such as social desirability. They did find that certain types of religiousness are associated with undesirable qualities. This is no surprise: like psychotherapy, medication, and hospitalization, religion can be distorted and misused. They also found that some types of religiousness are associated with positive qualities—but in convoluted thinking, any positive quality may be seen as a defence. Interestingly, they concluded that the more positive type of religiousness is associated with more frequent worship attendance.
We wish to clarify the obvious: the method did not set out to prove or demonstrate anything. The null hypothesis is that religion has no correlation with the dependent variables. We found this not to be the case. Dr Watters refers to this as “juggling statistical data.” We find numbers and statistical analysis refreshing because they are logical and reproducible, unlike opinions.
1. Neeleman J, Lewis G. Religious identity and comfort beliefs in three groups of psychiatric patients and a group of medical controls. Int J Soc Psychiatry 1994;40:124–34.
2. Sellars RW. The next step in religion. New York: The Macmillian Company 1918; 212.
3. Batson CD, Ventis WL. The religious experience. A social-psychological perspective. New York: Oxford University Press; 1982.
4. Batson CD, Schoenrade P, Ventis WL. Religion and the individual: a social-psychological perspective. New York: Oxford University Press; 1993.
Marilyn Baetz, MD
Rudy Bowen, MD
Gene Marcoux, MD
Ron Griffin, PhD
David B Larson, MD (deceased, March 2002)