Islam and Mental Health: Beliefs, Research, and Clinical Applications Harold G. Koenig, MD Professor of Psychiatry and Behavioral Sciences Associate Professor of Medicine Duke University Medical Center, Durham, North Carolina USA Adjunct Professor, King Abdulaziz University, Jeddah, Saudi Arabia Adjunct Professor, Ningxia Medical University, Yinchuan, People’s Republic of China Visiting Professor, Shiraz University of Medical Sciences, Shiraz, Iran
43
Embed
Islam and Mental Health: Beliefs, Research, and Clinical ... · • To attribute divinity to anything or anyone else, is shirk –the unpardonable sin of polytheism, unless repentance
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
Islam and Mental Health:
Beliefs, Research, and Clinical ApplicationsHarold G. Koenig, MD
Professor of Psychiatry and Behavioral Sciences
Associate Professor of Medicine
Duke University Medical Center, Durham, North Carolina USA
Adjunct Professor, King Abdulaziz University, Jeddah, Saudi Arabia
Adjunct Professor, Ningxia Medical University, Yinchuan, People’s Republic of China
Visiting Professor, Shiraz University of Medical Sciences, Shiraz, Iran
Overview
1. Introduction
2. Muslim and Christian beliefs
3. Comparisons: differences and similarities
4. Research on Islam and Mental Health
5. Clinical applications when treating Muslim patients
6. Further resources
(please place all microphones on mute during presentation)
Introduction
My area of expertise:
• healthcare professional who has treated patients for nearly 40 yrs
• clinical researcher on religion and health
• not a Christian or Muslim theologian; no theological training
whatsoever, except…
• have read the Bible repeatedly and the Qur’an repeatedly and, to
some extent, have a familiarity with the Hadith and Sunnah
• have many close friends and colleagues who are Sunni or Shia
Muslims (have over 100 peer-reviewed academic publications
and books with these colleagues)
• nearly a decade working with a team of Saudi investigators (Faten Al Zaben, Saad Al Shohaib, Haythum Tayeb, Mohammad Sehlo,
Waleed Agalghamdi), many Iranian investigators, Western China team (Wang)
Sources of Theological Information
The Qur’an: A new translation by M.A.S. Abdel Haleem (Oxford World’s Classics, 2005)
Holy Bible: New International Version
(Zondervan Bible Publishers, 1978)
Health and Well-Being in Islamic Societies: Background, Research, and Applications
(Koenig & Al Shohaib, 2014) (https://www.amazon.com/Health-Well-Being-Islamic-
Societies-Applications/dp/331905872X)
Islam and Mental Health: Beliefs, Research and Applications (Koenig & Al Shohaib,
Comparison of mental, social, behavioral, and physical health
in Muslim vs. non-Muslims
Mental Health No. Studies Better Worse Mixed Same
Depression 3 67% 33% 0% 0%
Suicide 7 43% 14% 14% 29%
Anxiety 7 14% 86% 0% 0%
Psychosis 2 100% 0% 0% 0%
Alcohol use/abuse 12 75% 0% 0% 25%
Drug use/abuse 6 50% 0% 0% 50%
Well-being 1 0% 0% 0% 100%
Optimism 3 0% 67% 33% 0%
Sense of control 6 33% 17% 33% 17%
Social Health
Social support 2 100% 0% 0% 0%
Marital stability 2 50% 50% 0% 0%
Delinquency/crime 3 67% 0% 33% 0%
Social capital 4 50% 50% 0% 0%
Comparison of mental, social, behavioral, and physical health
in Muslim vs. non-Muslims
No. Studies Better Worse Mixed Same
Behavioral Health
Cigarette smoking 8 38% 13% 0% 50%
Exercise 6 17% 67% 17% 0%
Diet 4 25% 50% 25% 0%
Weight 7 57% 43% 0% 0%
Extra-marital sex 12 67% 8% 8% 17%
Physical Health
Heart disease 10 20% 40% 20% 10%
Hypertension 8 75% 25% 0% 0%
Cerebrovascular disease 2 100% 0% 0% 0%
Dementia 0 0% 0% 0% 0%
Diabetes 6 33% 33% 0% 33%
Cholesterol/triglycerides 3 67% 33% 0% 0%
Immune function 2 0% 50% 0% 50%
Endocrine function 0 0% 0% 0% 0%
Cancer 19 37% 11% 11% 42%
Self-rated health 8 13% 50% 0% 37%
Mortality 14 43% 36% 7% 14%
Anxiety in Hemodialysis Patients
60 hemodialysis patients in Iran were randomized to either Qur'an
recitation or a control group. Patients at baseline and 1 month
afterward by STAI. The intervention involved listening to the
recitation of the Qur'an in traditional cantillation voice. The
control group received no intervention. Recitation of the Qur'an
was effective in reducing anxiety in the intervention group,
decreasing STAI score at baseline from 128.5 to 82.1, compared to
the control group which experienced no change in anxiety scores
from baseline to follow-up (118.3 vs. 120.1). Between-subject
comparison at follow-up, after adjusting for baseline differences,
indicated a significant reduction in anxiety in the intervention
versus the control group (F = 15.5, p = 0.0002, Cohen's d = 1.03).
Babamohammadi H, Sotodehasl N, Koenig HG, Jahani C, Ghorbani R (2015). The
effect of Qur’an recitation on anxiety/depression in hemodialysis patients: A
randomized clinical trial. Journal of Religion and Health 2015; 54(5):1921-30;
2017; 56(1):345-354
0 1
60
80
100
120
140
Qur'an Recitation
ControlsA
nxie
ty (
ST
AI)
Time (months)
0 1
0
5
10
15
20
25
30
35
40D
epre
ssio
n (
BD
I-II)
Time (months)
Qur'an Recitation
Controls
Clinical Applicationswhen treating Muslim Patients
To Include or Not Include Religion in the Treatment of Muslim Patients
“We created man – We know what his soul whispers to him: We are closer to him than his jugular vein.” (Qur’an 50:16)
This is the beginning of health, real health and well-being. This verse expresses the idea that God is close, closer than even life itself (jugular vein represents life). God must come first, before everything else – then, and only then, will true mental health follow.
The best way for a person to experience good mental is by developing a close connection with God and experiencing God’s love, mercy, and practical help that He can provide, as they submit, love and serve Him.
How can we ignore this as therapists responsible for caring for people experiencing emotional illness and deep inner pain?
Is it Ethical to Bring up Religion/Spirituality?
Should therapists bring up the subject of
religion/spirituality in therapy? Is it Ethical?
The answer: YES! to both questions
I would argue that it is unethical to ignore this great
potential source of healing, based on what we know
now from systematic research, including randomized
controlled trials.
Clinical Applications
1) Take a “Spiritual History”
2) Respect and value the religious/spiritual beliefs
of the patient (if without such beliefs, honor that)
3) Support the religious/spiritual beliefs and
consider them a mental health resource
4) Consider religiously-integrated psychotherapy
from a Muslim perspective
Psychiatric Organization Guidelines(all recommend a spiritual history)
American Psychiatric AssociationAmerican Psychiatric Association Committee on Religion and Psychiatry (1990).
Guidelines regarding possible conflict between psychiatrists’ religious commitments
and psychiatric practice. American Journal of Psychiatry 147:542.
Royal College of Psychiatrists (United Kingdom)Cook, C. C. H. (2013). Recommendations for psychiatrists on spirituality and
religion. Position statement Royal College of Psychiatrists, London. Retrieved on
12/15/19 from https://www.rcpsych.ac.uk/pdf/PS03_2013.pdf.
World Psychiatric AssociationMoreira‐Almeida, A., Sharma, A., van Rensburg, B. J., et al. (2016).
WPA position statement on spirituality and religion in psychiatry.
World Psychiatry, 15(1), 87-88. [IF=34.0 vs. AJP at 13.7]