Spiritual belief, social support, physical functioning and depression among older people in Bulgaria and Romania

Abstract

Objectives: An exploratory investigation is reported into the role of spirituality and religious practice in protecting against depression among older people living in rural villages in Bulgaria and Romania, two neighbouring countries with similar cultural, political and religious histories, but with differing levels of current religiosity.

Methods: In both countries, interviews were conducted with samples of 160 persons of 60 years and over in villages of similar socio-economic status. The Hospital Anxiety and Depression-D scale and the Royal Free Interview for Religious and Spiritual Beliefs were used to assess depression and spiritual belief and practice respectively. In addition social support, physical functioning and the presence of chronic diseases were assessed. One year later, follow-up interviews were conducted with 58 of the original sample in Bulgaria, in which additional measures of depression and of spiritual belief and practice were also included.

Results: The study demonstrates, as expected, significantly lower levels of spiritual belief in the Bulgarian sample (Bulgarian mean 29.7 (SD = 19.1), Romanian mean 47.6 (SD = 11.2), t = 10.2, p < 0.001), as well as significantly higher levels of depression (Bulgarian mean 12.0 (SD = 4.9), Romanian mean 7.3 (SD = 4.1), t = 9.3, p < 0.001), the latter attributable in large part to higher morbidity and disability rates, but less evidently to differences in strength of belief. However, analyses from both the cross-sectional study and the one-year follow-up of the Bulgarian sample do suggest that spiritual belief and practice may both influence and reflect physical and mental illness.

Conclusions: Much of Eastern Europe displays high rates of depression among its older population and provides opportunities for investigation of the role of religious belief and practice in preventing and coping with depression. Further research is encouraged in populations of diverse religiosity.

Keywords:

• religion
• Eastern Europe
• social change
• coping
• mental health

Acknowledgements

We thank Andrey Ivanov and Dimitar Petrov in Bulgaria, and Dr Alexandru Coitreau and Oana in Romania for providing help with data collection, Dr Donald Coggan of the MRC Unit in Southampton for giving advice in questionnaire design, and the Research Division of Community Clinical Sciences at the University of Southampton for providing funding for these studies.