In Brazil, during the XX century, dozens of Spiritist psychiatric hospitals emerged seeking to integrate conventional medical treatment with complementary spiritual therapy. This combined inpatient treatment is largely found in Brazil, where many psychiatric hospitals stem from the Spiritist movement. The present report describes the use of these spiritual practices, their operating structure, health professionals involved, modalities of care, and institutional difficulties in integrating spiritual practices with conventional treatment in six leading Brazilian Spiritist psychiatric hospitals. These hospitals combine conventional psychiatric treatment with voluntary-based spiritual approaches such as laying on of hands ("fluidotherapy"), lectures regarding spiritual and ethical issues, intercessory prayer, spirit release therapy ("disobsession") and "fraternal dialogue". The non-indoctrination and optional nature of these spiritual complementary therapies seem to increase acceptance among patients and their family members. In conclusion, the Spiritist psychiatric hospitals in Brazil have, for more than half a century, provided an integrative approach in the treatment of psychiatric disorders, associating conventional and spiritual treatments, more specifically Spiritist therapy. The lack of standardized treatment protocols and scientific studies remain a barrier to assessing the impact of this integrative approach on patients' mental health, quality of life, adherence, and perceived quality of treatment.
SUMMARY The term meditation can be used in many different ways, according to the technique to which it refers. Transcendental Meditation (MT) is one of these techniques. TM could serve as a model for research on spiritual meditation, unlike the meditation techniques based on secular knowledge. The purpose of the present study is to conduct a bibliographic review to organize scientific evidence on the effects of TM on neurophysiology, neurochemistry, and cognitive and behavioral aspects of its practitioners. To conduct this critical narrative review of the literature, we searched for scientific papers on the PubMed database of the National Center for Biotechnology Information. The keywords used in the search were Transcendental Meditation, Neuroscience of meditation e Meditation and behavior. We selected 21 papers that analyzed different aspects that could be altered through meditation practice. We concluded that TM has positive and significant documentable neurochemical, neurophysiological, and cognitive-behavioral effects. Among the main effects are the reduction of anxiety and stress (due to the reduction of cortisol and norepinephrine levels), increase of the feeling of pleasure and well-being (due to the increase of the synthesis and release of dopamine and serotonin), and influence on memory recall and possible consolidation. Further studies are needed using creative and innovative methodological designs that analyze different neural circuitry and verify the clinical impact on practitioners.
, pelo voto de confiança que me concedeu e pelos valiosos aprendizados que me proporcionou. O estímulo e o apoio que me oferece são fundamentais e tem valor inestimável, o que me torna capaz de superar muitos desafios acadêmicos. À minha coorientadora, Profa Dra Clarice Gorenstein, pelos ensinamentos que me foram passados com atenção e segurança durante todo o processo de desenvolvimento do mestrado. A Frederico Camelo Leão, pelo importante incentivo em vários momentos de minha carreira, em particular na pós graduação. Por ter me permitido compartilhar conhecimentos e ideais durante os anos que faço parte do ProSER, o que tem me proporcionado experiências significantes. À Camila Bertini Martins, pela parceria, e por ter realizado as análises estatísticas. À Juliane Gonçalves, por ser minha companheira no cotidiano acadêmico e por dividir comigo momentos de aprendizados e desafios.
A assistência religiosa a pacientes com transtornos psiquiátricos graves internados é um problema pouco discutido entre psiquiatras. Aspectos legais asseguram o direito à assistência religiosa aos pacientes, no entanto alguns aspectos específicos conduzem a reflexão e cautela em determinadas situações. Assim, objetiva--se com o presente trabalho discutir os aspectos éticos, legais e científicos da assistência religiosa em hospitais psiquiátricos. Serão abordados também alguns comentários sobre os conceitos de autonomia, beneficência e não maleficência, contidos nos princípios bioéticos. Ao final, é apresentada a experiência do Hospital João Evangelista na abordagem de tais casos. Como conclusão, situações de conflito ético e legal podem surgir, pois os pacientes têm direito a receber assistência religiosa, porém podem apresentar manifestações psicopatológicas que poderiam levar a prejuízo de seu quadro clínico diante da abordagem religiosa. A orientação dos familiares e as relações entre hospital, médico, paciente e família são essenciais para a resolução de tais conflitos.Braghetta CC, et al. / Rev Psiq Clín. 2011;38(5):189-93 Palavras-chave: Espiritualidade, religião e medicina, psiquiatria. AbstractThe religious assistance to inpatients with severe psychiatric disorders is a problem rarely discussed among psychiatrists. Legal aspects ensure the right to religious assistance to such patients, although some specific aspects lead to reflection and caution in certain situations. Thus, the main of the work is to discuss ethical, legal, scientific and religious aspects of religious assistance in psychiatric hospitals. It will also address some comments on the concepts of autonomy, beneficence and nonmaleficence, contained in bioethical principles. Finally, it will be presented the experience of the João Evangelista Hospital approach on such cases. In conclusion, ethical and legal conflicts can appear because patients have the right to receive a religious attendance. However, in some conditions, this assistance could lead to a worse in patient's clinical status. Family orientation and doctor-patient-hospital relationship are essential to resolve these conflicts.Braghetta CC, et al. / Rev Psiq Clín. 2011;38(5):189-93 Keywords: Spirituality, religion and medicine, psychiatry.Endereço para correspondência: Camilla Casaletti Braghetta. Hospital João Evangelista. Avenida Nova Cantareira, 3050 -02340-000 -São Paulo, SP. IntroduçãoA religiosidade e a espiritualidade são dimensões integrantes da experiência social e cultural humana e, portanto, da vivência cotidiana de grande parte da população. Um estudo da Organização Mundial da Saúde (OMS) investigou 5.087 pessoas em 18 países, e, dentre os países cristãos fora da África, o Brasil teve a maior porcentagem de entrevistados que indicaram ser "moderadamente" ou "extremamente" religiosos (80% a 90%) 1 .Dados do censo demográfico realizado no ano de 2000 mostram que parcela superior a 90% da população brasileira possui alguma denominação religiosa e grande parte da popu...
BackgroundAlthough observational studies have already shown promising results of flourishing, a broader concept of health based on positive psychology, there is still a gap in the literature regarding studies that combine different topics of flourishing in a single intervention.ObjectivesTo develop a comprehensive and integrate intervention based on positive psychology gathering different topics of flourishing to improve mental health outcomes in individuals with depressive symptoms.MethodsThe following steps were performed: (1) a comprehensive literature review; (2) the designing of a 12-session group intervention based on the values, virtues, and topics of flourishing; (3) assessment of the rationale, coherence, and feasibility by a panel of healthcare professionals answering semi-structured questions, and (4) application of an e-Delphi technique including mental health experts to reach a consensus of at least 80% for each item of the protocol.ResultsA total of 25 experts participated in the study, 8 in the panel with semi-structured questions and 17 in the e-Delphi technique. A three-round e-Delphi technique was required to reach a consensus for all items. In the first round, a consensus was reached for 86.2% of the items. The remaining items (13.8%) were either excluded or reformulated. In the second round, a consensus was not obtained on one item, which was reformulated and approved in the third round. Qualitative analyses of the open questions were performed and suggestions for the protocol were considered. The final version of the intervention was composed of 12 weekly group sessions with 90-min each. The topics included in the intervention were physical and mental health, virtues and character strengths, love, gratitude, kindness, volunteering, happiness, social support, family, friends and community, forgiveness, compassion, resilience, spirituality, purpose and meaning of life, imagining the “best possible future,” and flourishing.ConclusionThe flourishing intervention was successfully developed using an e-Delphi technique. The intervention is ready to be tested in an experimental study to verify its feasibility and effectiveness.
Background: Several instruments that measure spirituality present overlaps with positive emotions, impacting the interpretation of their findings. In order to minimize these problems, we aimed to develop, assess the reliability and validate a new scale to evaluate spirituality.Methods: The instrument was designed using a theoretical framework minimizing tautological issues (i.e., Koenig’s framework), a qualitative study investigating the definitions of spirituality, the development of the first version of instrument by experts’ meetings and a qualitative cognitive debriefing. Then, the instrument was examined for its content validity by a multidisciplinary group of judges and was pilot-tested in two different groups – less religious (medical students – n = 85) and more religious (practicing religious members – n = 85). Finally, psychometric properties and validity were assessed.Results: The developed Attitudes Related to Spirituality Scale (ARES) is a self-report 11-item instrument using five-level Likert items. ARES presented appropriate psychometric properties revealing excellent internal consistency (alpha = 0.98) and temporal stability (ICC = 0.98). Likewise, ARES was strongly correlated with other validated R/S instruments (i.e., Duke Religion Index and Brief Multidimensional Measure of Religiousness/Spirituality) and was able to discriminate higher and lower religious groups. In the exploratory factor analysis, a unidimensional structure of the scale was described. Fit indices for the scale demonstrated good fit in the unidimensional model.Conclusion: The ARES is a reliable, valid and stable one-dimension instrument that is appropriate for use in the Portuguese-speaking population.Descriptors: Spirituality; Scale; Factorial Analysis; Instrument; Measure; Psychometrics.
Impacto de uma experiência de quase-morte e conversão religiosa sobre a saúde mental de um criminoso: relato de caso e revisão da literatura Impact of a near-death experience and religious conversion on the mental health of a criminal: case report and literature review Abstract Objective: Near-death experiences have been defined as profound psychological events that may occur to a person while close to death or in a situation of extreme physical or emotional distress. These experiences seem to have an important effect on the patients' mental health and may occur in several situations despite their cultural and religious beliefs. Case description: The present case report describes the positive impact of a near-death experience (Greyson scale > 7) followed by religious conversion on the mental health of a former prisoner. Comments: Investigation of the role of near-death experiences by the scientific community could shed light on the coping mechanisms and moral/ethical transformations that take place in these individuals. Keywords: Near-death experience, religion and medicine, criminality, mental health, social reintegration. ResumoObjetivo: As experiências de quase-morte são definidas como eventos psicológicos profundos, que podem ocorrer quando uma pessoa está em morte iminente ou em situação de intensa crise física ou emocional. Essas experiências parecem ter efeito importante sobre a saúde mental desses pacientes e ocorrem em diversas situações, a despeito de culturas e crenças religiosas. Despite consistent reports describing behavioral changes associated with NDEs, few studies have investigated these changes or their impact on extreme conditions, as is the case of highly dangerous criminals.The present report describes the case of a former prisoner reporting an NDE followed by religious conversion and the influence of the event on the life and mental health of the individual. Case reportOur case was a 45-year old male born in the state showed an important degree of spiritual well-being, and frequently engaged in spiritual activities, as part of his daily life. The score obtained on the psychopathy scale (12) was primarily associated with his past history, which involved juvenile delinquency and conduct disorders during childhood. The scores therefore reflect a partial personality disorder, with less severe alterations and allowing for a higher degree of social integration when compared with subjects identified as psychopaths. 19The participant signed an informed consent form and agreed to have his case described and published. DiscussionThere is much discussion about the impact of spirituality on the lives of human beings 20,21 and also of the influence of NDE on the mental health of individuals. 22Some phenomena, such as the continuation of complex mental functions when the brain is inactive or hypoxic, reveal a possible methodological insufficiency of materialistic science in describing these events, because it is based on a reductionist model of classical physics.Some authors have suggested that one type ...
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