‘Patient Patients’ in Psychiatric Care for Depression Disorders Show Decreased Symptoms

Psychiatric inpatients with major depressive disorders who increased in the virtue of patience during hospitalization also showed fewer symptoms of depression, according to a Baylor University study.

“The findings are significant because depressive disorders are the most common cause of inpatient psychiatric hospitalization among adults in the United States,” said lead author Sarah A. Schnitker, Ph.D., associate professor of experimental psychology and neuroscience at Baylor University. “Patience — defined as the ability to stay calm during adversity, waiting, frustration or suffering — is highly relevant in inpatient psychiatric settings.”  

This is the first study to show a connection between patience and decreasing levels of major depressive disorder symptoms in a clinical setting. Although this study does not show that patience causes a decrease in depression, it does extend previous work with non-clinical samples, Schnitker said.

Previous research has found associations between patience, well-being and psychiatric outcomes in non-clinical samples — such as among college students. Patience also has been found to buffer against suicidal thoughts in individuals with cardiac disease, who are at heightened risk for suicide attempts.

The study was published in The Journal of Positive Psychology.

Researchers analyzed data from 216 participants who completed assessments of themselves at intake and discharge from a mental health center following a spiritually integrated treatment program. The length of their stays varied from two to 32 days, with seven days the average period. The treatment program in the study, conducted at Pine Rest Christian Mental Health Services in Grand Rapids, Michigan, included opportunities for patients to take part in meditation, spiritual reflection and worship, as well as customary individual and group psychotherapy, medication and meetings with psychiatrists, case managers and chaplains.

At intake and discharge, patients rated themselves on an 11-item scale of three aspects of patience: patience in interpersonal relationships; patience during such hardships as illness; and patience with such daily hassles as traffic jams. They also completed a questionnaire to assess eight possible symptoms of major depressive disorder: lack of pleasure, depressed mood, sleep disturbances, low energy, change in appetite/eating, self-disparagement, psychomotor agitation and trouble concentrating. In addition, they were asked to rate the frequency of symptoms in the past month.

Results showed that participants’ patience increased significantly overall and in all aspects of patience, with the most pronounced change in the area of hardships. Meanwhile, symptoms of depression also decreased across treatment, and those decreases corresponded with increases in life hardship and interpersonal patience. Although these results were not able to establish whether changes in patience predicted changes in depression — or whether changes in depression predicted changes in patience — previous data suggest changes in patience precede other outcomes.

Past research has found that patiently regulating emotions and staying peaceful amid suffering, frustrations or obstacles allows people to stay engaged in pursuing goals, exert greater effort toward those goals and have higher achievement satisfaction.

Schnitker said the study was limited because researchers relied on self-reporting by inpatients. Future studies including other methods, such as behavior observation and clinicians’ ratings, would be of value, she said.

“This research is really exciting because it employs a strength-based approach to think about how psychiatric inpatients, who so often are defined by their deficits or problems, might cultivate a draw upon the character strength of patience to meet treatment goals,” Schnitker said.

*Co-researchers included Pine Rest Christian Mental Health Services in Traverse City, Michigan; the psychology department of the University of South Alabama in Mobile, Alabama; Fuller Theological Seminary’s Graduate School of Psychology in Pasadena, California; the psychology department of Hope College in Holland, Michigan; the department of graduate psychology in Azusa Pacific University in Azusa, California; Pastoral Services and Clinical Pastoral Education department of Pine Rest Christian Mental Health Services in Grand Rapids, Michigan.  

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