Death Anxiety and Attitude Toward Death in Patients with Schizophrenia and Depression

Şizofreni ve Depresyon Hastalarında Ölüm Kaygısı ve Ölüme Karşı Tutum

Death, as for every human being, is a problem for psychiatric patients, too. Fear of death and the uncertainty about what will happen after death are seemingly an endless part of the human thinking. In patients with acute psychiatric disorders, death and attitude toward death anxiety have not been studied much, yet this topic is an existential perspective for each and every human being.

In a study, the correlation between death and psychiatric disorders was analyzed. The study included patients with depression, schizophrenic patients and healthy individuals. The study was conducted over twenty patients diagnosed with recurrent depressive disorder, a total of twenty patients with schizophrenia spectrum disorders, and twenty healthy volunteers with no psychiatric disorders. Sociodemographic data were collected from all three groups (gender, age, relationship status, occupation, social class, educational background, condition of insubordination, etc.). The prevalence of positive and negative symptoms in schizophrenia was measured with the PANSS (Positive and Negative Syndrome Scale). Death anxiety and the attitude toward death were measured, using the BORFETTA scale (attitude, anxiety, total score), and the severity of depressive symptoms were evaluated with the Beck’s Depression Inventory and Hamilton Depression Rating Scale.

Upon the in-depth analysis of the results:

  • While the healthy volunteers showed the lowest levels in the total BORFETTA score and in the death anxiety sub-scale, the depressive patients had the highest values.
  • A group of significant differences was spotted in the attitude toward death; the schizophrenic patients were the patients with the highest values in terms of the attitude toward death.
  • Surprisingly, the severity of the disorder and psychological functionality were significantly correlated with all three aspects of the BORFETTA scale (attitude, anxiety, total score): The worse the severity of the disorder and psychological functions are, the higher the death anxiety gets and the more negative becomes the attitude toward death.

When the sociodemographic attributes were compared:

  • The relationship status was significantly correlated with BORFETTA (total score, sub-scale of death anxiety, and sub-scale of attitude toward death).
  • Insubordination was correlated with all BORFETTA values.
  • Finally, social class and attitude toward death were negatively correlated.The higher the social class is, the lower become the attitude toward death (in other words, a positive attitude toward death).
  • No significant correlation coefficients could be found between the BORFETTA values and clinical traits, such as the age of commencement, duration of the disorder, duration of hospitalization, and positive family background.
  • The attitude toward death was worse in the schizophrenic patient group. A particularly negative attitude toward death was found in the schizophrenic patients with apparent negative symptoms.
  • In the schizophrenic patients, particularly in those with apparent negative symptoms, the attitude toward death was significantly negative.

These results show similarities and differences regarding death and death anxiety in patients with psychotic and mood disorders. Existential aspects, such as death and meaningful life, should be taken into consideration in the treatment of patients with psychotic and mood disorders.

– Mavrogiorgou, P., Haller, K., & Juckel, G. (2020). Death anxiety and attitude to death in patients with schizophrenia and depression. Psychiatry Research, 113148.