In this study, the investigators want to assess spiritual resources, spiritual distress and spiritual coping in patients with psychiatric disorders of the affective spectrum with a new designed questionnaire the Spiritual Distress and Resources Questionnaire (SDRQ)

The inclusion of the spiritual dimension in healthcare has been a recommendation of the World Health Organization (WHO) since 1984. According to the WHO, 'spiritual' refers "to those aspects of human life relating to experiences that transcend sensory phenomena. This is not the same as 'religious', though for many people the spiritual dimension of their lives includes a religious component. The spiritual aspect of human life may be viewed as an integrating element holding together the physical, psychological and social dimensions. It is often perceived as being concerned with meaning and purpose". Today there is a growing body of scientific evidence for therapeutic relevance of the spiritual dimension in different fields of medical health care. Based on this increasing scientific evidence, medical associations such as the Royal College of Psychiatrists recommend the assessment of spiritual needs for therapeutic goals. Despite those long-standing calls and findings, these recommendations have not yet been widely implemented. Even in palliative care, patients indicate that their spiritual concerns are often inadequately addressed. Many clinicians report that they lack the required communication skills to adequately address spiritual concerns, while patients are not used to bring up their spiritual needs by themselves. As spiritual needs can only be integrated into care delivery if known to the practitioners, an explicit assessment is necessary. There are numerous instruments to assess spiritual aspects in the context of health care research - but only few to be used in a clinical context. Furthermore, there are many instruments that take into account the specific spiritual needs at the end of life in palliative care, while there are fewer established instruments in the care of chronic diseases. To close this gap, the investigators constructed and validated a new screening tool for assessing spiritual distress and resources, the Spiritual Distress and Resources Questionnaire (SDRQ) in patients with chronic pain in a previous project within the National Research Program "Smarter Health Care" (NRP 74).

The results of this NRP 74 project showed clearly: Spiritual aspects are considered as important in the context of chronic pain by health care professionals and patients alike. They could be important resources to be integrated in a multimodal pain therapy.

In this study, the investigators want to assess spiritual resources, spiritual distress and spiritual coping in patients with psychiatric disorders of the affective spectrum. To compare the results with the results of chronic pain patients, similar questionnaires as in the above mentioned study within NRP 74 will be used. Additionally, the investigators want to assess the proportion and characteristics of patients who wish spiritual aspects to be integrated in the therapeutic setting. Overall, the goal is to create knowledge to adequately address spiritual aspects in those patients who wish the integration of their spiritual needs into treatment.

Inclusion Criteria:

• Minimum age of 18 years
• Sufficient command of German language as assessed by local study coordinator
• Psychiatric disorder of the affective spectrum (depressive disorder, anxiety disorder, obsessive-compulsive disorder, adjustment disorder, somatoform disorder)

Exclusion Criteria:

• Cognitive disorders that would impair participation in assessment

To investigate the objectives, 220 psychiatric patients suffering from an affective disorder (ICD F3/F4) will be recruited consecutively. Because we assess a questionnaire with 22 items for our primary objective, the number of 220 patients seems reasonable. The project population consists of psychiatric patients at the outpatient and day-clinics of the Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry of Zurich.