Relationship between Spirituality and Acceptance of Illness Level in Bipolar Patients

Olga Putri Atsira, Erikavitri Yuliati, Atika Atika, Abdurachman Abdurachman, Margarita Maria Maramis


Bipolar disorder is a chronic mental condition that affects patients’ quality of life. The management process is affected by acceptance of illness. The ability to accept the illness is related to the spirituality level which is something that is held strongly by Indonesian people. There has been very little research related to the relationship between spirituality with bipolar disorder. This study aimed to analyze relationship between spirituality levels with acceptance of illness in patients with bipolar disorder. This study is a correlational study using questionnaire from bipolar disorder patients contacted through Harmony in Diversity online community as a sample. Samples were taken in total sampling according to inclusion and exclusion criteria. The numbers of samples were 30 samples. Calculation of the correlation between acceptance of illness in patients with bipolar disorder with vertical spirituality (RWB) (p = 0.050) (r = 0.306), horizontal spirituality (EWB) (p = 0.001) (r = 0.556), and general spirituality (SWB) (p = 0.007) (r = 0.444). There is a significant positive correlation between acceptance of illness in patients with bipolar disorder and general spirituality with a more significant horizontal dimension compared to vertical dimension.


acceptance of illness, bipolar disorder, spirituality


 1. NIMH. Bipolar Disorder [Internet]. NIMH; 2018. Available from:

 2. Merikangas KR, Jin R, He J-P, Kessler RC, Lee S, Sampson NA, et al. Prevalence and Correlates of Bipolar Spectrum Disorder in the World Mental Health Survey Initiative. Arch Gen Psychiatry [Internet]. 2011;68(3):241. Available from:

 3. Cruz M, Pincus HA, Welsh DE, Greenwald D, Lasky E, Kilbourne AM. The relationship between religious involvement and clinical status of patients with bipolar disorder. Bipolar Disord. 2010;12(1):68–76.

 4. Chang CK, Hayes RD, Perera G, Broadbent MTM, Fernandes AC, Lee WE, et al. Life expectancy at birth for people with serious mental illness and other major disorders from a secondary mental health care case register in London. PLoS One. 2011;6(5).

 5. Phillips ML. Neural Markers That Distinguish Bipolar Disorder From Major Depressive Disorder: Moving Closer to a Reality. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging; 2019.

 6. Mccormick U, Murray B, Mcnew B. Diagnosis and treatment of patients with bipolar disorder: A review for advanced practice nurses. J Am Assoc Nurse Pract. 2015;27(9):530–42.

 7. Kanyangarara M, Hamapumbu H, Mamini E, Lupiya J, Stevenson JC, Mharakurwa S, et al. Malaria knowledge and bed net use in three transmission settings in southern Africa. Malar J; 2018.

 8. Roy NT, Sajith M, Bansode MP. Assessment of factors associated with low adherence to pharmacotherapy in elderly patients. J Young Pharm; 2017.

 9. Netczuk-Gwozdziewicz M. Personal resources in coping with stress among paramedics part 2. Sci J Mil Univ L Forces; 2018.

 10. Ho RTH, Chan CKP, Lo PHY, Wong PH, Chan CLW, Leung PPY, et al. Understandings of spirituality and its role in illness recovery in persons with schizophrenia and mental-health professionals: A qualitative study. BMC Psychiatry; 2016.

 11. Faigin CA, Pargament KI. Strengthened by the spirit: Religion, spirituality, and resilience through adulthood and aging. In: Resilience in Aging: Concepts, Research, and Outcomes. 2011. p. 163–80.

 12. Granqvist P, Kirkpatrick LA. Religion, spirituality, and attachment. In: APA handbook of psychology, religion, and spirituality : Context, theory, and research [Internet]. 2013. p. 139–55. Available from:

 13. McCullough ME, Carter EC. Religion, self-control, and self-regulation: How and why are they related? In: APA handbook of psychology, religion, and spirituality (Vol 1): Context, theory, and research; 2012.

 14. Koenig HG. Religion, Spirituality, and Health: The Research and Clinical Implications. ISRN Psychiatry [Internet]. 2012;2012:1–33. Available from:

 15. Jaberi A, Momennasab M, Yektatalab S, Ebadi A, Cheraghi MA. Spiritual Health: A Concept Analysis. Journal of Religion and Health; 2017.

 16. Williams N. The mood disorder questionnaire. Occupational Medicine. 2017.

 17. Imam SSS, Karim NHAN, Jusoh NR, Mamad NE. Malay Version of Spiritual Well-being Scale: Is Malay Spiritual Well-Being Scale A Psychometrically Sound Instrument? J Behav Sci [Internet]. 2009;4(1):72–83. Available from:

 18. Chabowski M, Polański J, Jankowska-Polanska B, Lomper K, Janczak D, Rosinczuk J. The acceptance of illness, the intensity of pain and the quality of life in patients with lung cancer. J Thorac Dis; 2017.

 19. Randall D, Thomas M, Whiting D, McGrath A. Depression Anxiety Stress Scales (DASS-21). J Head Trauma Rehabil; 2017.

 20. Rowland TA, Marwaha S. Epidemiology and risk factors for bipolar disorder. Ther Adv Psychopharmacol; 2018.

 21. Vega P, Barbeito S, Ruiz De Azúa S, Martínez-Cengotitabengoa M, González-Ortega I, Saenz M, et al. Bipolar disorder differences between genders: Special considerations for women. Women’s Health; 2011.

 22. Allahbakhshian M, Javarpour M, Parvizi S. Spiritual well-being of patients with multiple sclerosis. Iran J Nurs Midwifery Res [Internet]. 2016;16:202–6. Available from:

 23. Rezaie Z, Sciences M, Welfare S, Sciences M, Sciences M. Relationship between components of Spiritual well-being with hope and life satisfaction in elderly cancer patients in Kashan ; 2015.

 24. Sidhom Y, Djebara M Ben, Hizem Y, Abdelkefi I, Kacem I, Gargouri A, et al. Bipolar disorder and multiple sclerosis: A case series. Behav Neurol; 2014.

 25. Kahan NR, Silverman B, Liphshitz I, Waitman DA, Ben-Zion I, Ponizovsky AM, et al. No apparent association between bipolar disorder and cancer in a large epidemiological study of outpatients in a managed care population. Int Clin Psychopharmacol; 2018.

 26. Nasiry Zarrin Ghabaee, Davood., Bagheri-Nesami M, Malekzadeh Shafaroudi M. Relationship between spiritual well-being and quality of life in multiple sclerosis patients. J Nurs Midwifery Sci. 2016;3(2):25–31.

 27. Bogusz R, Humeniuk E. Psychosocial determinants of disease acceptance in selected mental disorders. Ann Agric Environ Med; 2017.

 28. Uchmanowicz I, Jankowska-Polanska B, Motowidlo U, Uchmanowicz B, Chabowski M. Assessment of illness acceptance by patients with COPD and the prevalence of depression and anxiety in COPD. Int J COPD; 2016.

 29. Liu X, Yang X, Yao L, Zhang Q, Sun D, Zhu X, et al. Prevalence and related factors of depressive symptoms in hemodialysis patients in northern China. BMC Psychiatry. 2017;

 30. Jafari E, Dehshiri GR, Eskandari H, Najafi M, Heshmati R, Hoseinifar J. Spiritual well-being and mental health in university students. In: Procedia - Social and Behavioral Sciences; 2010.

 31. Wagani R, Colucci E. Spirituality and wellbeing in the context of a study on suicide prevention in North India. Religions; 2018.

 32. Yahaya N, Momtaz YA, Othman M, Sulaiman N, Arisah FM. Spiritual well-being and mental health among Malaysian adolescents. Life Sci J. 2012;9(1):440–8.

 33. Taliaferro LA, Rienzo BA, Pigg RM, Miller MD, Dodd VJ. Spiritual well-being and suicidal ideation among college students. J Am Coll Heal; 2009.

 34. Anema C, Johnson M, Zeller JM, Fogg L, Zetterlund J. Spiritual well-being in individuals with fibromyalgia syndrome: Relationships with symptom pattern variability, uncertainty, and psychosocial adaptation. Res Theory Nurs Pract; 2009.

 35. Lee Y. The relationship of spiritual well-being and involvement with depression and perceived stress in Korean nursing students. Glob J Health Sci; 2014.



  • There are currently no refbacks.