Depression in a rural area; on the relation between endogenous depression, religion and suicide
The premorbid personality of patients with endogenous (unipolar, vital) depressions frequently shows the typical characteristics of the 'Typus melancholicus' as described by Tellenbach.
It may be supposed that in these patients exists a relation, cq. interaction between these character-traits and a more specific religious orientation which is based on the strictest form of dogmatical Calvinism. Older publications already mentioned a correlation between such a religious orientation and a higher suicide-rate.
Typical points of resemblance can be found between this religious denomination and the so-called pre-depressive character: a high level of conscience, a strong need for achievements but also a slight pessimism, a lability of self-esteem and in the back-ground a latent but constant fear to get into a situation of failing with relation to these 'positive' aspects.
An investigation of the religious orientation among 54 patients with severe endogenous depression gave support to this supposition: 8 of these 54 patients were members of a specimen of such a typical orthodox-calvinistic church, the so-called Reformed-Community.
This number was significantly higher as compared with the number of patients — also members of this church — in a group of 146 hospitalised patients with somatic diseases.
All the patients were treated in the same general hospital and lived in the same (mostly rural) area.