In this study, we focused on the role of spirituality and its function in the mood stabilization of different patient groups with severe skin diseases. Our main finding was that all parameters of mood pathology were negatively associated with existential and, to a minor extent, with religious well-being. Most significantly, hope immanent (for a better future) was confirmed as being the strongest negative correlate of mood pathology. More unexpectedly, hope transcendent (for a better afterlife) also turned out as a distinct predictor of more adequate adjustment to a chronic/life-threatening skin disease. In line with the previous findings [
1], we observed an increased amount of somatization in SSc compared to MM patients. This could also be the cause of reduced physical well-being as published recently [
24]. Interestingly, we found that the dimension of connectedness (feeling connected with the universe) was positively related to all parameters of psychiatric symptom burden. This is in contrast to recent research which mostly demonstrated the salutogenic effect of the feeling of “being connected” in anxious/depressive inpatients, assessed by means of different parameters, such as sense of coherence or more adequate coping strategies. However, in conjunction with the previous work, we assumed that feeling connected to the universe might mirror feelings of alienation and isolation from the real world in this specific patient group [
23]. In more recent studies, we could show that patients with a skin disease exhibited a substantially lower level of experiences of sense and meaning (
p < 0.001) in comparison with the general population. Patients with LE had a lower religious/spiritual well-being (
p < 0.001), while patients with LE and MM had a lower level of general religiosity (
p < 0.001) and religious well-being (
p < 0.001). By contrast, MM patients exhibited a higher level of forgiveness (
p < 0.01) and hope transcendent (
p < 0.01) and a lower level of connectedness (
p < 0.001). No differences were found for hope immanent and the amount of existential well-being in skin disease patients compared to the general population [
24].
In line with the previous research [
23], we conclude that our initial results, concerning different groups of patients with severe skin conditions, confirm the hypothesis that there exists a high therapeutic potential of the spiritual dimension in clinical treatment. However, these results still have to be confirmed by employing larger samples incorporating centres in other countries and different dermatologic patient groups, such as metastasizing melanoma, psoriasis, or atopic dermatitis. Further studies might also consider the fact that other variables, such as personality traits, could mediate or moderate the correlations in addition to poor QoL that might have also influenced the outcome of the current study in SSc and LE patients [
3]. Therefore, more research is needed to make a more general statement about the role of spirituality in skin diseases. The dimension of hope, especially, seems to be of central relevance for the mood stability of patients dealing with these severe skin diseases. Further research might focus now on the development of spiritually integrated therapeutic interventions, such as supplying patients, with hope or discussing existential questions as a potential treatment for dermatological patients [
2]. In fact, there is already a lot of literature on how to integrate spiritual dimensions, such as hope or sense, of meaning most effectively into patient treatment [
19]. Hope therapy [
18] was reported to increase some psychological strengths and reduce some symptoms of psychopathology [
4]. Furthermore, the core-dimension of existential therapy [
16] of finding a meaning in life for psychological well-being can be found prominently discussed in the literature [
25].