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Association Between Religious Service Attendance and Lower Suicide Rates Among US Women
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IMPORTANCE: Previous studies have linked suicide risk with religious participation, but the majority have used ecologic, cross-sectional, or case-control data. OBJECTIVE: To examine the longitudinal association between religious service attendance and suicide and the joint associations of suicide with service attendance and religious affiliation. DESIGN, SETTING, AND PARTICIPANTS: We evaluated associations between religious service attendance and suicide from 1996 through June 2010 in a large, long-term prospective cohort, the Nurses' Health Study, in an analysis that included 89 708 women. Religious service attendance was self-reported in 1992 and 1996. Data analysis was conducted from 1996 through 2010. MAIN OUTCOMES AND MEASURES: Cox proportional hazards regression models were used to examine the association between religious service attendance and suicide, adjusting for demographic covariates, lifestyle factors, medical history, depressive symptoms, and social integration measures. We performed sensitivity analyses to examine the influence of unmeasured confounding. RESULTS: Among 89 708 women aged 30 to 55 years who participated in the Nurses' Health Study, attendance at religious services once per week or more was associated with an approximately 5-fold lower rate of suicide compared with never attending religious services (hazard ratio, 0.16; 95% CI, 0.06-0.46). Service attendance once or more per week vs less frequent attendance was associated with a hazard ratio of 0.05 (95% CI, 0.006-0.48) for Catholics but only 0.34 (95% CI, 0.10-1.10) for Protestants (P = .05 for heterogeneity). Results were robust in sensitivity analysis and to exclusions of persons who were previously depressed or had a history of cancer or cardiovascular disease. There was evidence that social integration, depressive symptoms, and alcohol consumption partially mediated the association among those occasionally attending services, but not for those attending frequently. CONCLUSIONS AND RELEVANCE: In this cohort of US women, frequent religious service attendance was associated with a significantly lower rate of suicide.
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“and even greater protective effects regarding substance use disorders10 and suicide risk.11,12”
From Brazilian Psychiatric Association guidelines on the integration of spirituality into mental health clinical practice: Part 1. Spiritual history and differential diagnosis (2023) · cites this paper as [12]
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Long, K. N. G., Gregg, R., VanderWeele, T. J., Oman, D., & Laird, L. D. (2019) · Religions · doi:10.3390/rel10070412 · Cited by 13
Self-citationHathaway, D. B., Oliveira, F. H. A. D. O. E., Mirhom, M., Moreira‐Almeida, A., Fung, W. L. A., & Peteet, J. R. (2021) · Academic Medicine · doi:10.1097/acm.0000000000004167 · Cited by 14
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“11, 12 However, since specific ways to interpret or experience R/S, including the use of negative religious coping strategies, could be associated with worse mental health outcomes, clinicians should be aware of these potential negative effects in clinical practice.”
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Metadata
- Authors
- VanderWeele, T. J., Li, S., Tsai, A. C., & Kawachi, I.
- Affiliations
- Harvard University (US)
- Corresponding author
- VanderWeele, Tyler J.
- Venue
- JAMA Psychiatry
- Publisher
- American Medical Association (AMA)
- Published
- 2016-08-01
- Volume
- 73
- Issue
- 8
- Pages
- 845
- ISSN
- 2168-622X (ISSN-L)
- PMC
- PMC7228478
- OpenAlex
- W2461556580
- Cited by
- 363
- References
- 35
- Citations by year
- 2026: 20 · 2025: 53 · 2024: 31 · 2023: 69 · 2022: 29 · 2021: 38 · 2020: 41 · 2019: 25 · 2018: 28 · 2017: 20 · 2016: 8
- FWCI
- 35.67
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- JAMA Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- National Cancer Institute (UM1CA186107)
- Topics
- Social Sciences › Health › Religion, Spirituality, and Psychology
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Sociology and Political Science › Religion and Society Interactions
- Keywords
- religious service attendance, suicide, religious affiliation, women, Catholicism, Protestantism, social integration, depressive symptoms, alcohol consumption, suicide risk factors, Nurses' Health Study
- MeSH terms
- Suicide Prevention, Adult, Cause of Death, Female, Health Surveys, Humans, Longitudinal Studies, Middle Aged, Prospective Studies, Religion and Psychology, Risk, Sex Factors, Statistics as Topic, Suicide, United States, Cohort Studies, Proportional Hazards Models, Case-Control Studies
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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