Religion, spirituality and depression in prospective studies: A systematic review
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BACKGROUND: Many empirical studies have shown inverse associations between measures of religiousness and spirituality (R/S) and depression. Although the majority of these studies is cross-sectional, a considerable number of prospective studies have also appeared. METHODS: The current systematic review offers an overview of the major pattern of associations between the measures of R/S and depression / depressive symptoms in 152 prospective studies (until 2017). RESULTS: With on average two R/S measures per study (excluding measures of religious struggle, treated separately), 49% reported at least one significant association between R/S and better course of depression, 41% showed a non-significant association, and 10% indicated an association with more depression or mixed results. The estimated strength of these associations was modest (d = -0.18). Of the studies that included religious struggle, 59% reported a significant association with more depression (d = +0.30). Especially among persons identified with psychiatric symptoms, R/S was significantly more often protective (d = -0.37). In younger samples and in samples of patients with medical illness, R/S was less often protective. Studies with more extensive adjustment for confounding variables showed significantly more often associations with less depression. Geographical differences in the findings were not present. LIMITATIONS: Given the huge heterogeneity of studies (samples size, duration of follow-up), the current synthesis of evidence is only exploratory. CONCLUSION: In about half of studies, R/S predicted a significant but modest decrease in depression over time. Further inquiry into bi-directional associations between religious struggle and (clinical) depression over time seems warranted.
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Prospective high-quality studies have confirmed the predominantly positive effect of R/S across different psychiatric conditions, including depressive disorders and bipolar disorders.
“Prospective high-quality studies have confirmed the predominantly positive effect of R/S across different psychiatric conditions, including depressive disorders8 and bipolar disorders,9”
Being religious is often associated with improved mental health.
“Evidence suggests that being religious is often associated with improved mental health.1–3”
From Religiosity & mental health seeking behaviors among U.S. adults (2024) · cites this paper as [2]
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- Koenig, H.G., 2018. Religion and Mental Health: Research and Clinical Applications. Academic Press (Elsevier), San Diego, CA, pp. 177-201.
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- Authors
- Braam, A. W., & Koenig, H. G.
- Affiliations
- University of Humanistic Studies (NL)
- Duke University (US)
- Corresponding author
- Braam, Arjan W.
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2019-10
- Volume
- 257
- Pages
- 428-438
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W2956051434
- Cited by
- 340
- References
- 24
- Citations by year
- 2026: 30 · 2025: 47 · 2024: 37 · 2023: 97 · 2022: 44 · 2021: 60 · 2020: 22 · 2019: 1 · 2013: 1
- FWCI
- 6.71
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Affective Disorders (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- University of Humanistic Studies OAI Repository (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Topics
- Social Sciences › Health › Religion, Spirituality, and Psychology
- Social Sciences › Sociology and Political Science › Religion and Society Interactions
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- religiosity, spirituality, depression, depressive symptoms, religious struggle, course of depression, protective factors, psychiatric symptoms, disease, confounding adjustment, prospective study
- MeSH terms
- Depression, Humans, Prospective Studies, Religion, Spirituality
About these checks
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.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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