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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 disorders8 and bipolar disorders,9”
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“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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Metadata
- 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
- 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
- Health Sciences › Medicine › Psychiatry and Mental health › 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
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![Fig. 1 Flowchart on the inclusion of papers for the current systematic review (note: 'Other sources' also included an EMBASE search [534 abstracts, 11 selected] with exclusion of papers that had also been identified in Pubmed and Psychinfo).](/paper-figures/1b6e84f5b14e4654ad7476d8fbc567b5/religion-spirituality-and-depression-in-prospective-studies-a-systematic-review-figure-1.png)