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Research on Religion, Spirituality, and Mental Health: A Review
Open accessAbstract
Religious and spiritual factors are increasingly being examined in psychiatric research. Religious beliefs and practices have long been linked to hysteria, neurosis, and psychotic delusions. However, recent studies have identified another side of religion that may serve as a psychological and social resource for coping with stress. After defining the terms religion and spirituality, this paper reviews research on the relation between religion and (or) spirituality, and mental health, focusing on depression, suicide, anxiety, psychosis, and substance abuse. The results of an earlier systematic review are discussed, and more recent studies in the United States, Canada, Europe, and other countries are described. While religious beliefs and practices can represent powerful sources of comfort, hope, and meaning, they are often intricately entangled with neurotic and psychotic disorders, sometimes making it difficult to determine whether they are a resource or a liability.
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“Spirituality serves to comfort people, assuage anxiety, and increase feelings of security, also boosting confidence in oneself and/or in what Harold G. Koenig (2009) calls “Divine beings”.”
From Trauma, Spirituality, and Healing: A Journey through the Lens of an Incarcerated Person (2022) · cites this paper as Koenig (2009)
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“In extant literature, spirituality is shown to predict psychological well-being for adults who have experienced childhood trauma (Balgobin 2021), leading to less depression, suicide, anxiety, and substance abuse (Koenig 2009).”
From Trauma, Spirituality, and Healing: A Journey through the Lens of an Incarcerated Person (2022) · cites this paper as Koenig 2009
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“The research literature on religiosity and mental health offers two entangled empirical narratives: some studies suggest that religious beliefs can present a psychological buffer against stress and hopelessness; other studies, however, indicate an intricate link between religious beliefs and psychotic and neurotic disorders [54–56].”
From Unpleasant meditation-related experiences in regular meditators: Prevalence, predictors, and conceptual considerations (2019) · cites this paper as [55]
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“As we see through Joseph's experience, Koenig (2009) shows that the struggles that arise from negative spiritual coping can significantly increase anxiety, wherein people feel that God is punishing them, has abandoned them, or is not able to intercede on their behalf.”
From Trauma, Spirituality, and Healing: A Journey through the Lens of an Incarcerated Person (2022) · cites this paper as Koenig (2009)
In the citing paper
“Also, religion and spirituality seem to confer resilience 112, 113.”
From Resilience in mental health: linking psychological and neurobiological perspectives. (2013) · cites this paper as [112]
In the citing paper
“Thus, religious beliefs may provide a sense of meaning and purpose during difficult life circumstances 112.”
From Resilience in mental health: linking psychological and neurobiological perspectives. (2013) · cites this paper as [112]
In the citing paper
“One of them is that religion and spirituality may stimulate a sense of life purpose 112, 115”
From Resilience in mental health: linking psychological and neurobiological perspectives. (2013) · cites this paper as [112]
In the citing paper
“Some authors33,34 attribute this finding to the influence of psychological theories, such as Sigmund Freud's35 psychoanalysis, which is known to have pathologized religious behavior.”
From How psychiatrists think about religious and spiritual beliefs in clinical practice: findings from a university hospital in São Paulo, Brazil (2019) · cites this paper as [34]
In the citing paper
“Religion/spirituality has been associated, for example, with lower rates of suicide, depression, anxiety, and substance misuse, better recovery in cases of depression and greater overall well-being.1–4”
From A preliminary survey on the religious profile of Brazilian psychiatrists and their approach to patients' religiosity in clinical practice (2016) · cites this paper as [3]
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“…differences in definitions and conceptualizations, religion and spirituality (R/S) are often examined together, or the terms are used interchangeably (Koenig, 2009), with positive associations being found between R/S, mental and physical health variables, and resilience (Schwalm et al., 2022).”
White, C., & Ramos, A. (2025) · International Journal for the Psychology of Religion · doi:10.1080/10508619.2025.2521574 · Cited by 2
“Substantial previous research has found a positive association between religious commitments, positive mental health status, and greater life satisfaction (Greenfield & Marks, 2007; Koenig, 2009; Lim & Putnam, 2010).”
Mental illness in Catholic priests: evidence for research and mental health care
Bocalon, P. C., Rossato, L., Scorsolini‐Comin, F., & Mendes, K. D. S. (2024) · Mental Health Religion & Culture · doi:10.1080/13674676.2024.2436435 · Cited by 1
“Understanding the complexities of priests ’ mental health is crucial to developing e ff ective interventions and support programmes, which should incorporate religiosity and spirituality as essential dimensions of care (Cunha et al., 2021; Koenig,2009).”
Mental Health and Illness Perceptions and Experiences in Canadian Christian Congregations
Thiessen, J., Cusanelli, E., Wong, A. C. K., & Roso, J. (2025) · Review of Religious Research · doi:10.1177/0034673x251348193 · Cited by 1
“…and resources are for shaping human perceptions, experiences, and identity related to health and well-being, including religion’s reported positive effects in this domain (Aneshensel, Phelan, Thiessen et al. and Bierman 2013; Durkheim 1951; Ellison 1991; Koenig 2009; VanderWeele et al. 2016).”
Yoo, J. (2025) · Journal for the Study of Spirituality · doi:10.1080/20440243.2025.2518923 · Cited by 1
“…as an organized and shared system of beliefs derived from institutional religion (Cragun, Hammer, and Nielsen 2015; Saroglou 2014), spirituality is described as connectedness with sacred others and a search for inner peace or meaning in life (Koenig 2009; Weath-ers, McCarthy, and Coffey 2015).”
Matta, S. E., Schieffler, D. A., Braford, M. B., Kanter, R. L., Staysniak, G., Jester, D. J., & Jeste, D. V. (2025) · Military Medicine · doi:10.1093/milmed/usaf487 · Cited by 1
Baran, P. M., Pereira, D., Pocinho, M. M. F. D. D., Rodrigues, N. M. V., & Mamcarz, P. J. (2025) · Scientific Reports · doi:10.1038/s41598-025-30165-4 · Cited by 3
“This finding contradicts traditional assumptions about spirituality’s universally beneficial effects 32 but aligns with emerging research on spiritual struggles 81 .”
Gannamraju, S. K., & Chembrolu, V. H. (2025) · Frontiers in Psychology · doi:10.3389/fpsyg.2025.1730103 · Cited by 1
Chan, W. Y. A., Tulloch, G., & Patrick, M. (2025) · Journal of Disability & Religion · doi:10.1080/23312521.2025.2594216 · Cited by 1
“…hope, grat-itude, empowerment, ability to cope with stress, and lower levels of depression/anxiety and loneliness, etc.), and social wellbeing (e.g. marital adjustment and satisfaction, social connectedness, more prosocial behaviors, etc.) (Bożek et al., 2020; Fry, 2024; Koenig, 2009; Ryff, 2021).”
Hamamra, B. T., Shehab, E., & Zabadi, N. (2025) · Victims & Offenders · doi:10.1080/15564886.2025.2601615 · Cited by 1
“While global literature often identifies religion as a protective factor against suicide (Kannan et al., 2010; Koenig, 2009), our findings, consistent with Saiz et al. (2021) and Ooi et al. (2023), illustrate how, for some, faith can become a source of guilt or feelings of abandonment by God.”
Brandt, P.-Y., Hashimoto, Y. Z., Robert, Z. D., Dessart, G., & Stauffer, L. (2025) · Religions · doi:10.3390/rel16121581 · Cited by 1
“…with mental health, several have results that present a U-shaped curve for the relationship between religion/spirituality and mental health (Badyal 2003; Balbuena et al. 2013; Blazer 2009; Dilmaghani 2018; Koenig 2009; Rasic et al. 2011; Rickhi et al. 2015; Schieman 2008; Snowshoe et al. 2017).”
Szczukiewicz, P., & Ciepliński, K. M. (2025) · Journal of Psychology and Theology · doi:10.1177/00916471251395961 · Cited by 1
“They should possess knowledge about the diversity of patients’ religious beliefs and be trained to distinguish between religious pathology and appropriate expressions of faith (Eck, 2002; Koenig, 2009; Worthington et al., 1996).”
Brown, A. N., & Hunter, S. C. (2026) · Journal of Humanistic Psychology · doi:10.1177/00221678261435219 · Cited by 2
Johnson, K. A. (2026) · Cambridge University Press eBooks · doi:10.1017/9781009527842 · Cited by 1
Tasijawa, F. A., Yusuf, A., Rizki Fitryasari, P. K., & Herwawan, J. H. (2026) · Journal of Religion and Health · doi:10.1007/s10943-026-02763-7 · Cited by 1
Hetsroni, A., & Lowenstein-Barkai, H. (2012) · International journal of communication · Cited by 1
Auditory Processing Learning Disability, Suicidal Ideation, and Transformational Faith
Bailey, F. S., & Yocum, R. G. (2015) · Journal of Research on Christian Education · doi:10.1080/10656219.2015.1008084 · Cited by 1
“As early as kindergarten she viewed herself as somewhat inferior and consequent entries showed that her self-esteem deteriorated as she grew older, phenomena consistent with the findings of Kreisman et al. (2012). Dana participated in remedial academics in elementary, middle, and senior high school.”
BackgroundResultInfluentialNo religion or spirituality and mental health
Mackin, C. (2010) · The Psychiatrist · doi:10.1192/pb.34.7.304a · Cited by 1
Birth practices of Nigerian women in the UK
Dike, P. (2013) · British Journal of Midwifery · doi:10.12968/bjom.2013.21.1.41 · Cited by 1
Addiction in Iran: The Need for Culturally and Religiously Adapted Preventive/Recovery Programs
Hafizi, S. (2013) · international journal high risk behaviors & addiction · doi:10.5812/ijhrba.8003 · Cited by 1
“Koenig H G. Commentary: why do research on spirituality and health, and what do the results mean?”
BackgroundInfluentialThe pain of existing and religion from the perspective of Catholics
Saltareli, S., Raminelli-da-Silva, T. D. C., Castanho, A. C. F., Falconi-Gomez, R. R., Colhado, O. C. G., & Faleiros-Sousa, F. A. E. (2015) · Revista Latino-Americana de Enfermagem · doi:10.1590/0104-1169.0188.2604 · Cited by 1
“Religion offers comfort, meanings and hope for individuals in these situations(17).”
BackgroundThe Spiritual Competence Aspect in Counselling Service
Baru, R., Aeshah, W., Ahmad, A. W., Othman, M. S., Hadhzrullatfhi, S., & Omar, S. H. S. (2014) · RePEc: Research Papers in Economics · Cited by 1
STORY FORMED IDENTITY AND SPIRITUALITY IN PSYCHOLOGICAL AND THEOLOGICAL DIALOGUE
Jankowski, P. J. (2011) · Cited by 1
Metadata
- Authors
- Koenig, H. G.
- Affiliations
- Duke Medical Center (US)
- Corresponding author
- Koenig, Harold G
- ORCID
- Koenig, Harold G
- Venue
- The Canadian Journal of Psychiatry
- Publisher
- SAGE Publications
- Published
- 2009-05
- Volume
- 54
- Issue
- 5
- Pages
- 283-291
- ISSN
- 0706-7437 (ISSN-L)
- 1497-0015
- OpenAlex
- W181914314
- Cited by
- 1,442
- References
- 77
- Citations by year
- 2026: 53 · 2025: 88 · 2024: 100 · 2023: 90 · 2022: 100 · 2021: 122 · 2020: 153 · 2019: 85 · 2018: 101 · 2017: 75 · 2016: 83 · 2015: 70 · 2014: 73 · 2013: 81 · 2012: 76
- FWCI
- 8.39
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Canadian Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Center for Spirituality, Theology and Health, Duke University
- Topics
- Social Sciences › Health › Religion, Spirituality, and Psychology
- Social Sciences › Sociology and Political Science › Religion and Society Interactions
- Social Sciences › Arts and Humanities › Philosophy › Study and Philosophy of Religion
- Keywords
- religion, spirituality, mental health, depression, suicide, anxiety, psychosis, substance abuse, stress coping, religious beliefs and practices, neurosis, psychotic delusions
- MeSH terms
- Adaptation, Psychological, Alcoholism, Anxiety Disorders, Mental Disorders, Culture, Depressive Disorder, Humans, Mental Health, Prognosis, Psychotic Disorders, Religion and Psychology, Suicide, Substance-Related Disorders, Spirituality
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