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Spiritual and religious beliefs as risk factors for the onset of major depression: an international cohort study

Published online by Cambridge University Press:  29 January 2013

B. Leurent ,
I. Nazareth ,
J. Bellón-Saameño ,
M.-I. Geerlings ,
H. Maaroos ,
S. Saldivia ,
I. Švab ,
F. Torres-González ,
M. Xavier  and
M. King
B. Leurent
Affiliation:
Mental Health Sciences Unit, Faculty of Brain Sciences, University College London Medical School, UK Research Department of Primary Care and Population Health, University College London Medical School, UK
I. Nazareth
Affiliation:
Research Department of Primary Care and Population Health, University College London Medical School, UK
J. Bellón-Saameño
Affiliation:
Department of Preventive Medicine, El Palo Health Centre, Malaga, Spain
M.-I. Geerlings
Affiliation:
University Medical Centre, Utrecht, The Netherlands
H. Maaroos
Affiliation:
Faculty of Medicine, University of Tartu, Estonia
S. Saldivia
Affiliation:
Departamento de Psiquiatrıa y Salud Mental, Universidad de Concepción, Chile
I. Švab
Affiliation:
Department of Family Medicine, University of Ljubljana, Slovenia
F. Torres-González
Affiliation:
CIBERSAM-Granada University, Granada, Spain
M. Xavier
Affiliation:
Department of Mental Health, Faculdade Ciencias Medicas, CEDOC, Lisboa, Portugal
M. King*
Affiliation:
Mental Health Sciences Unit, Faculty of Brain Sciences, University College London Medical School, UK
*
*Address for correspondence: Professor M. King, Mental Health Sciences Unit, University College London, Charles Bell House, 67–73 Riding House Street, London W1W 7EJ, UK. (Email: michael.king@ucl.ac.uk)
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Abstract

Background

Several studies have reported weak associations between religious or spiritual belief and psychological health. However, most have been cross-sectional surveys in the USA, limiting inference about generalizability. An international longitudinal study of incidence of major depression gave us the opportunity to investigate this relationship further.

Method

Data were collected in a prospective cohort study of adult general practice attendees across seven countries. Participants were followed at 6 and 12 months. Spiritual and religious beliefs were assessed using a standardized questionnaire, and DSM-IV diagnosis of major depression was made using the Composite International Diagnostic Interview (CIDI). Logistic regression was used to estimate incidence rates and odds ratios (ORs), after multiple imputation of missing data.

Results

The analyses included 8318 attendees. Of participants reporting a spiritual understanding of life at baseline, 10.5% had an episode of depression in the following year compared to 10.3% of religious participants and 7.0% of the secular group (p < 0.001). However, the findings varied significantly across countries, with the difference being significant only in the UK, where spiritual participants were nearly three times more likely to experience an episode of depression than the secular group [OR 2.73, 95% confidence interval (CI) 1.59–4.68]. The strength of belief also had an effect, with participants with strong belief having twice the risk of participants with weak belief. There was no evidence of religion acting as a buffer to prevent depression after a serious life event.

Conclusions

These results do not support the notion that religious and spiritual life views enhance psychological well-being.

Keywords

General practicelongitudinalmajor depressionreligionspirituality
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 10 , October 2013 , pp. 2109 - 2120
Copyright
Copyright © Cambridge University Press 2013 

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