Religiosity and Remission of Depression in Medically Ill Older Patients

Department of Psychiatry, Duke University Medical Center, Durham, NC 27710, USA.
American Journal of Psychiatry (Impact Factor: 12.3). 05/1998; 155(4):536-42. DOI: 10.1176/ajp.155.4.536
Source: PubMed


The effects of religious belief and activity on remission of depression were examined in medically ill hospitalized older patients.
Consecutive patients aged 60 years or over who had been admitted to medical inpatient services at a university medical center were screened for depressive symptoms. Of 111 patients scoring 16 or higher on the Center for Epidemiologic Studies Depression Scale, 94 were diagnosed with depressive disorder (DSM-III major depression or subsyndromal depression) by a psychiatrist using a structured psychiatric interview. After hospital discharge, depressed patients were followed up by telephone at 12-week intervals four times. At each follow-up contact, criterion symptoms were reassessed, and changes in each symptom over the interval since last contact were determined. The median follow-up time for 87 depressed patients was 47 weeks. Religious variables were examined as predictors of time to remission by means of a multivariate Cox model, with controls for demographic, physical health, psychosocial, and treatment factors.
During the follow-up period, 47 patients (54.0%) had remissions; the median time to remission was 30 weeks. Intrinsic religiosity was significantly and independently related to time to remission, but church attendance and private religious activities were not. Depressed patients with higher intrinsic religiosity scores had more rapid remissions than patients with lower scores.
In this study, greater intrinsic religiosity independently predicted shorter time to remission. To the authors' knowledge, this is the first report in which religiosity has been examined as a predictor of outcome of depressive disorder.


Available from: Harold Koenig
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    • "Religious beliefs and practices may prevent the development of depression, promote the resolution of depression , and/or help persons with depressive disorder cope with the illness [34]-[36]. Given the physiological alterations that occur in depression, religious beliefs and behaviors may help to normalize those changes. "
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    ABSTRACT: Background: Religious practices/experiences (RPE) may produce positive physiological changes in patients with major depressive disorder (MDD) and chronic medical illness. Here, we report cross-sectional relationships between depressive symptoms, RPE and stress biomarkers (pro-/ anti-inflammatory measures and stress hormones), hypothesizing positive associations between depressive symptoms and stress biomarkers and inverse associations between RPE and stress biomarkers. Methods: We recruited 132 individuals with both MDD and chronic illness into a randomized clinical trial. First, stress biomarkers in the baseline sample were compared to biomarker levels from a community sample. Second, relationships between depressive symptoms and biomarkers were examined, and, finally, relationships between RPE and biomarkers were * Corresponding author. D. L. Bellinger et al. 336 analyzed, controlling for demographics, depressive symptoms, and physical functioning. Results: As expected, inflammatory markers and stress hormones were higher in our sample with MDD compared to community participants. In the current sample, however, depressive symptoms were largely unrelated to stress biomarkers, and were unexpectedly inversely related to proinflam-matory cytokine levels (TNF-α, IL-1β). Likewise, while RPE were largely unrelated to stress biomarkers, they were related to the anti-inflammatory cytokine IL-1RA and the stress hormone norepinephrine in expected directions. Unexpectedly, RPE were also positively related to the pro-inflammatory cytokine IFN-γ and to IFN-γ/IL-4 and IFN-γ/IL-10 ratios. Conclusions: Little evidence was found for a consistent pattern of relationships between depressive symptoms or religiosity and stress biomarkers. Of the few significant relationships, unexpected findings predominated. Future research is needed to determine whether religious interventions can alter stress bio-markers over time in MDD.
    Open Journal of Psychiatry 10/2014; 4(4):335-352. DOI:10.4236/ojpsych.2014.44040
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    • "The present findings are consistent with the results of a recent systematic review of studies published before 2010 that reported over 90% of 42 studies found significant relationships between religious involvement and purpose or meaning in life, over 80% of 32 studies found significant relationships with optimism, 70% of 47 studies found relationships with generosity or altruism, and all five relevant studies reported relationships with gratefulness [16]. Research supports the view that religious beliefs and practices promote certain attitudes and practices that could help individuals with chronic medical illness adapt over the long-term to the disability and other life changes brought on by illness [12] [13] [14]. These findings are also consistent with a growing volume of research on religion/spirituality and quality of life [48] [49]. "
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    ABSTRACT: Objective: Religious involvement may help individuals with chronic medical illness cope better with physical disability and other life changes. We examine the relationships between religiosity, depressive symptoms, and positive emotions in persons with major depression and chronic illness. Methods: 129 persons who were at least somewhat religious/spiritual were recruited into a clinical trial to evaluate the effectiveness of religious vs. secular cognitive behavioral therapy. Reported here are the relationships at baseline between religious involvement and depressive symptoms, purpose in life, optimism, generosity, and gratefulness using standard measures. Results: Although religiosity was unrelated to depressive symptoms (F=0.96, p=0.43) and did not buffer the disability-depression relationship (B=-1.56, SE 2.90, p=0.59), strong relationships were found between religious indicators and greater purpose, optimism, generosity, and gratefulness (F=7.08, p<0.0001). Conclusions: Although unrelated to depressive symptoms in the setting of major depression and chronic medical illness, higher religious involvement is associated with positive emotions, a finding which may influence the course of depression over time.
    Journal of Psychosomatic Research 08/2014; 77(2). DOI:10.1016/j.jpsychores.2014.05.002 · 2.74 Impact Factor
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    • "Moreover, spiritual traditions for many centuries have provided theories of human nature and strategies for wellness, whether explicit or implicit, within dogma, practices, ritual, or sacred texts (Koenig et al., 1998; McCullough & Larson, 1999; Spilka & Bridges, 1989). Prayer and meditation, for instance, are often cited as valuable resources that reduce stress while fostering resilience and healing (Baetz Bowen, Jones, & Koru-Sengul, 2006; Hatala, 2008, 2011; Shapiro, 2009). "
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    ABSTRACT: The current status of the “biopsychosocial” model in health psy- chology is contested and arguably exists in a stage of infancy. Despite original goals, researchers have developed theoretical inte- grations across biopsychosocial domains only to a limited extent. In addition, the marginalization of “spirituality” in contempo- rary biopsychosocial health perspectives is questionable. This article addresses these issues by providing evidence that supports the inclu- sion of spirituality within current perspectives while at the same time discussing implications this inclusion bears on the concept of health. Overall, a biopsychosocial–spiritual or “holistic” perspective is advanced for use within health psychology, provided it can be approached from a multilevel integrative analysis. In the end, some clinical implications are discussed.
    Journal of Spirituality in Mental Health 10/2013; 15(4):256-276. DOI:10.1080/19349637.2013.776448
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