Religion/spirituality has been increasingly examined in medical research during the past two decades. Despite the increasing number of published studies, a systematic evidence-based review of the available data in the field of psychiatry has not been done during the last 20 years. The literature was searched using PubMed (1990–2010). We examined original research on religion, religiosity, spirituality, and related terms published in the top 25 % of psychiatry and neurology journals according to the ISI journals citation index 2010. Most studies focused on religion or religiosity and only 7 % involved interventions. Among the 43 publications that met these criteria, thirty-one (72.1 %) found a relationship between level of religious/spiritual involvement and less mental disorder (positive), eight (18.6 %) found mixed results (positive and negative), and two (4.7 %) reported more mental disorder (negative). All studies on dementia, suicide, and stress-related disorders found a positive association, as well as 79 and 67 % of the papers on depression and substance abuse, respectively. In contrast, findings from the few studies in schizophrenia were mixed, and in bipolar disorder, indicated no association or a negative one. There is good evidence that religious involvement is correlated with better mental health in the areas of depression, substance abuse, and suicide; some evidence in stress-related disorders and dementia; insufficient evidence in bipolar disorder and schizophrenia, and no data in many other mental disorders.
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Azhar, M. Z., & Varma, S. L. (1995a). Religious psychotherapy in depressive patients. Psychotherapy and Psychosomatics, 63(3–4), 165–168.
Azhar, M. Z., & Varma, S. L. (1995b). Religious psychotherapy as management of bereavement. Acta Psychiatrica Scandinavica, 91(4), 233–235.
Azhar, M. Z., Varma, S. L., & Dharap, A. S. (1994). Religious psychotherapy in anxiety disorder patients. Acta Psychiatrica Scandinavica, 90(1), 1–3.
Bishop, F. L., Barlow, F., Walker, J., McDermott, C., & Lewith, G. T. (2010). The development and validation of an outcome measure for spiritual healing: A mixed methods study. Psychotherapy and Psychosomatics, 79(6), 350–362.
Blay, S. L., Batista, A. D., Andreoli, S. B., & Gastal, F. L. (2008). The relationship between religiosity and tobacco, alcohol use, and depression in an elderly community population. American Journal of Geriatric Psychiatry, 16(11), 934–943.
Bonelli, R. M., & Wenning, G. K. (2006). Pharmacological management of Huntington’s disease: An evidence-based review. Current Pharmaceutical Design, 12(21), 2701–2720.
Borg, J., Andree, B., Soderstrom, H., & Farde, L. (2003). The serotonin system and spiritual experiences. American Journal of Psychiatry, 160(11), 1965–1969.
Borras, L., Mohr, S., Brandt, P. Y., Gillieron, C., Eytan, A., & Huguelet, P. (2007). Religious beliefs in schizophrenia: Their relevance for adherence to treatment. Schizophrenia Bulletin, 33(5), 1238–1246.
Braam, A. W., Beekman, A. T., Deeg, D. J., Smit, J. H., & van Tilburg, W. (1997). Religiosity as a protective or prognostic factor of depression in later life; Results from a community survey in The Netherlands. Acta Psychiatrica Scandinavica, 96(3), 199–205.
Braam, A. W., Beekman, A. T., van den Eeden, P., Deeg, D. J., Knipscheer, K. P., & van Tilburg, W. (1999). Religious climate and geographical distribution of depressive symptoms in older Dutch citizens. Journal of Affective Disorders, 54(1–2), 149–159.
Braam, A. W., Schrier, A. C., Tuinebreijer, W. C., Beekman, A. T., Dekker, J. J., & de Wit, M. A. (2010). Religious coping and depression in multicultural Amsterdam: A comparison between native Dutch citizens and Turkish, Moroccan and Surinamese/Antillean migrants. Journal of Affective Disorders, 125(1–3), 269–278.
Braam, A. W., Van den Eeden, P., Prince, M. J., Beekman, A. T., Kivela, S. L., Lawlor, B. A., et al. (2001). Religion as a cross-cultural determinant of depression in elderly Europeans: Results from the EURODEP collaboration. Psychological Medicine, 31(5), 803–814.
Burt, V. K., & Rudolph, M. (2000). Treating an Orthodox Jewish woman with obsessive-compulsive disorder: Maintaining reproductive and psychologic stability in the context of normative religious rituals. American Journal of Psychiatry, 157(4), 620–624.
Chatters, L. M., Bullard, K. M., Taylor, R. J., Woodward, A. T., Neighbors, H. W., & Jackson, J. S. (2008). Religious participation and DSM-IV disorders among older African Americans: Findings from the National Survey of American Life. American Journal of Geriatric Psychiatry, 16(12), 957–965.
Chi, F. W., Kaskutas, L. A., Sterling, S., Campbell, C. I., & Weisner, C. (2009). Twelve-Step affiliation and 3-year substance use outcomes among adolescents: Social support and religious service attendance as potential mediators. Addiction, 104(6), 927–939.
Coin, A., Perissinotto, E., Najjar, M., Girardi, A., Inelmen, E. M., Enzi, G., et al. (2010). Does religiosity protect against cognitive and behavioral decline in Alzheimer’s dementia? Current Alzheimer Research, 7(5), 445–452.
Cooper, H. M. (1984). The integrated research review: A systematic approach. Beverly Hills, CA: Sage Publications.
Cruz, M., Pincus, H. A., Welsh, D. E., Greenwald, D., Lasky, E., & Kilbourne, A. M. (2010). The relationship between religious involvement and clinical status of patients with bipolar disorder. Bipolar Disorder, 12(1), 68–76.
Cruz, M., Schulz, R., Pincus, H. A., Houck, P. R., Bensasi, S., & Reynolds, C. F, 3rd. (2009). The association of public and private religious involvement with severity of depression and hopelessness in older adults treated for major depression. American Journal of Geriatric Psychiatry, 17(6), 503–507.
Dervic, K., Oquendo, M. A., Grunebaum, M. F., Ellis, S., Burke, A. K., & Mann, J. J. (2004). Religious affiliation and suicide attempt. American Journal of Psychiatry, 161(12), 2303–2308.
Dew, R. E., Daniel, S. S., Goldston, D. B., McCall, W. V., Kuchibhatla, M., Schleifer, C., et al. (2010). A prospective study of religion/spirituality and depressive symptoms among adolescent psychiatric patients. Journal of Affective Disorders, 120(1–3), 149–157.
Fallon, B. A., Liebowitz, M. R., Hollander, E., Schneier, F. R., Campeas, R. B., Fairbanks, J., et al. (1990). The pharmacotherapy of moral or religious scrupulosity. Journal of Clinical Psychiatry, 51(12), 517–521.
Francis, L. J., & Mullen, K. (1993). Religiosity and attitudes towards drug use among 13–15 year olds in England. Addiction, 88(5), 665–672.
Ghandour, L. A., Karam, E. G., & Maalouf, W. E. (2009). Lifetime alcohol use, abuse and dependence among university students in Lebanon: Exploring the role of religiosity in different religious faiths. Addiction, 104(6), 940–948.
Harden, K. P. (2010). Does religious involvement protect against early drinking? A behavior genetic approach. Journal of Child Psychology & Psychiatry, 51(7), 763–771.
Hebert, R. S., Dang, Q., & Schulz, R. (2007). Religious beliefs and practices are associated with better mental health in family caregivers of patients with dementia: Findings from the REACH study. American Journal of Geriatric Psychiatry, 15(4), 292–300.
Horowitz, J. L., & Garber, J. (2003). Relation of intelligence and religiosity to depressive disorders in offspring of depressed and nondepressed mothers. Journal of the American Academy of Child and Adolescent Psychiatry, 42(5), 578–586.
Jones, E., & Watson, J. P. (1997). Delusion, the overvalued idea and religious beliefs: A comparative analysis of their characteristics. British Journal of Psychiatry, 170, 381–386.
Kaplan, Z., Matar, M. A., Kamin, R., Sadan, T., & Cohen, H. (2005). Stress-related responses after 3 years of exposure to terror in Israel: Are ideological-religious factors associated with resilience? Journal of Clinical Psychiatry, 66(9), 1146–1154.
Kaufman, Y., Anaki, D., Binns, M., & Freedman, M. (2007). Cognitive decline in Alzheimer disease: Impact of spirituality, religiosity, and QOL. Neurology, 68(18), 1509–1514.
Kendler, K. S., Gardner, C. O., & Prescott, C. A. (1997). Religion, psychopathology, and substance use and abuse; A multimeasure, genetic-epidemiologic study. American Journal of Psychiatry, 154(3), 322–329.
Kendler, K. S., Liu, X. Q., Gardner, C. O., McCullough, M. E., Larson, D., & Prescott, C. A. (2003). Dimensions of religiosity and their relationship to lifetime psychiatric and substance use disorders. American Journal of Psychiatry, 160(3), 496–503.
King, D. A., Lyness, J. M., Duberstein, P. R., He, H., Tu, X. M., & Seaburn, D. B. (2007). Religious involvement and depressive symptoms in primary care elders. Psychological Medicine, 37(12), 1807–1815.
Koenig, H. G. (2007). Religion and depression in older medical inpatients. American Journal of Geriatric Psychiatry, 15(4), 282–291.
Koenig, H. G. (2008). Concerns about measuring “spirituality” in research. The Journal of Nervous and Mental Disease, 196(5), 349–355.
Koenig, H. G. (2009). Research on religion, spirituality, and mental health: A review. Canadian Journal of Psychiatry, 54(5), 283–291.
Koenig, H. G. (2011). A research agenda for the field (ch. 3). Spirituality & health research: Methods, measurement, statistics, and resources (pp. 47–74). Philadelphia, PA: Templeton Foundation Press.
Koenig, H. G., Cohen, H. J., Blazer, D. G., Pieper, C., Meador, K. G., Shelp, F., et al. (1992). Religious coping and depression among elderly, hospitalized medically ill men. American Journal of Psychiatry, 149(12), 1693–1700.
Koenig, H. G., George, L. K., & Peterson, B. L. (1998). Religiosity and remission of depression in medically ill older patients. American Journal of Psychiatry, 155(4), 536–542.
Koenig, H. G., Hays, J. C., George, L. K., Blazer, D. G., Larson, D. B., & Landerman, L. R. (1997). Modeling the cross-sectional relationships between religion, physical health, social support, and depressive symptoms. American Journal of Geriatric Psychiatry, 5(2), 131–144.
Koenig, H. G., King, D. E., & Carson, V. B. (2012). Handbook of religion and health (2nd ed.). NY: Oxford University Press.
Larson, D. B., Pattison, E. M., Blazer, D. G., Omran, A. R., & Kaplan, B. H. (1986). Systematic analysis of research on religious variables in four major psychiatric journals, 1978–1982. The American Journal of Psychiatry, 143(3), 329–334.
Larson, D. B., Sherrill, K. A., Lyons, J. S., Craigie, F. C, Jr, Thielman, S. B., Greenwold, M. A., et al. (1992). Associations between dimensions of religious commitment and mental health reported in the American Journal of Psychiatry and Archives of General Psychiatry: 1978–1989. American Journal of Psychiatry, 149(4), 557–559.
Linden, S. C., Harris, M., Whitaker, C., & Healy, D. (2010). Religion and psychosis: The effects of the Welsh religious revival in 1904–1905. Psychological Medicine, 40(8), 1317–1323.
Maselko, J., Gilman, S. E., & Buka, S. (2009). Religious service attendance and spiritual well-being are differentially associated with risk of major depression. Psychological Medicine, 39(6), 1009–1017.
Miller, L., Davies, M., & Greenwald, S. (2000). Religiosity and substance use and abuse among adolescents in the National Comorbidity Survey. Journal of the American Academy of Child and Adolescent Psychiatry, 39(9), 1190–1197.
Miller, L., & Gur, M. (2002). Religiosity, depression, and physical maturation in adolescent girls. Journal of the American Academy of Child and Adolescent Psychiatry, 41(2), 206–214.
Miller, L., Warner, V., Wickramaratne, P., & Weissman, M. (1997). Religiosity and depression: Ten-year follow-up of depressed mothers and offspring. Journal of the American Academy of Child and Adolescent Psychiatry, 36(10), 1416–1425.
Mitchell, L., & Romans, S. (2003). Spiritual beliefs in bipolar affective disorder: Their relevance for illness management. Journal of Affective Disorders, 75(3), 247–257.
Mohr, S., Brandt, P. Y., Borras, L., Gillieron, C., & Huguelet, P. (2006). Toward an integration of spirituality and religiousness into the psychosocial dimension of schizophrenia. The American Journal of Psychiatry, 163(11), 1952–1959.
Moss, Q., Fleck, D. E., & Strakowski, S. M. (2006). The influence of religious affiliation on time to first treatment and hospitalization. Schizophrenia Research, 84(2–3), 421–426.
Mullen, K., Williams, R., & Hunt, K. (1996). Irish descent, religion, and alcohol and tobacco use. Addiction, 91(2), 243–254.
Nasser, E. H., & Overholser, J. C. (2005). Recovery from major depression: The role of support from family, friends, and spiritual beliefs. Acta Psychiatrica Scandinavica, 111(2), 125–132.
Neeleman, J., Halpern, D., Leon, D., & Lewis, G. (1997). Tolerance of suicide, religion and suicide rates: An ecological and individual study in 19 Western countries. Psychological Medicine, 27(5), 1165–1171.
Nimgaonkar, V. L., Fujiwara, T. M., Dutta, M., Wood, J., Gentry, K., Maendel, S., et al. (2000). Low prevalence of psychoses among the Hutterites, an isolated religious community. American Journal of Psychiatry, 157(7), 1065–1070.
Pressman, P., Lyons, J. S., Larson, D. B., & Strain, J. J. (1990). Religious belief, depression, and ambulation status in elderly women with broken hips. American Journal of Psychiatry, 147(6), 758–760.
Rammohan, A., Rao, K., & Subbakrishna, D. K. (2002). Religious coping and psychological wellbeing in carers of relatives with schizophrenia. Acta psychiatrica Scandinavica, 105(5), 356–362.
Rasic, D. T., Belik, S. L., Elias, B., Katz, L. Y., Enns, M., & Sareen, J. (2009). Spirituality, religion and suicidal behavior in a nationally representative sample. Journal of Affective Disorders, 114(1–3), 32–40.
Reynolds, C. A., Raine, A., Mellingen, K., Venables, P. H., & Mednick, S. A. (2000). Three-factor model of schizotypal personality: Invariance across culture, gender, religious affiliation, family adversity, and psychopathology. Schizophrenia Bulletin, 26(3), 603–618.
Sanua, V. D. (1969). Religion, mental health, and personality: A review of empirical studies. American Journal of Psychiatry, 125(9), 1203–1213.
Trindade, P. C., Simonaggio, R. G., Fernandes, L. F., Tamai, S., Uchida, R. R., & Sanches, M. (2010). Religiosity and gender differences among Brazilian schizophrenic patients. Schizophren Research, 122(1–3), 280–281.
Tsuang, M. T., Simpson, J. C., Tsuang, M. T., & Simpson, J. C. (2008). Commentary on Koenig (2008): “Concerns about measuring ‘spirituality’ in research”. The Journal of Nervous and Mental Disease, 196(8), 647–649.
Tsuang, M. T., Williams, W. M., Simpson, J. C., & Lyons, M. J. (2002). Pilot study of spirituality and mental health in twins. American Journal of Psychiatry, 159(3), 486–488.
Winter, U., Hauri, D., Huber, S., Jenewein, J., Schnyder, U., & Kraemer, B. (2009). The psychological outcome of religious coping with stressful life events in a Swiss sample of church attendees. Psychotherapy and Psychosomatics, 78(4), 240–244.
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Bonelli, R.M., Koenig, H.G. Mental Disorders, Religion and Spirituality 1990 to 2010: A Systematic Evidence-Based Review. J Relig Health 52, 657–673 (2013). https://doi.org/10.1007/s10943-013-9691-4
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