Previously studies appeared to show that religious and spiritual beliefs may be protective for depression, and were associated with better well-being. It was a widely held view amongst psychiatrists (who are not, as a group, particularly religious) that religion and spirituality protected your mood from the vicissitudes of life's misfortunes.
But now, a very large study, which followed up people for a year, has found there is an opposite relationship between religious belief and depression. Religion, and even more, spirituality not tied to formal religion, appears to be unhelpful in terms of protecting you from low mood, and could even be linked with more depression.
A key finding of the study, conducted in several different counties, is that a spiritual life view predisposed to major depression, especially significantly in the UK, where spiritual participants were nearly three times more likely to experience an episode of depression than the secular group.
The results are startling because previous research found formally religious people had good mental health habits and lifestyle, for example, previous studies established they were less likely to have ever used drugs or to have been hazardous drinkers.
Entitled 'Spiritual and religious beliefs as risk factors for the onset of major depression: an international cohort study', the relationship with religious and spiritual belief was investigated in depth by researchers led by Professor Michael King from University College London. Over 8,000 people visiting general practices across seven countries were followed up at six and 12 months. The general practices were in the UK, Spain, Slovenia, Estonia, the Netherlands, Portugal and Chile. These general practices covered urban and rural populations with considerable socio-economic variation.
The study has just been published in one of the most respected academic psychiatric journals, 'Psychological Medicine'. It was conducted by researchers at several UK and European universities and Chile.
The study defined religion as meaning the practice of a faith, eg going to a temple, mosque, church or synagogue. Being 'spiritual' was defined as not formally following a religion, but having spiritual beliefs or experiences. For example, believing that there is some power or force other than yourself, which might inﬂuence life.
People who held a religious or spiritual understanding of life had a higher incidence of depression than those with a secular life view. However, this ﬁnding varied by country; in particular, people in the UK who had a spiritual understanding of life were the most vulnerable to the onset of major depression.
Regardless of country, the stronger the spiritual or religious belief at the start of the study, the higher the risk of onset of depression.
Although the main ﬁnding of an association between religious life understanding and onset of depression varied by country, there was no evidence that spirituality may protect people, and only weak evidence that a religious life view was possibly protective in two countries (Slovenia and the Netherlands).
The incidence of depression over the subsequent 12 months was similar across the diﬀerent religious denominations (Catholic 9.8%, Protestant 10.9%, other religions 11.5%, no speciﬁc religion 10.8%).
Those with the more strongly held religious or spiritual convictions were twice as likely to experience major depression in the subsequent 12 months.
Although a religious, spiritual or secular outlook on life seems to be relatively stable in most people, slightly over a quarter of participants in this study changed their life view during the period of the study. And this was with a higher risk of depression for those changing to a more religious path, a lower risk for those moving in a secular direction.
Those in the process of developing a common mental disorder, like depression, may become involved in a 'search for meaning' for relief from symptoms, and this is one possible reason why previous research may have found a link between a religious or spiritual attitude, and poorer mental health.
That this study followed participants over a year, meant it was possible to demonstrate that it was more likely a spiritual and religious outlook which was leading to future lower mood, than the other way around.
Previous research had found that religion may have a protective eﬀect during and after the impact of life events but this study did not ﬁnd evidence of this.
The authors conclude that holding a religious or spiritual life perspective, in contrast to a secular outlook, predisposes to the onset of major depression. These beliefs and practice do not act as a buﬀer to adverse life events as had previously been thought.
But the authors acknowledge the wide variety of contrasting findings from other researchers in the field, make it difficult to come to a definitive conclusion as yet. The most that can be said with any certainty, they contend, is that if there is a link between religion/spirituality and psychological well-being, it is most probably weak.
After all, if religious belief has a powerful positive eﬀect on mental health, they argue it should be detected in most studies.
The dramatic rise in New Age movements and other non-traditional faiths, perhaps the embracing of alternative belief systems as embodied by complimentary health care in the West, might reﬂect a growing search for meaning, as more traditional religious practice has declined sharply.
A previous study by a team led by psychiatrists Michael King and Paul Bebbington, published in the 'British Journal of Psychiatry', found spiritual people were more likely than those who were neither religious nor spiritual, to have used or to have been dependent on drugs, suffered from generalised anxiety disorder, any phobia or any neurotic disorder.
Professor Michael King sums up all the research to date by concluding maximum psychiatric vulnerability seems to stem from spirituality not tied to religion.
Some may examine this study and argue its results suggest that while many might still be looking for answers far and wide, ironically, it could be those less religious and spiritual, who might already have found them.
Follow Dr Raj Persaud on Twitter: www.twitter.com/@DrRajPersaud