Religious and spiritual interventions in mental health care: a systematic review and meta-analysis of randomized controlled clinical trials

Abstract

Background.Despite the extensive literature assessing associations between religiosity/spirituality and health, few studies have investigated the clinical applicability of this evidence. The purpose of this paper was to assess the impact of religious/spiritual interventions (RSI) through randomized clinical trials (RCTs).Method.A systematic review was performed in the following databases: PubMed, Scopus, Web of Science, PsycINFO, Cochrane Collaboration, Embase and SciELO. Through the use of a Boolean expression, articles were included if they: (i) investigated mental health outcomes; (ii) had a design consistent with RCTs. We excluded protocols involving intercessory prayer or distance healing. The study was conducted in two phases by reading: (1) title and abstracts; (2) full papers and assessing their methodological quality. Then, a meta-analysis was carried out.Results.Through this method, 4751 papers were obtained, of which 23 remained included. The meta-analysis showed significant effects of RSI on anxiety general symptoms (p < 0.001) and in subgroups: meditation (p < 0.001); psychotherapy (p = 0.02); 1 month of follow-up (p < 0.001); and comparison groups with interventions (p < 0.001). Two significant differences were found in depressive symptoms: between 1 and 6 months and comparison groups with interventions (p = 0.05). In general, studies have shown that RSI decreased stress, alcoholism and depression.Conclusions.RCTs on RSI showed additional benefits including reduction of clinical symptoms (mainly anxiety). The diversity of protocols and outcomes associated with a lack of standardization of interventions point to the need for further studies evaluating the use of religiosity/spirituality as a complementary treatment in health care.

The Effect of Spiritual Counseling on Stress and Anxiety in Pregnancy: A Randomized Controlled Clinical Trial

“…This finding was consistent with the results of Saunders et al about the effect of spirituality on anxiety control (30). The results of a systematic review showed that the religious/spiritual interventions decrease the anxiety and depression symptoms (31). The positive effect of spiritual counseling on reducing stress level and anxiety in pregnant women can be attributed to the alignment of spiritual counseling approach with culture and the beliefs of individuals in response to mental concerns and being seeking the meaning in human life (32).…”

The Effects of Religious and Spiritual Interventions on the Resilience of Family Members of Patients in the ICU

“…Through realization of peace of mind and relief from mental pressures caused by the disease, spiritual interventions facilitate the process of treatment and recovery indirectly. People in different cultures tend to seek help from a holy and divine source in hard situations when they feel more need for spirituality in hardships (24)(25)(26)(27)(28)(29). Studies have shown that spirituality and spiritual beliefs improve one's ability to deal with diseases or facilitate the recovery process.…”

Brazilian scientific articles on &#8220;Spirituality, Religion and Health&#8221;

“…Nevertheless, few studies were experimental (Quasi-experimental or Clinical Trials). Other articles have already investigated the influence of R/S in experimental studies showing promising outcomes 19,20 ; therefore, we suggest that more studies using experimental protocols should be done in Brazil.…”