Elements of religiosity and spirituality help predict clinical response to treatment in adults with mild-to-moderate depression

1. In this randomized controlled trial, depressed patients who received Meditation-Based Lifestyle Modification (MBLM) had a greater increase in spirituality than those who received treatment as usual.

2. Furthermore, baseline interest in spirituality and engagement in mind-body practice were two predictive factors of improved depression and perceived stress in response to treatment.

Evidence Rating Level: 1 (Excellent)

Religiosity and spirituality (R/S) are associated with several positive mental health effects, including improvements in dementia, depression, and substance abuse. However, other studies have found negative effects of R/S on mental health through religious struggle. Meditation-Based Lifestyle Modification (MBLM) is a newer intervention that combines a focus on the mind and body with spirituality. Prior research has found that MBLM is effective in improving moderate depression. However, there is still a lack of understanding of how R/S plays into the effects of MBLM on depression. This study aimed to assess the role that R/S has in the treatment effects of MBLM on mild-to-moderate depression.

This randomized controlled trial included 81 participants at a psychiatry, psychosomatics, and psychotherapy clinic in Germany. Participants were included if they were adult psychiatric outpatients who were diagnosed with mild or moderate depression. Participants were randomized into one of three groups. The first group received 8 weeks of MBLM treatment, the second received treatment as usual (TAU), which consisted of tailored multimodal therapy, and the third received no further treatment, only drug continuation therapy. Following this, participants were randomized to either TAU or TAU and MBLM for 16 weeks. Depression severity was assessed using the Beck Depression Inventory (BDI)-II. Spirituality was assessed using a 5-point scaled question, the Aspects of Spirituality (ASP) questionnaire, and the Spiritual and Religious Attitudes in Dealing with Illness (SpREUK) questionnaire. The primary outcome was the impact of the treatment on spirituality, as assessed by the various spirituality questionnaires.

The results demonstrated that patients who received MBLM treatment had an increase in spirituality compared to the other treatment groups at 8 weeks. This effect was evidenced by higher scores on the various spirituality questionnaires, including metrics related to religious orientation, spiritual practices, and more. At 6 months, participants who received MBLM treatment demonstrated significantly higher scores on the various spirituality questionnaires than those who received TAU. There were two variables that were identified at 6 months that could predict the change in depression and perceived stress in these groups, and these were baseline interest in spirituality and baseline engagement in mind-body practice. However, the study was limited by the use of patient-rated questionnaires, which may have introduced bias. Nonetheless, the present study demonstrated that R/S can be a predictive factor of clinical outcomes in the treatment of depression.

Click to read the study in Journal of Integrative and Complementary Medicine

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