His conclusion: religious people are less likely to be depressed, anxious, or attempt suicide. The evidence is mostly cross-sectional – showing that depressed people are less likely to be religious, for whatever reason. But there are also a number of longitudinal studies, showing that people who are religious are less likely to become depressed in the future.
For people with psychotic delusions, the picture is more complicated. They are frequently highly religious, but the longitudinal studies suggest that psychosis comes first.
Koenig's conclusion, that religion can help to reduce symptoms of anxiety and depression, isn't terribly surprising. But what jumps out from the review is how many questions are left unanswered. For example,
- What's the magnitude of the effect? Is it big enough to make any meaningful difference? How does it compare with other factors that influence depression?
- Is it effective in severe depression, or just in mild depression (where placebos are also highly effective)?
- Is it religious beliefs, or attendance, or simply the much more vague concept of 'spirituality' that is important? Koenig's review doesn't really distinguish between them, probably because, historically, studies into the effects of religion didn't tend to.
They do give some practical advice, but even that demonstrates just how confusing this field can be for the unwary. They reckon that you can treat depression by encouraging a spirit of altruism, gratitude and forgiveness.
It's sound advice, no doubt. But I think that most atheists would rankle at the idea that these fall under the heading of 'religious and spiritual' interventions!
So we really are still a very long way away from answering the key question. To boil it down, I want to know whether it's possible to treat depression by prescribing a dose of religion. And if it is, then is it more effective than other treatment options?
If it turns out that a good way to treat depression is to pack people off to their local imam, then that really will raise some interesting ethical issues!
This work by Tom Rees is licensed under a Creative Commons Attribution-Share Alike 2.0 UK: England & Wales License.