Spiritual and religious interventions as additional tools to promote health?
There are currently many published scientific studies reporting the benefits of religiosity/spirituality on people’s health. However, most of these studies are observational, which indicates an association between the spiritual dimension and clinical improvement, but does not demonstrate a cause-effect relationship. Probably due to these findings, there has been a growing demand from the general population to introduce complementary religious/spiritual therapy in conjunction with conventional medical treatments.
In order to assess the scientific evidence that investigates the direct effect of this kind of approach on clinical outcomes, an article published in the journal Psychological Medicine presented a systematic review of spiritual and religious interventions in mental health. The work was carried out at the Institute & Department of Psychiatry, University of Sao Paulo Medical School by Juliane P. B. Gonçalves, Giancarlo Luchetti, Paulo Rossi Menezes, and Homero Vallada. The paper analysed only randomized controlled trials, to understand the real impact of such assistance in mental health, selected according to the international guidelines for systematic review and meta-analysis (Preferred Reporting Items for Systematic reviews and Meta-Analyses – PRISMA).
More than four thousand articles were selected in the first general screening of seven databases of international scientific publications. In the two subsequent phases of selection, most of the studies were excluded (because they were not spiritual or religious approaches, or were a duplicate paper, or were not published in English, Spanish or Portuguese), leaving only twenty-three articles. These twenty-three studies evaluated different populations who received applications of different health protocols and which included religious and/or spiritual aspects. The three most important assessed outcomes were mental health symptomatology, quality of life and adherence to medical treatment. The results of these complementary intervention approaches were equal or superior to the control group, who received either only the usual medical standard treatment and/or other complementary therapeutic approaches that did not involve religious/spiritual aspects.
The scientific literature has also shown the increasing need of patients to approach the topic of religiosity/spirituality with their doctors and health professionals. Usually, in clinical practice, including a spiritual dimension in the period of treatment and recovery of health has been seen as a positive aspect, even by health professionals who consider themselves agnostics or atheists. As a consequence, a growing number of hospitals and health services are offering this complementary approach together with the conventional medical treatments.
In conclusion, the quality of published clinical trials to date is still of a very limited number. Still, the meta-analysis of these few studies showed a favorable trend towards the religious/spiritual intervention. New studies on this subject are needed in order to confirm and clarify the results.
The full paper, published in Psychological Medicine, “Religious and spiritual interventions in mental health care: a systematic review and meta-analysis of randomized controlled clinical trials” by J. P. B. Gonçalves, G. Lucchetti, P. R. Menezes and H. Vallada is published Open Access and can be viewed here.