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

Gonçalves JP, Lucchetti G, Menezes PR, Vallada H - Psychol Med (2015)

Bottom Line: Through this method, 4751 papers were obtained, of which 23 remained included.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.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychiatry,University of Sao Paulo Medical School,Sao Paulo,SP,Brazil.

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.

No MeSH data available.


Related in: MedlinePlus

Flowchart of the selected studies following PRISMA (Preferred Reporting Items forSystematic reviews and Meta-Analyses) guidelines.
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fig01: Flowchart of the selected studies following PRISMA (Preferred Reporting Items forSystematic reviews and Meta-Analyses) guidelines.

Mentions: The survey of databases produced 4751 articles (see flowchart; Fig. 1). Phase 1 eliminated 4605 articles for not meeting theinclusion criteria: 4100 were out of theme and 283 had a different methodology, 155 wererepeated citations and 67 were in other languages, resulting in 146 articles. In phase 2,57 were excluded for not assessing spiritual interventions, 34 had a different methodologyand 17 did not have adequate randomization. Doubts about randomization appeared in 28articles. Authors were contacted by email, and despite 15 not responding, 12 studies wereincluded of the 13 returned. These 12 were added to the 11 included in phase 2; a computedtotal of 23 papers. Fig. 1.


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

Gonçalves JP, Lucchetti G, Menezes PR, Vallada H - Psychol Med (2015)

Flowchart of the selected studies following PRISMA (Preferred Reporting Items forSystematic reviews and Meta-Analyses) guidelines.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4595860&req=5

fig01: Flowchart of the selected studies following PRISMA (Preferred Reporting Items forSystematic reviews and Meta-Analyses) guidelines.
Mentions: The survey of databases produced 4751 articles (see flowchart; Fig. 1). Phase 1 eliminated 4605 articles for not meeting theinclusion criteria: 4100 were out of theme and 283 had a different methodology, 155 wererepeated citations and 67 were in other languages, resulting in 146 articles. In phase 2,57 were excluded for not assessing spiritual interventions, 34 had a different methodologyand 17 did not have adequate randomization. Doubts about randomization appeared in 28articles. Authors were contacted by email, and despite 15 not responding, 12 studies wereincluded of the 13 returned. These 12 were added to the 11 included in phase 2; a computedtotal of 23 papers. Fig. 1.

Bottom Line: Through this method, 4751 papers were obtained, of which 23 remained included.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.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychiatry,University of Sao Paulo Medical School,Sao Paulo,SP,Brazil.

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.

No MeSH data available.


Related in: MedlinePlus