Wellness Check: Spirituality

Spiritual wellbeing is protective against depression in young people

1. This systematic review found that spiritual wellbeing was protective against depression in young people aged 10 to 24 years.

2. However, negative religious coping was associated with greater depressive symptoms over time and personal importance of religion was not associated with depressive symptoms in this population.

Evidence Rating Level: 1 (Excellent)

Spirituality and religion can play an important role in the psychosocial development of young people. Studies have suggested that spirituality can have a positive effect on mental health in this population. Meanwhile, other research has noted that those with religious or spiritual struggles may be more susceptible to mental health problems. Given the mixed findings on the effects of spirituality on mental health outcomes in young people, it is necessary to understand this relationship better. This study aimed to review the current evidence on the impact of religion and spirituality on anxiety and depression in young people.

Of 3,706 identified records, 74 (n=45 longitudinal, 29 intervention) studies published between January 1, 2000, and July 21, 2021, were included in the review. Studies that had a mean participant age between 10 and 24 years, used diagnostic criteria to assess anxiety and depression, and evaluated one of the following: the association between religion or spirituality and depression or anxiety, the moderating impact of religiosity and spirituality on risk factors for depression or anxiety, or the impact of spiritual or religious interventions on depression or anxiety, were included. Studies were excluded if they used religious service attendance as the only indicator of religiosity. The study was carried out according to PRISMA guidelines. The primary outcome was the association between religiosity and spirituality and depression or anxiety.

The results demonstrated that spiritual wellbeing was protective against the development of depression in young people. Furthermore, interventions for spiritual wellbeing were associated with reductions in symptoms of depression and anxiety. However, several studies found that negative religious coping was associated with an increased risk of depression and anxiety, while religious salience was not related to depressive symptoms. The review was limited by the small number of studies conducted in lower-middle-income countries, which impacted the generalizability of the findings. Nonetheless, the present study found that religiosity and spirituality can exhibit both positive and negative effects on mental health in young people.

Spiritual intelligence may be associated with self-management of type 1 diabetes

1. In this cross-sectional study, spiritual intelligence was a significant predictor of self-management in patients with type 1 diabetes.

2. Furthermore, spiritual intelligence could predict 7.2% of the variations in self-management of young adult patients with type 1 diabetes.

Evidence Rating Level: 2 (Good)

Type 1 diabetes (T1D) is a chronic health condition that places a significant burden on affected individuals. Self-management of the disease is important in reducing the risk of health complications. Several factors may be associated with T1D self-management, including knowledge about the disease, age, and more. Spirituality may play a role in self-management in other conditions and positively affect disease outcomes. However, the impact of spirituality and spiritual intelligence on self-management of T1D remains poorly understood. This study aimed to investigate the association between spiritual intelligence and self-management of T1D.

This cross-sectional study included 220 adult patients with T1D who were referred to an outpatient diabetes clinic in Iran in 2022. Patients were included if they were aged 18 to 35, had a diagnosis of T1D, and were not suffering from any mental health disorders. Participants were excluded if they were taking psychiatric or narcotic drugs or were unable to read or write. Participants completed a 24-item questionnaire regarding critical thinking, personal meaning, transcendental consciousness, and consciousness development to evaluate spiritual intelligence. The Self-Report Measure of Self-Management of Type 1 Diabetes for Adolescents (SMOD-A) was used to assess self-management of T1D. The primary outcome was the association between the scores on the questionnaires regarding spiritual intelligence and T1D management.

The results demonstrated that spiritual intelligence was a significant predictor of T1D self-management after adjusting for confounding factors, including age, education level, disease duration, and more. The relationship between spiritual intelligence and diabetes management was estimated to be 0.27, and it was found that spiritual intelligence predicted 7.2% of the variability in self-management among patients with T1D. However, the study was limited by the self-reported nature of T1D self-management, which may have introduced bias. Nonetheless, the present study suggested that spiritual intelligence may play an important role in the self-management of T1D.

Spiritual health may be high among cancer patients in drug clinical trials

1. In this cross-sectional study, cancer patients enrolled in clinical trials demonstrated high levels of spiritual health, which was positively associated with psychological resilience.

2. Furthermore, several factors impacted spiritual health, including religious belief, nationality, and treatment regimen.

Evidence Rating Level: 2 (Good)

As one of the leading causes of death worldwide, cancer places a significant burden on affected individuals. New cancer treatments must undergo clinical trials to assess their safety and effectiveness, leading to many cancer patients participating in these trials. Those who participate in clinical trials tend to have more advanced cancers and often have high expectations for the treatment of interest. As such, these patients are vulnerable to negative feelings and spiritual distress. Therefore, exploring the spiritual needs of cancer patients, particularly those in drug trials, is necessary. This study aimed to investigate the spiritual wellbeing of cancer patients enrolled in clinical trials and assess the factors that contribute to spiritual wellbeing in this population.

This cross-sectional study included 244 cancer patients enrolled in drug clinical trials at the West China Hospital of Sichuan University between December 2022 and July 2023. Participants were included if they were 16 years or older, had a confirmed cancer diagnosis, and were enrolled in a clinical trial. Participants were excluded if they dropped out of the clinical trial part way through or had a concurrent medical condition. Participants completed the Memorial Symptom Assessment Scale Short Form (MSAS-SF), Connor-Davidson Resilience Scale 10 (CD-RISC 10), and Functional Assessment of Chronic Illness Therapy-Spiritual (FACIT-SP) to assess symptom burden, psychological resilience, and spiritual wellbeing, respectively. As well, demographic characteristics and clinical variables were obtained through questionnaires. The primary outcomes were the scores on the different questionnaires and their associations.

The results demonstrated that cancer patients enrolled in clinical trials had high levels of spiritual wellbeing, even more so than standard cancer patients. There was a positive association between psychological resilience and spiritual health and no association between symptom burden score and psychological resilience or spiritual health. Several factors influenced spiritual health, including religious belief, nationality, and treatment regimen. Notably, those patients receiving single antineoplastic therapy demonstrated lower overall spiritual health. However, the study was limited by the inclusion of mainly advanced-stage cancer patients, which may limit the generalizability of the findings to other cancer patients. Nonetheless, the present study demonstrated that spiritual health is high among cancer patients enrolled in clinical trials.

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