Spirituality, Religiousness, and Mental Health: A Literature Review of Religion's Impact in Mental Health

Abstract

Religious and spiritual involvement (R/S) plays a significant role in the mental health of many Americans, yet the nature of this relationship remains complex. Current empirical evidence from systematic reviews, longitudinal studies, and clinical trials demonstrates predominantly protective effects of R/S across major psychiatric disorders, with higher religious engagement generally associated with reduced depression and substance use, enhanced resilience following trauma, and improved outcomes in several other conditions. However, the relationship proves notably bidirectional, as religious struggle, negative religious coping, and certain doctrinal beliefs can exacerbate symptoms, particularly in obsessive-compulsive disorder through scrupulosity and in depression when spiritual conflicts arise. The magnitude of protective effects remains modest, with considerable variation across populations, cultural contexts, and measurement approaches. For anxiety disorders, findings remain inconsistent, with approximately half of studies showing benefits while others report null or negative effects. Substance use disorders show the most robust inverse relationship with R/S, while eating disorders and personality disorders demonstrate limited and conflicting evidence. Understanding these complex patterns has significant implications for clinical practice, supporting the integration of spiritual assessment and religiously informed interventions into mental health care while highlighting the critical need to distinguish adaptive from maladaptive religious cognitions. Future research must address fundamental gaps including the lack of mechanistic understanding, geographic bias toward American populations, and the need for validated assessment tools that can capture the multidimensional nature of religious experience and its varied impacts on psychological well-being.