Original Article

Spirituality and Depressive Symptoms in Primary Care Outpatients

Authors: Timothy P. Daaleman DO, MPH, Jay S. Kaufman, PHD

Abstract

Background: Although many studies have examined the relationship between religiosity and depressive symptoms in patient populations, there has been little work to understand and measure the effect of spirituality on depressive symptoms.


Objective: The purpose of this study was to examine the association of spirituality and symptoms of depression in primary care outpatients.


Methods: A cross-sectional analysis was performed of a dataset using 509 primary care outpatients who participated in an instrument validity study in the Kansas City (US) area. Patients were administered the Zung Depression Scale (ZDS) and the Spirituality Index of Well-Being (SIWB) in the waiting area before or after their appointment. Bivariate and multivariate analyses were performed to determine the relationship between the factors of interest and depressive symptoms.


Results: In bivariate analyses, less insurance coverage (P < 0.01) and greater spirituality (P< 0.01) were associated with less reported depressive symptoms. In a model adjusted for covariates, spirituality (P < 0.01) remained independently associated with less symptoms.


Conclusion: Primary care outpatients who report greater spirituality are more likely to report less depressive symptoms.


Key Points


* Spirituality, conceptualized as a congruent, meaningful life scheme, and a high degree of positive intentionality, or self-efficacy beliefs, is independently associated with fewer depressive symptoms in primary care outpatients.


* Spirituality can be viewed as conceptually distinct from religion and may be framed in a perspective of meaning and meaning-making as the patient experiences health and illness.

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