Religiosity and treatment response to antidepressant medication: a prospective multi-site clinical trial

Abstract

The present study examined the relationship between religiosity/spirituality and treatment response to antidepressant medication (citalopram). One-hundred and forty-eight Caucasian and African-American adults with uncomplicated major depression were treated with citalopram (20–60 mg/day) over an eight-week period in a prospective multi-site clinical trial. Treatment response was assessed weekly with the Hamilton Rating Scale for Depression. Religiosity (i.e., religious behaviours) and spirituality (i.e., spiritual well-being) were assessed at week 3. No significant associations between spirituality and treatment response were found; however, there was a strong curvilinear relationship between religiosity and treatment response. Compared to lower or higher levels of religiosity, a moderate level of religiosity was significantly associated with a higher likelihood of remission and greater reduction in severity of depression. This association was independent of social support, ethnicity, gender, education, and baseline depression severity. A moderate amount of religiosity appears to be independently associated with an enhanced treatment response to citalopram.

Keywords:

• religiosity
• spirituality
• depression
• antidepressant
• citalopram

Acknowledgements

The authors would like to acknowledge with appreciation the significant contributions of the research staff and clinical research coordinator staff at each of the three study sites, as well as all of the patients who participated in the trial.

Notes

Note

1. Researchers have yet to agree upon standard operational definitions for the constructs of religiosity and spirituality and there is still some debate as to whether these are distinct or overlapping constructs (Hall, Meador, & Koenig, 2008). In order to avoid confusion in this paper, religiosity is being defined here as behaviours and practices associated with religion (e.g., prayer, church attendance, etc.) and spirituality is being defined here as the existential aspects of religion (e.g., spiritual beliefs, faith, spiritual well-being).