Effect of religiosity/spirituality and sense of coherence on depression within a rural population in Greece: the Spili III project.

BACKGROUND: Recent research has addressed the hypothesis that religiosity/spirituality and sense of coherence buffer the negative effects of stress on numerous health issues. The aim of the current study was to further this work by exploring potential links between psycho-social factors such as religiosity/spirituality and sense of coherence with depression. METHODS: A total number of 220 subjects of the SPILI III cohort (1988-2012) attending a primary care setting in the town of Spili on rural Crete represented the target group. All participants underwent a standardized procedure. Validated questionnaires were used to evaluate sense of coherence, depression levels and religious and spiritual beliefs. A multiple linear regression analysis of the Beck Depression Inventory Scale (BDI) in relation to demographic characteristics, scores on the Royal Free Interview for Spiritual and Religious Beliefs scale (RFI-SRB) and Sense of Coherence scale (SOC) was performed. RESULTS: A significant inverse association was found between BDI and RFI-SRB scale (B-coef = -0.6999, p < 0.001), as well as among BDI and SOC scale (B-coef = -0.556, p < 0.001). CONCLUSIONS: The findings of the current observational study indicate that highly religious participants are less likely to score high in the depression scale. Furthermore, participants with high SOC scored significantly lower in the BDI scale. Further research is required in order to explore the potential effect of SOC and religiosity/spirituality on mental health.

Exploring the association of sense of coherence, and spiritual and religious beliefs in a rural population group on the island of Crete, Greece.

OBJECTIVES/AIM: This article reports the results of an observation study, aimed at exploring an association between spirituality, religiousness, and sense of coherence in a population group residing in a rural area of Crete, Greece. STUDY DESIGN AND METHODS: The study was conducted during the period 2007-2009. Subjects aged 65 years and older (n = 118) living in two remote and rural villages in the Heraklion county (Crete) were eligible. Eighty-nine people (51 women and 38 men) participated. Demographic data were obtained, and all participants were asked to complete the Greek version of the self-reported Royal Free Interview for Spiritual and Religious Beliefs, and the Sense of Coherence Scale. RESULTS: Most participants reported strong religious beliefs and this was found to be related with increased age. Widowed participants expressed greater religiousness and spirituality (p = 0.029). The total score for Sense of Coherence was negatively correlated with gender (women have lower scores, p < 0.05), marital status (widows presented lower scores, p < 0.001), and increased age. A strong positive correlation of the Sense of Coherence score with the Spiritual Scale as measured by three questions of the Royal Free Interview was also identified (p = 0.039). CONCLUSIONS: The impact of gender and marital status seem to be emerging determinants in defining sense of coherence among inhabitants of rural Crete. The positive association between religious/spiritual beliefs and sense of coherence deserves further attention to promote a multidimensional approach in its study.

Impact of religiosity/spirituality on biological and preclinical markers related to cardiovascular disease. Results from the SPILI III study.

OBJECTIVE: This study aimed at exploring to what extent psychosocial factors, such as religiosity/spirituality and sense of coherence, mediate the negative effects of stress on a variety of cardiometabolic indicators, i.e., hypertension, diabetes, cardiovascular and cerebrovascular disease, and atherosclerotic bio-clinical markers. DESIGN: A total of 220 subjects (66.2±16.0 years) of the SPILI III cohort (1988-2012) attending a primary care setting in Spili, a rural town in Crete, represented the target group for the present study. Of these, 195 (88.6%) participated in the re-examination (67.2±15.2 years). All participants underwent a standardized procedure including evaluation of anthropometric measurements, biochemical indicators of atherosclerosis, stress hormones, in parallel with ultrasound measurements of carotid intima media thickness (IMT). Religiosity, spirituality and sense of coherence were evaluated with the use of international questionnaires translated into the Greek language and linguistically validated. RESULTS: Participants with higher levels of religious and spiritual beliefs presented lower levels of carotid IMT (1.01±0.101 vs 1.53±0.502 mm, p<0.001). Patterns of inverse relationships were also observed between religiosity/spirituality and prevalence of diabetes (35.1% vs. 2%, p<0.001) with an estimated diabetes risk, fully adjusted odds ratio, 95% CI: 0.91 (0.87-0.94). Highly religious participants presented lower serum cortisol levels (12.3±5.8 vs. 18.2±5.1 µg/dl, p<0.001). Sense of coherence was positively associated with religiosity/spirituality [mean SOC (SD): 123±20 vs. 158±15) p<0.001]. CONCLUSIONS: These findings may be associated with a possible favourable effect of religiosity/spirituality on several cardio-metabolic determinants, therefore deserving further attention by healthcare practitioners and researchers.