Religiousness, depressive problems and suicidal ideation: a 9-year follow-up clinical case-control study from the Netherlands

Background: Previous studies on the complex relationship between religiousness with depressive problems and suicidality showed varying results and have mostly been cross-sectional. As relationships could be in different directions, this study aimed to examine this within a large prospective clinical cohort. Method: Data from the Netherlands Study of Depression and Anxiety (NESDA) was used (N = 2981 at baseline; M_age = 41.9 years and 33.1 % male). Religiousness was categorized into three groups: (1) non-affiliated (N = 1897); (2) affiliated, no to low commitment/attendance (N = 619); (3) affiliated, higher commitment/attendance (N = 465). These three groups were compared using mixed models with regard to major depressive disorder (MDD), (2) the severity of depressive symptoms, (3) suicidal thoughts, and (4) the severity of suicidal ideation, at baseline and at 2-, 4-, 6- and 9-years follow-up. Results: We found no noticeable differences between the groups regarding any of the outcomes, both in the total sample and in a sub-sample of 1115 people with a current classification of MDD at baseline (within the preceding six months). Limitations: Religiousness was only assessed at baseline and based on (mostly) Christian affiliations and demographic and belonging/behavioural measures of religion. Conclusion: In this cohort, being religiously affiliated with more or less commitment/attendance did not seem to protect against meeting the classification of MDD, having suicidal thoughts, or experiencing more depressive problems/suicidal ideation. However, it also did not seem to increase the risk. Further research should focus on internal religious aspects (e.g., God representation, moral objections to suicide) in relationship to depression and suicidality.