Duke Global Health Institute, Duke University, Durham, North Carolina.
Department of Sociology, Duke University, Durham, North Carolina.
JAMA Psychiatry. 2023 Mar 1;80(3):270-273. doi: 10.1001/jamapsychiatry.2022.4525.
Religious leaders commonly provide assistance to people with mental illness, but little is known about clergy views regarding mental health etiology and appropriate treatment.
To assess the views of religious leaders regarding the etiology and treatment of depression.
DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study used the National Survey of Religious Leaders, which is a nationally representative survey of leaders of religious congregations in the United States, with data collected from February 2019 to June 2020. Data were analyzed in September and October 2022.
Views about causes of depression (chemical imbalance, genetic problem, traumatic experience, demon possession, lack of social support, lack of faith, and stressful circumstances) and appropriate treatments (seeing a mental health professional, taking prescribed medication, and addressing the situation through religious activity).
The analytic sample was limited to congregations' primary leaders (N = 890), with a 70% cooperation rate. Clergy primarily endorsed situational etiologies of depression, with 93% (95% CI, 90%-96%) endorsing stressful circumstances, 82% (95% CI, 77%-87%) endorsing traumatic experiences, and 66% (95% CI, 59%-73%) endorsing lack of social support. Most clergy also endorsed a medical etiology, with 79% (95% CI, 74%-85%) endorsing chemical imbalance and 59% (95% CI, 52%-65%) endorsing genetics. A minority of clergy endorsed religious causes: lack of faith (29%; 95% CI, 22%-35%) or demon possession (16%; 95% CI, 10%-21%). Almost all of the religious leaders who responded to the survey would encourage someone with depressive symptoms to see a mental health professional (90%; 95% CI, 85%-94%), take prescribed medication (87%; 95% CI, 83%-91%), and address symptoms with religious activity (84%; 95% CI, 78%-89%). A small but nontrivial proportion endorsed a religious cause of depression without also endorsing chemical imbalance (8%; 95% CI, 5%-12%) or genetics (20%; 95% CI, 13%-27%) as a likely cause. A similar proportion would encourage someone exhibiting depressive symptoms to engage in religious treatment without also seeing a mental health professional (10%; 95% CI, 5%-14%) or taking prescribed medication (11%; 95% CI, 8%-15%).
In this cross-sectional survey, the vast majority of clergy embrace a medical understanding of depression's etiology and treatment. When clergy employ a religious understanding, it most commonly supplements rather than replaces a medical view, although a nontrivial minority endorse only religious interpretations. This should encourage greater collaboration between medical professionals and clergy in addressing mental health needs.
宗教领袖通常为精神病患者提供帮助，但对于神职人员对精神疾病病因和适当治疗的看法知之甚少。
评估宗教领袖对抑郁症病因和治疗的看法。
设计、地点和参与者：这项横断面研究使用了全国宗教领袖调查，这是一项针对美国宗教集会领袖的全国代表性调查，数据收集于 2019 年 2 月至 2020 年 6 月。数据分析于 2022 年 9 月和 10 月进行。
对抑郁症病因（化学失衡、遗传问题、创伤经历、恶魔附身、缺乏社会支持、缺乏信仰和压力环境）和适当治疗（咨询心理健康专业人员、服用规定药物以及通过宗教活动解决问题）的看法。
分析样本仅限于会众的主要领袖（N=890），合作率为 70%。神职人员主要认可抑郁症的情境病因，93%（95%CI，90%-96%）认可压力环境，82%（95%CI，77%-87%）认可创伤经历，66%（95%CI，59%-73%）认可缺乏社会支持。大多数神职人员也认可医学病因，79%（95%CI，74%-85%）认可化学失衡，59%（95%CI，52%-65%）认可遗传。少数神职人员认可宗教原因：缺乏信仰（29%；95%CI，22%-35%）或恶魔附身（16%；95%CI，10%-21%）。几乎所有接受调查的宗教领袖都会鼓励有抑郁症状的人咨询心理健康专业人员（90%；95%CI，85%-94%）、服用规定药物（87%；95%CI，83%-91%）以及通过宗教活动来解决症状（84%；95%CI，78%-89%）。一小部分但并非微不足道的比例支持抑郁症的宗教原因，而不支持化学失衡（8%；95%CI，5%-12%）或遗传学（20%；95%CI，13%-27%）作为可能的原因。同样比例的人会鼓励表现出抑郁症状的人接受宗教治疗，而不咨询心理健康专业人员（10%；95%CI，5%-14%）或服用规定药物（11%；95%CI，8%-15%）。
在这项横断面调查中，绝大多数神职人员接受了抑郁症病因和治疗的医学理解。当神职人员采用宗教理解时，它通常只是补充而不是取代医学观点，尽管少数人只支持宗教解释。这应该鼓励医疗专业人员和神职人员在解决心理健康需求方面进行更多合作。
