Religious Involvement, Inflammatory Markers and Stress Hormones in Major Depression and Chronic Medical Illness

Denise L. Bellinger¹, Lee S. Berk^1,2,3, Harold G. Koenig^3,4,5,6*, Noha Daher^2,7, Michelle J. Pearce^3,4,8, Clive J. Robins^4,9, Bruce Nelson¹⁰, Sally F. Shaw¹⁰, Harvey Jay Cohen^3,5, Michael B. King¹¹

¹Department of Pathology and Human Anatomy, School of Medicine, Loma Linda University, Loma Linda, CA, USA.
²Allied Health Studies, School of Allied Health Professions, Loma Linda University, Loma Linda, CA, USA.
³Center for Spirituality, Theology and Health, Duke University, Durham, NC, USA.
⁴Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.
⁵Department of Medicine, Duke University Medical Center, Durham, NC, USA.
⁶Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
⁷Epidemiology, Biostatistics and Population Medicine, School of Public Health, Loma Linda University, Loma Linda, CA, USA.
⁸School of Medicine, University of Maryland, Baltimore, USA.
⁹Department of Psychology and Neuroscience, Duke University Medical Center, Durham, NC, USA.
¹⁰Department of Research, Glendale Adventist Medical Center, Glendale, CA, USA.
¹¹Division of Psychiatry, Faculty of Brain Sciences, University College, London, UK.

DOI: 10.4236/ojpsych.2014.44040                

Abstract

Background: Religious practices/experiences (RPE) may produce positive physiological changes in patients with major depressive disorder (MDD) and chronic medical illness. Here, we report cross-sectional relationships between depressive symptoms, RPE and stress biomarkers (pro-/anti-inflammatory measures and stress hormones), hypothesizing positive associations between depressive symptoms and stress biomarkers and inverse associations between RPE and stress biomarkers. Methods: We recruited 132 individuals with both MDD and chronic illness into a randomized clinical trial. First, stress biomarkers in the baseline sample were compared to biomarker levels from a community sample. Second, relationships between depressive symptoms and biomarkers were examined, and, finally, relationships between RPE and biomarkers were analyzed, controlling for demographics, depressive symptoms, and physical functioning. Results: As expected, inflammatory markers and stress hormones were higher in our sample with MDD compared to community participants. In the current sample, however, depressive symptoms were largely unrelated to stress biomarkers, and were unexpectedly inversely related to proinflammatory cytokine levels (TNF-α, IL-1β). Likewise, while RPE were largely unrelated to stress biomarkers, they were related to the anti-inflammatory cytokine IL-1RA and the stress hormone norepinephrine in expected directions. Unexpectedly, RPE were also positively related to the proinflammatory cytokine IFN-γ and to IFN-γ/IL-4 and IFN-γ/IL-10 ratios. Conclusions: Little evidence was found for a consistent pattern of relationships between depressive symptoms or religiosity and stress biomarkers. Of the few significant relationships, unexpected findings predominated. Future research is needed to determine whether religious interventions can alter stress biomarkers over time in MDD.

Keywords

Religiosity, Depression, Inflammation, Immune Function, Stress Hormones

Conflicts of Interest

The authors declare no conflicts of interest.

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