Spirituality and Religiosity in Rheumatic Diseases: A Systematic Review

Several studies have demonstrated the influence of religiosity and spirituality (R/S) on patients with chronic diseases. However, few studies have explored the influence of R/S on autoimmune/non-autoimmune rheumatic diseases. We conducted a systematic review of the literature on the impact of religiosity and spirituality (R/S) on the health of patients with (autoimmune and non-autoimmune) rheumatic diseases. Systematic review of the literature according to the PRISMA protocol. Articles published between January 1912 and September 2024 in the Virtual Health Library (VHL), PubMed, Web of Science, Cochrane Library, Scopus, and PsychInfo databases were included. Few studies have explored the influence of R/S on non-autoimmune rheumatic diseases. Most studies have evaluated the impact of R/S on central sensitization pain syndromes, such as fibromyalgia, and degenerative diseases, such as osteoarthritis. Only two studies have been conducted in patients with autoimmune rheumatic diseases, rheumatoid arthritis, and idiopathic inflammatory myopathies. Among the 1614 articles found, 17 met the eligibility criteria. In the quality analysis of the studies, 76.5% were classified as "good." The findings were then divided into "psychological and physical impacts of R/S in patients with autoimmune rheumatic diseases" and "psychological and physical impacts of R/S in patients with non-autoimmune rheumatic diseases". The literature demonstrates the impact of R/S on improving quality of life, especially on lower pain scores, reducing stress, and improving mood and life satisfaction. This evidence is the most robust for non-autoimmune rheumatic diseases. The effects of R/S on non-psychological aspects are uncertain. Additionally, studies have small samples, and most are not longitudinal. Therefore, longitudinal studies that consider differences such as the type of religion, standardization of R/S level mapping methods, and larger samples are necessary.