Religiosity: A resilience factor protecting against depression in medical interns

Religion has been proposed as a potential resilience factor against depression, but cross-sectional study designs and the lack of a universal stressor have impeded establishing a causative, longitudinal relationship between religious attendance and resilience to depression.

Utilizing the national, prospective cohort Intern Health Study, we examined 5482 physicians as they entered the first year of residency in the following clinical disciplines: internal medicine, general surgery, pediatrics, obstetrics, gynecology, and psychiatry. Depression symptoms were quantified by the 9-item Patient Health Questionnaire, PHQ-9, scores. Religious attendance was self-reported on a scale ranging from 1- "Never" to 6- "More than once per week".

We found that religious attendance prospectively predicted significantly lower depressive symptom development among interns. Among religious interns, more frequent religious attendance was associated with a smaller increase in depression symptoms after the start of internship. Specifically, with each level of increase in the frequency of religious attendance, the increase in PHQ-9 score was mitigated by an effect size of -0.10. Furthermore, the effect of religious attendance on PHQ-9 score was consistent across most ethnic groups, including Latinos, East Asians, Whites, African Americans, and Arabs.

Religious attendance provides a dose-dependent protective effect against stress-induced depression throughout medical internship across many ethnic groups.