Effect of religious and spiritual interventions on anxiety, depression, and stress: A systematic review and meta-analysis of randomized clinical trials

This systematic review and meta-analysis aim to investigate the impact of religious and spiritual (R/S)-based interventions on mental health outcomes, specifically targeting depression, anxiety, and stress. The protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO), and the review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Five major databases—PubMed, Web of Science, Scopus, the Cochrane Library, and Google Scholar—were searched for English-language randomized clinical trials (RCTs) from inception to September 2024. Study quality was assessed using the Cochrane Collaboration tool. Meta-analysis was conducted using odds ratios (OR) with 95% confidence intervals (CI). Seventy-four RCTs were included. R/S-based interventions significantly reduced depression (OR = 0.127, CI: 0.077–0.209; Z = 8.15; P < 0.001), anxiety (OR = 0.118, CI: 0.066–0.211; Z = 7.21; P < 0.001), and stress (OR = 0.019, CI: 0.005–0.082; Z = 5.34; P < 0.001). However, the review identified notable heterogeneity in study quality and intervention design. These findings support the integration of R/S interventions in mental health care, highlighting their potential to improve psychological outcomes. Nonetheless, significant methodological variability across studies calls for cautious interpretation. Standardized intervention protocols and culturally tailored research are necessary to enhance clinical applicability. Future studies should also explore gender-specific responses and long-term outcomes. Incorporating spiritual well-being into holistic care may enrich mental health interventions, especially in diverse cultural settings.