title: Spirituality and depressive symptoms in primary care outpatients.
abstract: BACKGROUND
  Although many studies have examined the relationship between religiosity and depressive symptoms in patient populations, there has been little work to understand and measure the effect of spirituality on depressive symptoms.
  
  
  OBJECTIVE
  The purpose of this study was to examine the association of spirituality and symptoms of depression in primary care outpatients.
  
  
  METHODS
  A cross-sectional analysis was performed of a dataset using 509 primary care outpatients who participated in an instrument validity study in the Kansas City (US) area. Patients were administered the Zung Depression Scale (ZDS) and the Spirituality Index of Well-Being (SIWB) in the waiting area before or after their appointment. Bivariate and multivariate analyses were performed to determine the relationship between the factors of interest and depressive symptoms.
  
  
  RESULTS
  In bivariate analyses, less insurance coverage (P < 0.01) and greater spirituality (P < 0.01) were associated with less reported depressive symptoms. In a model adjusted for covariates, spirituality (P < 0.01) remained independently associated with less symptoms.
  
  
  CONCLUSIONS
  Primary care outpatients who report greater spirituality are more likely to report less depressive symptoms.
authors.affiliation: Dept. of Family Medicine, Program on Aging, Disability, and Long-Term Care, Cecil G. Sheps Center for Health Services Research, Univ. of North Carolina at Chapel Hill, Campus Box 7595, Manning Drive, NC 27599-7595, USA. tim_daaleman@med.unc.edu
authors.forename: Timothy P
authors.initials: TP
authors.lastname: Daaleman
authors.forename: Jay S
authors.initials: JS
authors.lastname: Kaufman
mesh_terms: D001294:Attitude to Health; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D005194:Family Practice; D005260:Female; D006801:Humans; D019458:Insurance Coverage; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000523:psychology*; D011320:Primary Health Care; D020377:Self Efficacy; D029181:Spirituality; D011795:Surveys and Questionnaires