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Understanding the role of religion in mental illness has always been complicated as some people turn to religion to cope with their illness, whereas others turn away. The overarching purpose of this study was to draw on quantitative and qualitative information to illuminate ways in which religiousness might be associated with changes in depressive symptomatology in a spiritually integrated inpatient treatment program. This repeated measures mixed method study examined the relations among religious comfort (RC), religious strain (RS), and depression in an inpatient psychiatric sample. Adult inpatients (N=248; Mage = 40.78 years; SD = 18.97) completed measures of RC, RS, and depression at pre- and post-treatment. Focusing on patient responses to open-ended questions regarding spiritual perspectives on their mental illness, qualitative themes were deduced via content analytic coding procedures to further clarify quantitative findings. Autoregressive cross-lagged panel models were used to test potential reciprocal influences among RC, RS, and depressive symptomatology between admission and discharge. Scores on RS decreased, whereas scores on RC increased. At both intake and discharge, depression was inversely associated with RC and directly correlated with RS. In addition, RC on admission was inversely associated with depressive symptom severity at discharge, whereas RS on admission did not predict later depression. Religious affiliation was also positively associated with RC. This is the first study to document a direct association between RS and depression, along with an inverse association with RC, in an inpatient psychiatric sample.
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