The Impact of Spiritual Healing on Moderate Depression in Adults: A Pilot Randomized Controlled Trial (RCT)

Background Depression is a common mental disorder and is together with anxiety the global leading cause of all non-fatal burden of disease. The core symptoms of depression are lowered mood, discouragement, loss of sense and meaning in life, lack of interest in other people and ordinary duties, and lack of energy and appetite. In addition, often diminished self-esteem, self-reproach and a feeling of guilt. These symptoms may vary in intensity and duration. Nevertheless, around half of people with depression worldwide do not receive treatment. Most mental disorders emerge before the age of 30, and lack of treatment might contribute to disability for many crucial years of an individual's life. In Norway, the 12 months prevalence and lifetime prevalence of depression is 10% and 20% respectably, higher in women than in men. Depression has been identified as a strong predictor for use of complementary and alternative medicine (CAM). A recent Norwegian study demonstrates that only 10.9% of those with moderate depression and/or anxiety visited psychiatric outpatient services while 17.6 % visited a complementary and alternative medicine (CAM) provider. This fact demonstrates that people with depression might be willing to seek help also from less established sources, such as CAM providers. Thus, it is possible that different CAM modalities may serve as a substitute or an alternative when access to psychologist/psychiatric services is limited.

Conventional medicine classifies depression as a mood disorder that manifests itself across a wide range of disease/symptom severity. Depression can be classified as mild, moderate or severe. Symptoms must have been persistent for at least two weeks and not be related to other medical or psychiatric diagnoses, or be due to substances. The World Health Organization ranks the social costs of depression as the 4th highest of all diseases. Furthermore, by 2020 current trends indicate that depression will represent the highest cost to society of any disease. Clearly, prevention, early diagnosis and intervention of depression have huge social significance.

The most commonly prescribed antidepressant drugs, selective serotonin reuptake inhibitors (SSRIs) have recently been shown to have best effect on severe depression, and no effect beyond placebo for mild and moderate depression. At the same time, SSRIs can be associated with serious adverse effects, and are associated with a higher vulnerability to develop a depressive episode later in life. Thus, one of the most common treatment options for depression has been documented to be of little or no help beyond placebo for moderate depression while at the same time possibly inducing serious adverse effects.

The Norwegian minister of health, Bent Høye, has taken the patients' request for an improved treatment situation seriously, and sent a letter to the five regional health authorities in which he wrote: "Many patients in psychological health care do not want to be treated with medication. These patients must be heard and taken seriously. Patients cannot be forced to take medication as long as necessary care and treatment can be provided otherwise".

Cognitive behavioral therapy (CBT) or structured psychological therapy should always be offered patients who do not receive, or do not want pharmaceutical antidepressant treatment. However, the waiting list for such treatments is often long due to the lack of competent professionals (psychologists and psychiatrist), especially in rural communities, but also at the district psychiatric centers are there long waiting lists for such treatments. These centers have to prioritize patients with major depression, meaning that patients with moderate depression have even less access to CBT.