Associations Between Religiosity, Spirituality and Depressive Symptoms Among People Experiencing Homelessness in São Paulo, Brazil: An Observational Study.

Despite the evident relationship between religiosity and spirituality (RS) and symptoms of depression found in different population groups, there is a lack of studies in more vulnerable groups, especially among people experiencing homelessness (PEH) in least developed countries. Our aim was to assess the association between RS and depressive symptoms in PEH in a large Brazilian urban center. This is an observational study in which a sample of PEH participated. We assessed the following variables: religiosity, spirituality, religious-spiritual coping and symptoms of depression. Results: A total of 456 PEH had participated, with an average age of 44.5 (SD = 12.6) years. Of these, 49.6% reported depressive symptoms at clinical level. The linear regression indicated that various aspects related to RS, such as going to a religious temple, having a private spirituality practice, and having a positive religious-spiritual coping related to the positive reinterpretation of stressful situations, were associated with a reduction in the chance of the participants reporting depressive symptoms. However, the presence of negative religious-spiritual coping, related to guilt, feelings of punishment, insecurity, and negative reinterpretation of stressors, increased the risk of symptoms of depression. Our results highlight the relevance of developing and testing the effects of psychosocial interventions that specifically incorporate aspects of RS which produce beneficial impact in the care of PEH who have a religion. This could be a helpful mechanism for reducing symptoms of depression and contributing to the social reintegration of these people. Furthermore, future studies should investigate how to mitigate the potential negative RS beliefs that may contribute to worsening symptoms of depression, to prevent them and mitigate their effects.