The exploratory relationship between spiritual health and depression, anxiety, and stress in individuals who attempted suicide in Yasuj, Southwest Iran: a cross-sectional study.

backgroundSuicide represents a major public health challenge globally, with depression, anxiety, and stress constituting well-established risk factors. Spiritual health has emerged as a potentially protective factor against psychological distress, yet its relationship with mental health outcomes in suicide attempters remains inadequately characterized, particularly in Middle Eastern populations where spiritual and religious frameworks play central roles in cultural identity.

objectiveThis study aimed to investigate the relationship between spiritual health and depression, anxiety, and stress among individuals who attempted suicide in Yasuj, Southwest Iran.

methodsThis cross-sectional study was conducted on 136 individuals who attempted suicide and were admitted to Imam Sajjad Hospital in Yasuj, Iran, during 2023-2024. Participants were selected using convenience sampling. Data were collected through face-to-face interviews using a demographic questionnaire, the Depression Anxiety Stress Scale-21 (DASS-21), and the Paloutzian and Ellison Spiritual Health Questionnaire. Data analysis was performed using SPSS version 26, employing descriptive statistics and Spearman correlation coefficients to examine relationships between spiritual health and psychological distress variables across urban and rural subgroups.

resultsThe sample consisted predominantly of young adults aged 16-30 years (70.6%), females (55.9%), single individuals (64.0%), and urban residents (76.5%). Drug ingestion was the most common suicide method (94.9%), and 34.5% reported prior suicide attempts. Severe to extremely severe depression was present in 80.9% of participants, with 81.6% experiencing severe to extremely severe stress, and 38.9% reporting severe to extremely severe anxiety. Spiritual health demonstrated significant negative correlations with depression (urban: r = -0.591, p < 0.01; rural: r = -0.544, p = 0.001) and stress (urban: r = -0.602, p < 0.01; rural: r = -0.499, p = 0.004). However, correlations between spiritual health and anxiety were weak and non-significant in both urban (r = -0.186, p = 0.059) and rural areas (r = -0.100, p = 0.585). Strong positive intercorrelations were observed among depression, anxiety, and stress (r = 0.430-0.663, all p < 0.01).

conclusionSpiritual health is significantly and inversely associated with depression and stress, but not with anxiety, among suicide attempters in Southwest Iran. These findings suggest that spiritual health may serve as a protective factor against specific dimensions of psychological distress in this high-risk population. The integration of spiritual health assessment and spiritually-informed interventions into comprehensive suicide prevention and post-attempt care protocols may enhance treatment outcomes, particularly for individuals whose cultural and personal identities incorporate spiritual dimensions. Future longitudinal research is needed to establish causal relationships and evaluate the efficacy of spiritually-integrated therapeutic interventions for reducing psychological distress and preventing suicide reattempts. CLINICAL TRIAL NUMBER: Not applicable.