Impact of spiritual healing on moderate depression in adults: a study protocol of a pilot randomised controlled trial (RCT)

Trine Stub, Audun Campell Irgens, Anne Helen Hansen, Olav Knudsen-Baas, Cornelia Gåskjenn, Agnete E Kristoffersen, Trine Stub, Audun Campell Irgens, Anne Helen Hansen, Olav Knudsen-Baas, Cornelia Gåskjenn, Agnete E Kristoffersen

Abstract

Introduction: Depression is a common mental disorder and the (global) leading cause of all non-fatal burden of disease worldwide. Currently, supported treatment for depression is antidepressant medication and different psychotherapeutic interventions. Many patients experience, however, adverse effects of antidepressant medication, while at the same time the access to psychotherapeutic interventions are limited. Many patients who suffer from depression turn to complementary medicine and among those modalities often spiritual healing. There is some evidence that consulting a spiritual healer can be beneficial for patients who suffer from depression, and that spiritual healing is associated with low risk. The aim of this protocol is to conduct a pilot randomised controlled trial (RCT) (spiritual healing as addition to usual care vs usual care alone) in preparation of a larger trial in adults with moderate depression, to examine feasibility and individuals' experience of spiritual healing.

Methods and analysis: This study is a pilot RCT with two parallel groups. A total of 28 adult patients with moderate depression, diagnosed by the physician and according to the Montgomery and Åsberg Depression Rating Scale criteria will be randomised to spiritual healing in addition to usual care (n=14) or usual care alone (n=14). To determine if there is a statistical indication of an effect of healing warranting a full-scale study; the separation test will be used. To investigate participants' experience with spiritual healing, a qualitative study will be included using semistructured interviews. The data will be analysed based on a direct content analysis.

Ethics and dissemination: This protocol was approved by regional committees for medical and health research ethics by the identifier (63692). The results will be disseminated through open-access, peer-reviewed publications, in addition to stakeholders' reporting and presenting at conferences.

Trial registration: Norwegian Centre for Research Data (845302) and clinicaltrials.gov (ID: NCT04766242).

Keywords: Adverse events; COMPLEMENTARY MEDICINE; Clinical trials; Depression & mood disorders; MENTAL HEALTH; PSYCHIATRY.

Conflict of interest statement

Competing interests: None declared.

© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Figures

Figure 1
Figure 1
Flow chart of the schedule of enrolment, intervention and assessment. BDI, Beck Depression Inventory; MADRS, Montgomery and Åsberg Depression Rating Scale.

References

    1. Whiteford HA, Degenhardt L, Rehm J, et al. . Global burden of disease attributable to mental and substance use disorders: findings from the global burden of disease study 2010. Lancet 2013;382:1575–86. 10.1016/S0140-6736(13)61611-6
    1. Mykletun A, Knudsen AK, Mathiesen KS. Psykiske lidelser i Norge: Et folkehelseperspektiv [Mental disorders in Norway: A public health perspective. Oslo: Norwegian Institute of Public Health, 2009.
    1. Breedlove SM, Rosenzweig MR, Watson NV. Biological psychology: an introduction to behavioral, cognitive, and clinical neuroscience. In: Mass: Sinauer associates. 5th. Sunderland, 2007.
    1. Wang PS, Aguilar-Gaxiola S, Alonso J, et al. . Use of mental health services for anxiety, mood, and substance disorders in 17 countries in the who world mental health surveys. Lancet 2007;370:841–50. 10.1016/S0140-6736(07)61414-7
    1. Kessler RC, Berglund P, Demler O, et al. . Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National comorbidity survey replication. Arch Gen Psychiatry 2005;62:593–602. 10.1001/archpsyc.62.6.593
    1. Eisenberg D, Golberstein E, Gollust SE. Help-seeking and access to mental health care in a university student population. Med Care 2007;45:594–601. 10.1097/MLR.0b013e31803bb4c1
    1. Druss BG, Rosenheck RA. Use of practitioner-based complementary therapies by persons reporting mental conditions in the United States. Arch Gen Psychiatry 2000;57:708–14. 10.1001/archpsyc.57.7.708
    1. Kessler RC, Soukup J, Davis RB, et al. . The use of complementary and alternative therapies to treat anxiety and depression in the United States. Am J Psychiatry 2001;158:289–94. 10.1176/appi.ajp.158.2.289
    1. Spinks J, Hollingsworth B. Policy implications of complementary and alternative medicine use in Australia: data from the national health survey. J Altern Complement Med 2012;18:371–8. 10.1089/acm.2010.0817
    1. Hansen AH, Kristoffersen AE. The use of CAM providers and psychiatric outpatient services in people with anxiety/depression: a cross-sectional survey. BMC Complement Altern Med 2016;16:461. 10.1186/s12906-016-1446-9
    1. Bazargan M, Ani CO, Hindman DW, et al. . Correlates of complementary and alternative medicine utilization in depressed, underserved African American and Hispanic patients in primary care settings. J Altern Complement Med 2008;14:537–44. 10.1089/acm.2007.0821
    1. Jorm AF, Griffiths KM, Christensen H, et al. . Actions taken to cope with depression at different levels of severity: a community survey. Psychol Med 2004;34:293–9. 10.1017/s003329170300895x
    1. MacPherson H, Thorpe L, Thomas K, et al. . Acupuncture for depression: first steps toward a clinical evaluation. J Altern Complement Med 2004;10:1083–91. 10.1089/acm.2004.10.1083
    1. Dozois DJA, Westra HA. The prevention of anxiety and depression: Theory, research, and practice. In: The nature of anxiety and depression: implication for prevention. Washington: American Psychological Association, 2004: p. 9–41.
    1. et alMurthy RS, Bertolote JM, Epping-Jordan J. Mental health: new understanding, new hope2001 14.01. Available: [Accessed 14 Jan 2009].
    1. Kirsch I, Deacon BJ, Huedo-Medina TB, et al. . Initial severity and antidepressant benefits: a meta-analysis of data submitted to the food and drug administration. PLoS Med 2008;5:e45. 10.1371/journal.pmed.0050045
    1. Kirsch I. The Emperor’s New Drugs: Medication and Placebo in the Treatment of Depression. Placebo, Berlin, Heidelberg: Springer Berlin Heidelberg, 2014: 291–303.
    1. Arroll B, Elley CR, Fishman T, et al. . Antidepressants versus placebo for depression in primary care. Cochrane Database Syst Rev 2009:CD007954. 10.1002/14651858.CD007954
    1. Bjørgen D, Kvisle IM, Stiftelsen Kompetansesenter for brukererfaring og tjenesteutvikling (KBT) . Etablering av legemiddelfrie behandlingstilbud - Alternativer til medikamentell behandling innen psykisk helsevern In English: Establish drug-free treatment options - Alternatives to drug treatment in mental health care; 2020.
    1. Berge T, Repål A, Den indre samtalen . Cognitive therapy in practice. In: Kognitiv terapi I praksis. English: the inner conversation. Oslo: Gyldendal Norsk Forlag AS, 2004.
    1. Helsedirektoratet. Depresjon 2016 27 01. Available: [Accessed 27 Jan 2017].
    1. Nasjonalt forskningssenter innen komplementær og alternativ medisin (NAFKAM) . NAFKAM-undersøkelsen 2014, Bruk av alternativ behandling i Norge [The nafkam survey 2014. Use of complementary and alternative medisin in Norway] Tromsø: Nasjonalt informasjonssenter for alternativ behandling (NIFAB); 2014. Available: [Accessed 30 Jan 2015].
    1. Van Aken R, Taylor B. Emerging from depression: the experiential process of healing touch explored through grounded theory and case study. Complement Ther Clin Pract 2010;16:132–7. 10.1016/j.ctcp.2009.11.001
    1. MacPherson H, Hammerschlag R, Lewith G. Acupuncture research strategies for establishing an evidence base. London: Churchill Livingstone, 2007: 260.
    1. Shore AG. Long-term effects of energetic healing on symptoms of psychological depression and self-perceived stress. Altern Ther Health Med 2004;10:42–8.
    1. Richeson NE, Spross JA, Lutz K, et al. . Effects of Reiki on anxiety, depression, pain, and physiological factors in community-dwelling older adults. Res Gerontol Nurs 2010;3:187–99. 10.3928/19404921-20100601-01
    1. Joyce J, Herbison GP. Reiki for depression and anxiety. Cochrane Database Syst Rev 2015;4:CD006833. 10.1002/14651858.CD006833.pub2
    1. Kristoffersen AE, Stub T, Knudsen-Baas O, et al. . Self-Reported Effects of Energy Healing: A Prospective Observational Study With Pre-Post Design. In: Explore: the Journal of science and healing, 2018.
    1. Paterson C, Britten N. In pursuit of patient-centred outcomes: a qualitative evaluation of the 'measure yourself medical outcome profile'. J Health Serv Res Policy 2000;5:27–36. 10.1177/135581960000500108
    1. Thompson TDB, Weiss M. Homeopathy--what are the active ingredients? An exploratory study using the UK medical research council's framework for the evaluation of complex interventions. BMC Complement Altern Med 2006;6:37. 10.1186/1472-6882-6-37
    1. Pennebaker JW, Barger SD, Tiebout J. Disclosure of traumas and health among holocaust survivors. Psychosom Med 1989;51:577–89. 10.1097/00006842-198909000-00009
    1. Montgomery SA, Åsberg M. A new depression scale designed to be sensitive to change. Br J Psychiatry 1979;134:382–9. 10.1192/bjp.134.4.382
    1. Malt UF, Andreassen OA, Malt Albertsen E, et al. . Lærebok i psykiatri. English:Textbook in psychiatry. Oslo: Gyldendal Akademisk, 2017.
    1. Foreningen for utgivelse av Norsk legemiddelhåndbok . Terapikapitel T5.5 Depresjoner. (In English: Therapy chapter). In: Norsk legemiddelhåndbok (in English: Norwegian medicine handbook). Oslo, 2013.
    1. Steer RA, Cavalieri TA, Leonard DM, et al. . Use of the beck depression inventory for primary care to screen for major depression disorders. Gen Hosp Psychiatry 1999;21:106–11. 10.1016/s0163-8343(98)00070-x
    1. Aickin M. Separation tests for early-phase complementary and alternative medicine comparative trials. Evidence-Based Integrative Medicine 2004;1:225–31. 10.2165/01197065-200401040-00001
    1. Statens legemiddelverk (Norwegian Medicines Agency) . Melding Om mistenkt bivirkning ved bruk AV legemidler (ink. naturlegemidler). Oslo: Folkehelseinstituttet; 2009.
    1. Quinn Patton M. Qualitative research & evaluation methods. Integrating theory and practice. California: SAGE publications, Inc, 2015.
    1. Interviews KS. An introduction to qualitative research interviewing. Thousand Oaks California: Sage, 1996.
    1. Hsieh H-F, Shannon S. Qualitative health research. 15, 2005: 1277.
    1. Malterud K, Siersma VD, Guassora AD. Sample size in qualitative interview studies: guided by information power. Qual Health Res 2016;26:1753–60. 10.1177/1049732315617444
    1. The World Medical Association (WMA) . Declaration of Helsinki-Ethical principles for medical research involving human subjects 1964; 2013. [Accessed 24 May 2013].
    1. Kristoffersen AE, Stub T, Melhus M, et al. . Prevalence and associations for use of a traditional medicine provider in the SAMINOR 1 survey: a population-based study on health and living conditions in regions with SAMI and Norwegian populations. BMC Complement Altern Med 2017;17:530. 10.1186/s12906-017-2037-0
    1. Risberg T, Lund E, Wist E, et al. . Cancer patients use of nonproven therapy: a 5-year follow-up study. J Clin Oncol 1998;16:6–12. 10.1200/JCO.1998.16.1.6
    1. Patsopoulos NA. A pragmatic view on pragmatic trials. Dialogues Clin Neurosci 2011;13:217–24. 10.31887/DCNS.2011.13.2/npatsopoulos
    1. Paterson C, Britten N. In Pursuit of Patient-Centred Outcomes: A Qualitative Evaluation of the ‘Measure Yourself Medical Outcome Profile’. Journal of Health Services Research & Policy 2000;5:27–36.

Source: PubMed

3
Se inscrever