Re: 'Religious service attendance and major depression: A case of reverse causality?'

摘要

In a recent article, Maselko et al. (1) noted that previous studies have found seemingly protective associations between attendance at religious services and depression. In their own analyses, they looked in the opposite direction and showed that early onset of major depressive disorder predicts subsequent discontinuation of religious service attendance. They noted that this could be responsible for the seemingly protective association of religious participation with depression. If persons who are depressed are more likely to cease attending services, then with cross-sectional data, it may artificially appear as though attending services protects against depression. This may be an instance of "reverse causation." Many studies and meta-analyses (2, 3) that previously reported associations between religious service attendance and depression used cross-sectional data. Maselko et al. noted that because of the possibility of reverse causation, the use of such cross-sectional data does not give evidence of causality. They are to be commended for paying more detailed attention to issues of temporality than is seen in most of the literature on associations between religion and health.