Association between religiosity and anxiety and depression among university students: a cross-sectional study

BACKGROUND: Religion, a fundamental element of human history, provides meaning and a coping mechanism, contributing to lower depression and anxiety levels. However, some may argue that strict religious doctrines and the spread of misconceptions and stigmas may increase the pressure on religious individuals, leading to higher levels of depression and anxiety. As it has not been addressed yet in Lebanon, this study aims to assess the influence of religiosity and potential confounding factors, such as gender, smoking status, physical activity, and health problems, on anxiety and depression among university students in Lebanon. METHODS: A cross-sectional study was conducted using an online questionnaire disseminated to university students. The participants' demographics, lifestyle habits, religiosity using the Religious Commitment Inventory 10 (RCI-10), depression using the Patient Health Questionnaire (PHQ-9), and anxiety levels using the Generalized Anxiety Disorders Questionnaire (GAD-7) were assessed. Bivariate and multivariable analyses were conducted to assess the association between the dependent variables (PHQ-9 and GAD-7 respectively) and religiosity by controlling for the effect of potential confounders. An alpha of 0.05 was considered statistically significant. RESULTS: A total of 353 participants were included, of whom 44% exhibited moderate to severe anxiety symptoms, and 41% moderate to severe depressive symptoms. Female gender (adjusted OR (95%CI) = 1.98 (1.07; 3.66); p = 0.03) and experiencing health problems (5.41 (2.93; 9.94); p < 0.001) were positively associated with severe anxiety levels, while religiosity (0.95 (0.92;0.98); p < 0.001) was associated with decreased anxiety levels. Regarding depression, social media use of more than 4 h per day (3.45 (1.27; 9.41); p = 0.02) and health problems (5.89 (3.17; 10.9); p < 0.001) were positively associated with severe levels, while physical activity (0.44 (0.21; 0.94); p = 0.04) and religiosity (0.96 (0.93; 0.99); p = 0.01) were associated with lower depression levels. CONCLUSION: This study revealed a high proportion of anxiety and depression among university students, yet both were negatively associated with religiosity. These findings underscore the need to integrate religious and cultural considerations into clinical practice, promote exercise as part of patient care, and develop culturally sensitive training programs for mental health professionals in Lebanon. Future research should explore causal relationships between religiosity, social media use, exercise, and mental health outcomes.