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Am J Psychiatry 161:586, March 2004
© 2004 American Psychiatric Association


Book Forum:
Psychoneuroimmunology

The Link Between Religion and Health: Psychoneuroimmunology and the Faith Factor

Edited by Harold G. Koenig and Harvey Jay Cohen. New York, Oxford University Press, 2002, 304 pp., $35.00.

WILLIAM R. YATES, M.D.
Tulsa, Okla.

This book contains 15 chapters written by national experts in a variety of disciplines. Most of the authors participated in a 1999 conference at Duke University to "review the effects of stress on the immune system and see how this knowledge might inform us about the religion-health relationship."

The number of studies supporting beneficial effects for religion on mental health, physical health, and mortality is growing, but no biological mechanism for such an effect has been proven. The editors propose that religion may have a beneficial effect on immune function through the neuroendocrine system’s modulation of the stress response. Several chapters address this hypothesis by examining neuroendocrine and immune function factors in cancer, autoimmune disorders, wound healing, HIV infection, and other infections. Although there are some studies supporting the editors’ hypothesis, clearly there is a long way to go.

One of the important research issues addressed in this book is defining the multiple domains that exist under the umbrella of religion. Many early studies examined the role of religious denomination on health. Clearly, this categorization fails to recognize the complex features of religion and faith. The authors note that religious belief, religious behavior (i.e., frequency of church attendance), use of religion in coping, spirituality, and other features of religion may be related more directly to the beneficial effects of religion on health. Potentially important confounding issues, such as lower rates of smoking in church attenders, are also noted in this book. The authors review the psychometric issues involved in many of these religious domains and make specific recommendations for researchers who want to include religion as a descriptive variable.

A final chapter summarizes the editors’ recommendation for an agenda for future research in the study of the effects of religion on health. They advocate a series of research projects, some classified as high priority and others classified as most practical. Some of the most practical studies would have a limited cost. For example, adding several measures of religiosity and several immune function markers to standard chemotherapy clinical trials could help examine the relationship between religion and immune response. The editors give additional examples of how "piggybacking" religion assessments may provide valuable information about the effect of religion on disease, health, and treatment response.

I would recommend this book for clinical researchers interested in contributing to the study of the role of religion in psychiatry and medicine. Clinicians interested in the relationship between religion and health will also enjoy this summary of the current state of knowledge and glimpse into potential future research studies.




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* Articles by YATES, W. R.
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* Neurophysiology


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