There has been a lot of research suggesting that being religious is good for a person's health. Now, a study suggests that struggling with religious beliefs during an illness diminishes the chances of recovering.

Kenneth I. Pargament of Duke University and colleagues questioned and followed 596 older patients from 1996 to 1997. Patients who reported that they "felt alienated from or unloved by God and attributed their illness to the devil" had a 19 percent to 28 percent increase in the risk of dying, the researchers reported in the Aug. 13-27 issue of Archives of Internal Medicine. That was the case even after the researchers accounted for the patients' relative health, mental health and demographic status.

"To our knowledge, this is the first empirical study to identify religious variables that increase the risk of mortality," the researchers wrote.

The researchers speculated that there could be a variety of explanations for the findings. A religious struggle could somehow directly affect health, perhaps by affecting the immune system. Or it could be that people who would tend to have such struggles would also tend to have emotional or personality differences, or more stress, anxiety and depression.

"Expressions of dissatisfaction, confusion and discontent with God and religion are not normative in the United States. . . . Thus, individuals who voice religious dissatisfaction and discontent in the midst of their illnesses may alienate themselves from the support and caring of family, friends, clergy and health professionals," researchers wrote.

"Clearly, additional research is needed to examine these and other potential mediating variables," they wrote. "Further research is needed to determine whether interventions that reduce religious struggles might also improve medical prognosis."