Most studies report positive associations between religiosity and spirituality and aspects of mental health, while a small proportion report mixed or fully negative associations. The aim of this study was to assess the associations of religiosity measured more specifically, with mental health in a secular environment, using a nationally representative sample of Czech adults (n = 1795). We measured religious affiliation, conversion experience, non-religious attitudes and the stability of these attitudes, mental health problems, and anxiety levels. Compared to stable non-religious respondents, unstable non-religious and converted respondents who perceived God as distant were more likely to experience anxiety in close relationships, and had higher risks of worse mental health. Our findings support the idea that the heterogeneity of findings in associations between religiosity/spirituality and mental health could be due to measurement problems and variation in the degree of secularity. A shift towards religiosity could be expected to be seen in a substantial part of non-religious respondents in problematic times.

Department of Community and Occupational Medicine University Medical Center Groningen University of Groningen 9713 AV Groningen The Netherlands

Department of Social Medicine and Public Health Faculty of Medicine and Dentistry Palacký University in Olomouc 771 47 Olomouc Czech Republic

Graduate School Kosice Institute for Society and Health P J Safarik University in Kosice 040 11 Kosice Slovakia

Olomouc University Social Health Institute Palacký University Olomouc 771 11 Olomouc Czech Republic

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