Handbook of Schizophrenia Spectrum Disorders, Volume III

Abstract

Abstract Previous research into psychosis as it relates to religion or spirituality has focused on the phenomenon of religious delusion. Due to the prevalence of religious material in delusional systems, some psychiatrists may fear that all expo- sure to religion/spirituality conveys the risk of exacerbating psychosis. However, recent investigation reveals that for many psychotic patients, religion/spirituality offers solace, social support, and enhanced coping. Private religiousness/spirituality (i.e. prayer, beliefs, or a relationship to the divine) appears to be a prevalent method for coping with schizophrenia. Evidence also suggests that public religiousness (i.e. service attendance, Bible study groups) is helpful to some psychotic patients. Different styles of religious coping have been found to correlate with important health outcomes in the major psychoses, such as quality of life, medication adher- ence, substance abuse and suicide. If confirmed, this research may have clinical and public health implications. Mental health care providers may need to be trained to support religious coping among psychotic patients, rather than assuming it to be an irrelevant or possibly destabilizing force. Educational interventions may help reli- gious groups to better accept and integrate individuals livingwith schizophrenia into their communities, thus enhancing social support for the severely mentally ill. This chapter will review the following topics: (1) the disabling and stigmatizing effects of severe mental illness, and the lack of adequate community support worldwide, in the context of limited available inpatient care; (2) the dearth of research characteriz- ing relationships between religiousness/spirituality and severe mental illness, which exists in spite of the plethora of research on its relationship to depression, anxi- ety, substance abuse, and overall psychological well-being; (3) religious delusions in psychotic illness and concerns that exposure to religion may worsen psychosis; (4) the role of the cultural and religious context in determining howpsychotic illness is understood; (5) review of past and current research on the relationship between religiousness/spirituality and health outcomes in the severely mentally ill; (6) direc- tions for future research; and (7) potential implications of research for treatment and community interventions.