/random/ - random

With regards to the relationship between religiosity and presence of religious delusions and hallucinations, findings are contradictory with some studies suggesting higher prevalence of religious delusions and hallucinations in those with higher religiosity[26] and others suggesting lack of relationship between the two.[16]

With regard to socio-demographic variables, reports suggest that the religious content of delusions is related to the marital status and education of schizophrenic patients.[16] Occasional studies suggest a relationship between religious delusions and cognitive deficits.[27]

Religious delusions influence help seeking, treatment, and outcome. Evidence suggests that those with religious delusions take longer to establish service contact,[28,29] receive more medications, have overall higher symptom scores, and have poorer functioning.[28] Those with religious delusion/hallucination are more likely to receive magico-religious healing, are not satisfied with psychiatric treatment,[26] and are more likely not to adhere to psychiatric treatment.[27] Evidence also suggests that those with religious delusions have poor outcome[30,31] and more frequently indulge in violence[32,33] and self-harm.[34,35,36] Some authors suggest that religious delusions can influence the health beliefs models and consequently lead to poor treatment compliance.[37]

In a review of 70 studies, the authors evaluated the relationship between religion, supernatural beliefs, and psychopathology.[11] The authors reported that 30 out of the 70 studies (43%) have found a relationship between delusions and hallucinations, and religion and the supernatural beliefs. Majority of the studies (27 of 30 studies) directly described religious delusions, of which 20 studies described delusions to be of a religion-based nature and 14 considered delusions to be of supernatural nature. Thirteen studies reported on religious hallucinations, with 11 having religious content and 9 finding more supernatural content.[11]

Many studies have evaluated the influence of religion on severity of psychopathology and the findings are contradictory. Some suggest that religious activities and beliefs are more in persons who experience more severe symptoms, especially psychotic and general symptoms,[38] whereas others suggest that increased religious activity is associated with reduced level of symptoms.[39] Data also suggest that higher religiosity is associated with absence of first-rank symptoms.[40]

Relationship of religion and other clinical aspects in patients of schizophrenia

Researchers have shown that religion/religiousness in patients with schizophrenia is associated with increased social integration, reduced risk of suicide attempts,[38,41] reduce risk of substance use,[38,42] decreased rate of smoking,[43] better quality of life,[10,44,45] lower level of functioning,[26] and better prognoses.[46] With regard to the relationship of religion and psychosocial adaptation, the findings are contradictory, with some reporting better psychosocial adaptation[47] and others reporting poor social and psychological status in a majority of patients.[9] Religious support and spirituality has also been found to be associated with better recovery[42,48,49] and reduced relapse rate.[47,50] However, in some patients, higher religiosity has been linked to higher risk of suicide attempt.[38]

Religion and treatment adherence in schizophrenia

Some studies suggest that religion/religiousness in patients with schizophrenia is associated with better treatment adherence with psychiatric treatment,[4,38,47] whereas others suggest association of religion with poor treatment adherence.[38,51] Some studies suggest that higher religiosity is associated with lower preference for psychiatric treatment.

Religious coping in schizophrenia

Religious coping is multidimensional and refers to functionally oriented expressions of religion in times of stress. Religious coping is operationally defined as “the use of religious beliefs or behaviors to facilitate problem-solving to prevent or alleviate the negative emotional consequences of stressful life circumstances.”[52] The concept of religious coping has been refined and categorized as helpful or positive, harmful or negative, and with mixed implications. The positive religious coping strategies include religious purification/forgiveness, religious direction/conversion, religious helping, seeking support from clergy/members, collaborative religious coping, religious focus, active religious surrender, benevolent religious reappraisal, spiritual connection, and marking religious boundaries. The negative religious coping strategies include spiritual discontent, demonic reappraisal, passive religious deferral, interpersonal religious discontent, reappraisal of God's powers, punishing God reappraisal, and pleading for direct intercession.[53] The religious coping strategies with mixed implications include religious rituals in response to crisis, self-directing, deferring, and pleading religious coping.

Few studies have evaluated the types of religious coping employed by patients with schizophrenia and their role in dealing with the stressful situation.[18,54,55] Studies suggest that up to 80% of patients use religious coping as a means of dealing with their illness.[39] Others have reported that in 45% of patients, spirituality and religiousness was helpful in coping with the illness.[18] Studies which have compared different disorders suggest that patients with schizophrenia, bipolar disorder, and schizoaffective disorder use religious coping for a significantly greater number of years and perceive the same to be more helpful than those diagnosed with depressive disorders.[56]

Studies also suggest that religious coping influences other parameters. Studies suggest that religious coping in patients of schizophrenia is associated positively with psychological and existential well-being, with positive religious coping being the primary predictor of psychological well-being.[57] A study revealed that benevolent religious reappraisal was associated with better well-being, better adjustment, and lesser personal loss from mental illness, whereas punishing God reappraisal and reappraisal of God's powers were associated, with a greater correlation, with lesser well-being and adjustment and greater personal loss from mental illness.[58] Positive religious coping has also been associated with higher quality of life in the domain of psychological health.[8] Negative religious coping has been associated with lower quality of life[8] and higher distress (assessed by Depression, Anxiety and Stress scale).[59] Longitudinal studies have shown that higher salience of religion and use of positive religious coping at the baseline are predictive of lesser negative symptoms, better quality of life, and better clinical global impression.[49] Participation in spiritual activities has been shown to be associated with better social functioning and dealing with negative symptoms.[60]