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Religiousness/Spirituality and Schizophrenia: Implications for Treatment and Community Support

  • Jennifer A. NolanEmail author
  • Rachel E. Dew
  • Harold G. Koenig
Chapter

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 exposure 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 adherence, 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 religious groups to better accept and integrate individuals living with 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 characterizing relationships between religiousness/spirituality and severe mental illness, which exists in spite of the plethora of research on its relationship to depression, anxiety, 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 how psychotic 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) directions for future research; and (7) potential implications of research for treatment and community interventions.

Keywords

Religion Spirituality Schizophrenia 

Abbreviations

HIV

human immunodeficiency virus

HIV/AIDS

human immunodeficiency virus/ acquired immune deficiency syndrome

CBT

cognitive-behavioral therapy

RCBT

religious-based cognitive-behavioural therapy

PCT

pastoral counselling therapy

MBSR

mindfulness-based stress reduction

fMRI

functional magnetic resonance imaging

DSM-IV

Diagnostic and Statistical Manual of Mental Disorders, 4th Edition

CASA

National Center on Addiction and Substance Abuse

DSM

Diagnostic and Statistical Manual

CASH

Comprehensive Assessment of Symptoms and History

CASH-CS

Comprehensive Assessment of Symptoms and History an adapted culturally sensitive version

ECA

Epidemiologic Catchment Area

QOL

Quality of Life

WHOQOL-BREF

World Health Organization Quality of Life-BREF

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Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  • Jennifer A. Nolan
    • 1
    Email author
  • Rachel E. Dew
    • 2
  • Harold G. Koenig
    • 3
  1. 1.Center for Child and Family Policy, Social Science Research InstituteDuke UniversityDurhamUSA
  2. 2.Division of Child & Adolescent Psychiatry, Department of Psychiatry & Behavioral SciencesDuke Child & Family Study Center, Duke University Medical CenterDurhamUSA
  3. 3.Department of Psychiatry and Behavioral SciencesDuke University Medical CenterDurhamUSA

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