Religion and schizophrenia

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The relationship between religion and schizophrenia is of particular interest to psychiatrists because of the similarities between religious experiences and psychotic episodes. Religious experiences often involve reports of auditory and/or visual phenomena, which sounds seemingly similar to those with schizophrenia who also commonly report hallucinations and delusions. These symptoms may resemble the events found within a religious experience. [1] However, the people who report these religious visual and audio hallucinations also claim to have not perceived them with their five senses, rather, they conclude these hallucinations were an entirely internal process. [2] This differs from schizophrenia, where the person is unaware that their own thoughts or inner feelings are not happening outside of them. They report hearing, seeing, smelling, feeling, or tasting something that deludes them to believe it is real. They are unable to distinguish between reality and hallucinations because they experience these hallucinations with their bodily senses that leads them to perceive these events as happening outside of their mind. [3] [4] In general, religion has been found to have "both a protective and a risk increasing effect" for schizophrenia. [5]

Contents

A common report from those with schizophrenia is some type of religious belief that many medical practitioners consider to be delusional — such as the belief that they are possessed by demons, that a god is talking to them, that they themselves are divine beings, or that they are prophets. [6] [7] [8] Active and adaptive coping skills in subjects with residual schizophrenia are associated with a sound spiritual, religious, or personal belief system. [9]

Trans-cultural studies have found that such beliefs are much more common in patients who also identify as Christian and/or reside in predominately Christian areas such as Europe or North America. [10] [11] By comparison, patients in Japan much more commonly have delusions surrounding matters of shame and slander, [10] and in Pakistan matters of paranoia regarding relatives and neighbors. [11]

Background

Schizophrenia is a complex psychotic disorder in which symptoms include emotional blunting, intellectual deterioration, social isolation, disorganized speech and behavior, delusions, and hallucinations. The causes of schizophrenia are unclear, but it seems that genetics play a heavy role, as individuals with a family history are far more likely to suffer from schizophrenia. [12] [13] The disorder can be triggered and exacerbated by social and environmental factors, with episodes becoming more apparent in periods of high stress. Neurologists have found that the schizophrenic brain has larger ventricles (fluid-filled cavities) compared to a non-schizophrenic brain. This is hypothesized to be due to loss of nerve cells. [14] Symptoms usually appear around the onset of early adulthood. [12] It is rare for a child to be diagnosed with schizophrenia, in part because of the difficulty in establishing what erroneous thoughts and beliefs can be attributed to childhood development [15] and which thoughts and beliefs can be attributed to schizophrenia. With psychiatric medication (usually antipsychotics) and therapy, individuals with schizophrenia can live successful and productive lives. [16]

Role of religion in schizophrenia treatment

It has been shown in longitudinal studies that those suffering from schizophrenia have varying degrees of success when religion plays a significant role in their recovery. [17] It would seem that the use of religion can either be a helpful method of coping with the disorder, or it can be a significant hindrance in recovery. Especially for those who are active in a religious community, religion can also be a very valuable tool in coping with the disorder. [18] [19] It can be difficult, however, to distinguish if a religious experience is genuine to the spiritual person, or if it is a positive symptom of the illness. [20] This is where a skilled and reliable therapist can help. Provided that a therapist is open to the use of religion in one's treatment, and that the patient is open and receiving said treatment, it is entirely possible to tie religion in with professional therapeutic aids and medication in order to meet a desirable goal. Those who are involved in their church and are spiritual on a daily basis, while getting psychiatric treatment have reported fewer symptoms and a better quality of life. They learn to see their religion as a source of hope rather than a tormenting reality. [21]

Religion as a trigger for schizophrenia

Schizophrenia can be triggered by a variety of environmental factors, including significant stress, intensely emotional situations, and disturbing or uncomfortable experiences. It is possible that religion can sometimes be a trigger for schizophrenia in those who are vulnerable; religious imagery is often very grandiose, and beckons a large personal change within an individual. This could potentially lead to a psychotic episode due to the shift in realistic thinking; a sufferer may believe that they themselves are a deity or messiah. These symptoms may cause violent behavior, either toward others or themselves. [22] In some instances, they may also experience more distress-inducing symptoms if they believe that a god is using their illness as a punishment. The patient may refuse treatment based on religious beliefs; in certain instances, one might believe that their delusions and hallucinations are actually a divine experience, and therefore deny any treatment. [23]

See also

Related Research Articles

Psychosis is a condition of the mind or psyche that results in difficulties determining what is real and what is not real. Symptoms may include delusions and hallucinations, among other features. Additional symptoms are incoherent speech and behavior that is inappropriate for a given situation. There may also be sleep problems, social withdrawal, lack of motivation, and difficulties carrying out daily activities. Psychosis can have serious adverse outcomes.

A delusion is a false fixed belief that is not amenable to change in light of conflicting evidence. As a pathology, it is distinct from a belief based on false or incomplete information, confabulation, dogma, illusion, hallucination, or some other misleading effects of perception, as individuals with those beliefs are able to change or readjust their beliefs upon reviewing the evidence. However:

Schizoaffective disorder is a mental disorder characterized by abnormal thought processes and an unstable mood. This diagnosis requires symptoms of both schizophrenia (psychosis) and a mood disorder: either bipolar disorder or depression. The main criterion is the presence of psychotic symptoms for at least two weeks without any mood symptoms. Schizoaffective disorder can often be misdiagnosed when the correct diagnosis may be psychotic depression, bipolar I disorder, schizophreniform disorder, or schizophrenia. This is a problem as treatment and prognosis differ greatly for most of these diagnoses. many people with schizoaffective disorder have other mental disorder including anxiety disorders

<span class="mw-page-title-main">Delusional disorder</span> Mental illness featuring beliefs with inadequate grounding

Delusional disorder, traditionally synonymous with paranoia, is a mental illness in which a person has delusions, but with no accompanying prominent hallucinations, thought disorder, mood disorder, or significant flattening of affect. Delusions are a specific symptom of psychosis. Delusions can be bizarre or non-bizarre in content; non-bizarre delusions are fixed false beliefs that involve situations that could occur in real life, such as being harmed or poisoned. Apart from their delusion or delusions, people with delusional disorder may continue to socialize and function in a normal manner and their behavior does not necessarily seem odd. However, the preoccupation with delusional ideas can be disruptive to their overall lives.

<span class="mw-page-title-main">Thought disorder</span> Disorder of thought form, content or stream

A thought disorder (TD) is a disturbance in cognition which affects language, thought and communication. Psychiatric and psychological glossaries in 2015 and 2017 identified thought disorders as encompassing poverty of ideas, neologisms, paralogia, word salad, and delusions—all disturbances of thought content and form. Two specific terms have been suggested—content thought disorder (CTD) and formal thought disorder (FTD). CTD has been defined as a thought disturbance characterized by multiple fragmented delusions, and the term thought disorder is often used to refer to an FTD: a disruption of the form of thought. Also known as disorganized thinking, FTD results in disorganized speech and is recognized as a major feature of schizophrenia and other psychoses. Disorganized speech leads to an inference of disorganized thought. Thought disorders include derailment, pressured speech, poverty of speech, tangentiality, verbigeration, and thought blocking. One of the first known cases of thought disorders, or specifically OCD as it is known today, was in 1691. John Moore, who was a bishop, had a speech in front of Queen Mary II, about "religious melancholy."

Kurt Schneider was a German psychiatrist known largely for his writing on the diagnosis and understanding of schizophrenia, as well as personality disorders then known as psychopathic personalities.

Stimulant psychosis is a mental disorder characterized by psychotic symptoms. It involves and typically occurs following an overdose or several day binge on psychostimulants; however, one study reported occurrences at regularly prescribed doses in approximately 0.1% of individuals within the first several weeks after starting amphetamine or methylphenidate therapy. Methamphetamine psychosis, or long-term effects of stimulant use in the brain, depend upon genetics and may persist for some time.

In psychology, schizotypy is a theoretical concept that posits a continuum of personality characteristics and experiences, ranging from normal dissociative, imaginative states to extreme states of mind related to psychosis, especially schizophrenia. The continuum of personality proposed in schizotypy is in contrast to a categorical view of psychosis, wherein psychosis is considered a particular state of mind, which the person either has or does not have.

The mental status examination (MSE) is an important part of the clinical assessment process in neurological and psychiatric practice. It is a structured way of observing and describing a patient's psychological functioning at a given point in time, under the domains of appearance, attitude, behavior, mood and affect, speech, thought process, thought content, perception, cognition, insight, and judgment. There are some minor variations in the subdivision of the MSE and the sequence and names of MSE domains.

The Hearing Voices Movement (HVM) is the name used by organizations and individuals advocating the "hearing voices approach", an alternative way of understanding the experience of those people who "hear voices". In the medical professional literature, ‘voices’ are most often referred to as auditory verbal hallucinations. The movement uses the term ‘hearing voices’, which it feels is a more accurate and 'user-friendly' term.

Thought broadcasting is a type of delusional condition in which the affected person believes that others can hear their inner thoughts, despite a clear lack of evidence. The person may believe that either those nearby can perceive their thoughts or that they are being transmitted via mediums such as television, radio or the internet. Different people can experience thought broadcasting in different ways. Thought broadcasting is most commonly found among people who have a psychotic disorder, specifically schizophrenia.

Schizophreniform disorder is a mental disorder diagnosed when symptoms of schizophrenia are present for a significant portion of time, but signs of disturbance are not present for the full six months required for the diagnosis of schizophrenia.

Oneiroid syndrome (OS) is a condition involving dream-like disturbances of one's consciousness by vivid scenic hallucinations, accompanied by catatonic symptoms (either catatonic stupor or excitement), delusions, or psychopathological experiences of a kaleidoscopic nature. The term is from Ancient Greek "ὄνειρος" (óneiros, meaning "dream") and "εἶδος" (eîdos, meaning "form, likeness"; literally dream-like / oneiric or oniric, sometimes called "nightmare-like"). It is a common complication of catatonic schizophrenia, although it can also be caused by other mental disorders. The dream-like experiences are vivid enough to seem real to the patient. OS is distinguished from delirium by the fact that the imaginative experiences of patients always have an internal projection. This syndrome is hardly mentioned in standard psychiatric textbooks, possibly because it is not listed in DSM.

An auditory hallucination, or paracusia, is a form of hallucination that involves perceiving sounds without auditory stimulus. While experiencing an auditory hallucination, the affected person hears a sound or sounds that did not come from the natural environment.

<span class="mw-page-title-main">Grandiose delusions</span> Subtype of delusion

Grandiose delusions (GDs), also known as delusions of grandeur or expansive delusions, are a subtype of delusion characterized by extraordinary belief that one is famous, omnipotent, wealthy, or otherwise very powerful. Grandiose delusions often have a religious, science fictional, or supernatural theme. Examples include the extraordinary belief that one is a deity or celebrity, or that one possesses extraordinary talents, accomplishments, or superpowers.

Brief psychotic disorder—according to the classifications of mental disorders DSM-IV-TR and DSM-5—is a psychotic condition involving the sudden onset of at least one psychotic symptom lasting 1 day to 1 month, often accompanied by emotional turmoil. Remission of all symptoms is complete with patients returning to the previous level of functioning. It may follow a period of extreme stress including the loss of a loved one. Most patients with this condition under DSM-5 would be classified as having acute and transient psychotic disorders under ICD-10. Prior to DSM-IV, this condition was called "brief reactive psychosis." This condition may or may not be recurrent, and it should not be caused by another condition.

Childhood schizophrenia is similar in characteristics of schizophrenia that develops at a later age, but has an onset before the age of 13 years, and is more difficult to diagnose. Schizophrenia is characterized by positive symptoms that can include hallucinations, delusions, and disorganized speech; negative symptoms, such as blunted affect and avolition and apathy, and a number of cognitive impairments. Differential diagnosis is problematic since several other neurodevelopmental disorders, including autism spectrum disorder, language disorder, and attention deficit hyperactivity disorder, also have signs and symptoms similar to childhood-onset schizophrenia.

The diagnosis of schizophrenia, a psychotic disorder, is based on criteria in either the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, or the World Health Organization's International Classification of Diseases (ICD). Clinical assessment of schizophrenia is carried out by a mental health professional based on observed behavior, reported experiences, and reports of others familiar with the person. Diagnosis is usually made by a psychiatrist. Associated symptoms occur along a continuum in the population and must reach a certain severity and level of impairment before a diagnosis is made. Schizophrenia has a prevalence rate of 0.3-0.7% in the United States.

<span class="mw-page-title-main">Religious delusion</span> Delusion involving religious themes or subject matter

A religious delusion is defined as a delusion, or fixed belief not amenable to change in light of conflicting evidence, involving religious themes or subject matter. Religious faith, meanwhile, is defined as a belief in a religious doctrine or higher power in the absence of evidence. Psychologists, scientists, and philosophers have debated the distinction between the two, which is subjective and cultural.

<span class="mw-page-title-main">Caffeine-induced psychosis</span> Mental disorder

Caffeine-induced psychosis is a relatively rare phenomenon that can occur in otherwise healthy people. Overuse of caffeine may also worsen psychosis in people suffering from schizophrenia. It is characterized by psychotic symptoms such as delusions, paranoia, and hallucinations. This can happen with ingestion of high doses of caffeine, or when caffeine is chronically abused, but the actual evidence is currently limited.

References

  1. ↑ Murray, ED.; Cunningham MG; Price BH (2012). "The role of psychotic disorders in religious history considered". The Journal of Neuropsychiatry and Clinical Neurosciences. 24 (4): 410–26. doi:10.1176/appi.neuropsych.11090214. PMID   23224447. S2CID   207654711.
  2. ↑ Webb, Mark. "Religious Experience". Stanford Encyclopedia of Philosophy.
  3. ↑ "Overview - Schizophrenia". Nhs.Uk.
  4. ↑ Webb, Mark. "Religious Experience". Stanford Encyclopedia of Philosophy.
  5. ↑ Gearing, Robin Edward, Dana Alonzo, Alex Smolak, Katie McHugh, Sherelle Harmon, and Susanna Baldwin. "Association of religion with delusions and hallucinations in the context of schizophrenia: Implications for engagement and adherence." Schizophrenia research 126, no. 1 (2011): 150-163.
  6. ↑ Siddle, Ronald; Haddock, Gillian; Tarrier, Nicholas; Faragher, E. Brian (1 March 2002). "Religious delusions in patients admitted to hospital with schizophrenia". Social Psychiatry and Psychiatric Epidemiology. 37 (3): 130–138. doi:10.1007/s001270200005. PMID   11990010.
  7. ↑ Mohr, Sylvia; Borras, Laurence; Betrisey, Carine; Pierre-Yves, Brandt; Gilliéron, Christiane; Huguelet, Philippe (1 June 2010). "Delusions with Religious Content in Patients with Psychosis: How They Interact with Spiritual Coping". Psychiatry: Interpersonal and Biological Processes. 73 (2): 158–172. doi:10.1521/psyc.2010.73.2.158. PMID   20557227.
  8. ↑ Siddle, R; Haddock, G; Tarrier, N; Faragher, EB (March 2002). "Religious delusions in patients admitted to hospital with schizophrenia". Social Psychiatry and Psychiatric Epidemiology. 37 (3): 130–8. doi:10.1007/s001270200005. PMID   11990010.
  9. ↑ Shah, Ruchita, et al. "Relationship between spirituality/religiousness and coping in patients with residual schizophrenia." Quality of Life Research 20.7 (2011): 1053-1060.
  10. 1 2 Tateyama M, Asai M, Hashimoto M, Bartels M, Kasper S (1998). "Transcultural study of schizophrenic delusions. Tokyo versus Vienna and Tübingen (Germany)". Psychopathology. 31 (2): 59–68. doi:10.1159/000029025. PMID   9561549.
  11. 1 2 Stompe T, Friedman A, Ortwein G, Strobl R, Chaudhry HR, Najam N, Chaudhry MR (1999). "Comparison of delusions among schizophrenics in Austria and in Pakistan". Psychopathology. 32 (5): 225–34. doi:10.1159/000029094. PMID   10494061.
  12. 1 2 van Os, J; Kapur, S (2009-08-22). "Schizophrenia". Lancet. 374 (9690): 635–45. doi:10.1016/S0140-6736(09)60995-8. PMID   19700006.
  13. ↑ Picchioni, MM; Murray, RM (2007-07-14). "Schizophrenia". BMJ (Clinical Research Ed.). 335 (7610): 91–5. doi:10.1136/bmj.39227.616447.BE. PMC   1914490 . PMID   17626963.
  14. ↑ Page, Dan. "UCLA Researchers Map How Schizophrenia Engulfs Teen Brains".
  15. ↑ McLeod, Saul. "Egocentrism". simplepsychology.org. Retrieved April 17, 2017.
  16. ↑ "Grohol, John M., Dr. "Atypical Antipsychotics for Schizophrenia." Psych Central. N.p., 17 July 2016. Web. 14 Apr. 2017".
  17. ↑ Mohr, S. (1 November 2006). "Toward an Integration of Spirituality and Religiousness Into the Psychosocial Dimension of Schizophrenia". American Journal of Psychiatry. 163 (11): 1952–1959. doi:10.1176/appi.ajp.163.11.1952.
  18. ↑ Danbolt, Lars J. (31 March 2011). "The Personal Significance of Religiousness and Spirituality in Patients With Schizophrenia". International Journal for the Psychology of Religion. 21 (2): 145–158. doi:10.1080/10508619.2011.557009.
  19. ↑ Helman, DS (2018). "Recovery from schizophrenia: An autoethnography". Deviant Behavior. 39 (3): 380–399. doi:10.1080/01639625.2017.1286174.
  20. ↑ Koenig, Harold G. (2007). "Religion, spirituality and psychotic disorders". Archives of Clinical Psychiatry (São Paulo). 34: 95–104. doi: 10.1590/S0101-60832007000700013 . ISSN   0101-6083.
  21. ↑ Mohr, S; Huguelet P. "The relationship between schizophrenia and religion and its implications for care" (PDF). Swiss Medical Weekly. Archived from the original (PDF) on 2016-03-27. Retrieved 2012-04-26.
  22. ↑ Mohr, Sylvia; Huguelet, Philippe (2004). "The relationship between schizophrenia and religion and its implications for care". Swiss Medical Weekly. 134: 369–376. CiteSeerX   10.1.1.117.217 .
  23. ↑ Mohr, Sylvia; Borras, Laurence; Rieben, Isabelle; Betrisey, Carine; Gillieron, Christiane; Brandt, Pierre-Yves; Perroud, Nader; Huguelet, Philippe (11 October 2009). "Evolution of spirituality and religiousness in chronic schizophrenia or schizo-affective disorders: a 3-years follow-up study" (PDF). Social Psychiatry and Psychiatric Epidemiology. 45 (11): 1095–1103. doi:10.1007/s00127-009-0151-0. PMID   19821066.
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