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Why psychotic patients with religious delusions are harder to cure.

We all hold beliefs that are not provable, and defining when these beliefs cross the line and become psychotic delusions is not easy. It's clear that such a line does exist, however: every town has its share of people whose religious beliefs fall sufficiently far outside the conventional that they are declared psychotic.

In popular imagination, at least, psychotic delusions often have a religious component. In reality, many psychotic delusions are not religious. However, many delusions involve hallucinations or mind control by unseen agents, and so it's not too surprising that those who experience them fold them into their religious background. The religious beliefs don't trigger the psychosis, but they become enmeshed within it.

But do religious beliefs help or hinder those with delusions?

Sylvia Mohr, at the University Hosptial of Geneva in Switzerland, took a look at over 200 psychiatric outpatients at two mental health institutions - one in Geneva and the other in Trois-Rivières, Québec. Half of them had frequent psychotic delusions, and 38 (around one in six of the total sample) had delusions with religious content.

She found that religious nature of their delusions did help some patients to cope. For some, who believed they were being persecuted demons, belief in their god or guardian angel gave them comfort and strength to deal with their condition. This is what one patient said:

The auras say "we will catch him" and "we will kill him," and they make me feel external pain. At the beginning, I was hopeless and I believed that the auras were strong and superior. I spoke to the priest about the auras, and he helped me to find the courage to fight. God loves me and comforts me. With the help of God, I am winning against the auras. They cannot hurt me anymore, and they are inferior. I don't speak about this to the psychiatrist, because it is very personal. I do not have a mental disorder, but a physical illness due to the auras, so I take the medication".

For one patient, who believed he was being controlled by supernatural entities, turning to his priest helped them to understand that his delusion was an illness. Others had similar tails to tell.

However for most patients (55%, in fact), the religious component of their delusions actually made their condition more serious. This was especially the case for those suffering from self-delusions - thinking that they are somebody else. The delusion that you are John the Baptist seems to make it harder to cope with your disease than the delusion that you are Napoleon!

Patients with delusions - and especially those with religious delusions - tended also to be more religious than those. And this is where their real problems begin.

For one thing, despite being more religious, patients with religious delusions actually engage in fewer group religious activities and receive less support from their religious communities than do patients with non-religious delusions. That's presumably because their religious communities find these religious delusions particularly disturbing.

These patients also are more likely to find that their religion brings them into conflict with psychiatrists and others who are trying to provide mental health support. In fact, one in four of them have come to believe that their religion does not allow them to take antipsychotic medication.

So religion is a mixed bag when it comes to psychosis. For some, it provides solace. For others, however, it increases the danger that they will sink further into their own delusions - a problem exacerbated by the fact that they are shunned by their religious colleagues.For these patients, their religion is more often a burden than a support.


ResearchBlogging.orgMohr, S., Borras, L., Betrisey, C., Pierre-Yves, B., Gilliéron, C., & Huguelet, P. (2010). Delusions with Religious Content in Patients with Psychosis: How They Interact with Spiritual Coping Psychiatry: Interpersonal & Biological Processes, 73 (2), 158-172 DOI: 10.1521/psyc.2010.73.2.158

Creative Commons License This article by Tom Rees was first published on Epiphenom. It is licensed under Creative Commons.

8 comments:

  1. If only 55% of the patients experience enhanced difficulty managing their psychosis because of religion, it seems to me that this research shows that "psychotic patients with religious delusions are approximately no harder to cure than those without religious delusions."

    Maybe I missed something, or maybe I need to read the original article.

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  2. Others had similar tails to tell.

    But were they forked tails?

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  3. I suppose if one lives in an environment where people believe that gods or demons communicate with people, then who is anyone to tell anyone else that the voice in their head isn't god or isn't demons or isn't cluing them in on divine secrets?

    We live in a society where most people accept that some people get (or got) messages from beyond. We don't live in a society where lots of people think they are Napoleon.

    If you live in a society that ennobles the idea that there are invisible clothing fibers that only the "chosen" can see, then you're going to have a hard time convincing someone who believes they've caught a glimpse of the emperor's magical robes that the emperor is really naked. From their perspective you're just jealous because you don't have their gift.

    For all we know, Jesus could have been a guy with religious delusions.

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  4. Scott, I should perhaps have said 'treat' rather than cure. Have a religious element to the delusions can make them less (or more) troublesome. But when they are present then patients get less support from their communities and also are more likely to refuse treatment.

    That might be, as articulett says, because they are less likely to see their symptoms as evidence of a disease.

    Pierce... very droll!

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  5. This is consistent with my gut feelings about religion's influence on recovery from substance abuse, etc. It probably helps some people, but it also seems risky. "Surrendering oneself to a higher power" may be a comforting exercise which helps people to cope with difficult situations -- as long as the delusion of a higher power remains a benign one!

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  6. As someone with schizoaffective disorder, I can attest to this. I know I am at my worst when I'm engaging in religion. It makes my delusions worse. I heard a staff member in the mental hospital I stayed in say that psychoses want to protect themselves. I find that very true! My psychosis wants to feed off my religious delusions. I wonder if this is true in religious people without schizophrenia. It almost seems that religion is a symbiotic delusion in those without schizophrenia.

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  7. so how do we treat such patients?

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  8. First you must be able to accept the differences..one is dealing in a totally different dimension then the other..and what if the normal world from which the psychiatric doctors anchor there beliefs from their facts of flesh and blood and man social communications that pose no sense of difference then meer animals with understandable intelligence ..I believe the information ib the holy scriptures to be true even if you can't explain them..if you're saying anyone who has a spiritual encounter with something you classify as delusion or psychotic then there are more psychologically abnormal people then not..we are a unique species we operate in three dimensions mind body and spirit and this only in this dimension of time..meaning present..we only understand the future when it comes to the present and our memories of what's past are only our experiences of the future as present releases.

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