Religion and Spirituality in Psychiatry

Conclusion: Summary of What Clinicians Need to Know 359considered a delusion. Yet, disentangling beliefsfrom delusions may be tricky.Three criteria can help to make thisdistinction:1 The experience reported by the patient givesthe impression that it is a delusion.2 Other psychiatric symptoms are present.3 The outcome of the experience seems morelike the evolution of a mental illness, ratherthan that of a life-enhancing experience.In the management of patients with religiousdelusions, clinicians need cultural sensitivity tobe respectful and to differentiate between functionaland dysfunctional beliefs. The question isnot if the belief is true or false, because this is notthe central question in delusions with religiouscontent. Rather, the clinician has to decide ifthe behaviors associated with the delusion and/or hallucination are dysfunctional therapeuticintervention and require or not. If so, the treatmentof the delusion should be standard for suchsymptoms, including medication, psychotherapy,and social support, while helping the individualdetermine what the belief means in his or hercurrent life situation.8. MOOD DISORDERSAND BEREAVEMENTReligion can be related to depression in variousways, either increasing vulnerability or promotingrecovery. Although studies rarely address clinicalsamples, there is evidence that religiousnessmay improve depression outcomes. However,more and more studies demonstrate that depressivesymptoms are often accompanied by religiousdiscontent manifested as negative feelingstoward God or a sense of having been abandonedby God. Also, people involved in religion may bemore likely to report feelings of guilt, even thoughthis may reflect more about their perceived moralstandards and religious upbringing than aboutpathological guilt.In its myths and beliefs, religion has a greatpotential for helping people cope with the endof life bereavement, and with. In this context,the relationship with God may provide comfortif a loved one dies and help compensate for thelack of a love relationship. A meta-analysis onthe relationship between religious and spiritualbeliefs and bereavement showed that about halfthe studies reported benefits. Beyond a “directeffect,” religious and spiritual beliefs could havean impact on other aspects besides depressivesymptoms, such as autonomy, personal growth,or engagement in social activities.The relationship between religiousness and thetwo poles of the bipolar disorder spectrum mayfollow the vulnerability-stress model. There is littleevidence on how religiousness is related to thepresentation and course of bipolar disorder. It ishypothesized that religiousness itself may becomea subject of mood swings, but it could also evokedisillusionment in the patient and suspicion inthe clinician. Regarding the relationship betweenfacets of religiousness and bipolar disorder, fouraspects deserve special mention:1 Symptom formation : Do aspects of religiousnesssuch as the religious tradition influencethe emergence of religious insights and emotionsduring the manic state?2 Religious experiences during mania : Bipolarpatients sometimes cherish the memory oftheir enlightened state or spiritual discoveries,irrespective of the negative consequences oftheir manic episodes.3 Religious preoccupations as early signs : Whenbipolar patients intensify their religiousinvolvement, this may in turn lead to religiousand spiritual preoccupations.4 Disillusionment with religion : In the depressivestate and the symptom-free interval,disillusionment with religion and spiritualitymay be experienced. This may interfere with aperson’s ability to cope with a chronic mentaldisorder and represent an additional loss inlife, the loss of trust in one’s religion.Suicide statistics show that, to a limited extent,religiousness can be protective. Besides the rolethat social integration plays in lowering suicide