Religious beliefs heavily influence life philosophies and value systems at the individual and collective levels, making the studies of spirituality crucial in various populations, including people diagnosed with schizophrenia. In their non-systematic literature review, Grover, Davuluri, and Chakrabarti (2014) summarize the global psychiatric community’s knowledge regarding the connections between spirituality, religion, well-being, behaviors, and disease progression in schizophrenia patients. The purpose of this report is to analyze the source and the implications for decision-making.
In the manuscript, individual studies’ results are grouped on the basis of thematic proximity, with eight themes in total. Conflicting findings have been found in the majority of these themes, including the question of whether religious attendance is higher in schizophrenia patients compared to the general population (Grover et al., 2014). Whether religiousness is conducive to better treatment outcomes is also unclear. There are studies that link religiosity to successful psychosocial adaptation, lower disease relapse rates, and more pronounced risks of suicide attempts (Grover et al., 2014). Similarly, there is no consensus regarding the selected group’s religiosity and treatment adherence. Different studies report associations between religiousness and excellent adherence, insufficient adherence, and the unwillingness to receive treatment (Grover et al., 2014). At the same time, the source effectively summarizes the findings that are consistent across multiple studies, such as Christian schizophrenia inpatients’ tendency to experience religious delusions more frequently than Muslim and Buddhist patients (Grover et al., 2014). Therefore, the study identifies the remaining research gaps instead of making straightforward conclusions regarding religiosity in schizophrenia.
The authors utilize methodologically heterogeneous studies from diverse cultural contexts to argue for the inclusion of religion into schizophrenia theoretical models. In terms of data, because of the non-systematic method’s peculiarities, the authors do not detail specific inclusion/exclusion criteria used in study selection, which results in the heterogeneity of the sources in terms of evidence levels. Specifically, the findings are backed up with evidence from systematic reviews, individual RCTs, long-term cohort studies, and qualitative research (Grover et al., 2014). The study centers on exploring the need for changes to the biopsychosocial model that informs schizophrenia treatment without considering patients’ religious identity and beliefs (Grover et al., 2014). The authors, however, do not test any specific hypotheses and focus on providing the first comprehensive review of religion in schizophrenia to justify the need for change in schizophrenia treatment.
In terms of utility, despite the findings’ ambiguity, the authors’ final claim can promote ethical decision-making in the treatment of schizophrenia. The final thesis refers to the need for promoting a whole-person approach to schizophrenia treatment by integrating spirituality into the biopsychosocial model and increasing clinicians’ awareness of patients’ spiritual issues and needs (Grover et al., 2014). In the absence of detailed recommendations for clinicians, the study still highlights the importance of religious coping to 45-80% of individuals with schizophrenia and mental healthcare professionals’ inability to recognize it (Grover et al., 2014). By emphasizing this knowledge, the article might encourage practitioners to explore the ways of promoting positive religious coping in individuals with the discussed diagnosis. This determination can maximize psychiatrists’ adherence to professional ethics, including the principles of non-discrimination, respecting patients’ right to self-determination, and working collaboratively with healthcare consumers while remaining conscious of one’s own biases. Based on this, the source possesses some utility in terms of promoting more respectful attitudes to diverse religious groups, but the lack of specific recommendations limits its practice-orientedness.
Finally, the discussed article is influential in determining the high-priority directions for future research by summarizing research gaps peculiar to spirituality in schizophrenia. Its main conclusion has implications for practice by promoting the recognition of schizophrenia patients’ religious needs by psychiatry professionals. This general recommendation can emphasize the ethical aspects of decision-making in mental healthcare, including respect for the patient’s identity, non-discrimination, and close collaboration with schizophrenia patients to provide the best possible care.
Grover, S., Davuluri, T., & Chakrabarti, S. (2014). Religion, spirituality, and schizophrenia: A review. Indian Journal of Psychological Medicine, 36(2), 119–124.