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.{{Cite journal| author=Murray, ED. | author2=Cunningham MG | author3=Price BH | title=The role of psychotic disorders in religious history considered | journal= The Journal of Neuropsychiatry and Clinical Neurosciences| volume=24 | issue=4 | pages=410–26 | doi=10.1176/appi.neuropsych.11090214 | pmid=23224447| year=2012 | s2cid=207654711 }} 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.{{cite web |last1=Webb |first1=Mark |title=Religious Experience |url=https://plato.stanford.edu/entries/religious-experience/#:~:text=Reports%20of%20religious%20experiences%20reveal,hearing%20with%20bodily%20sense%20organs. |website=Stanford Encyclopedia of Philosophy}}
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.{{cite web |title=Overview - Schizophrenia |url=https://www.nhs.uk/mental-health/conditions/schizophrenia/overview/#:~:text=Schizophrenia%20is%20a%20long%2Dterm,thoughts%20and%20ideas%20from%20reality. |website=Nhs.Uk}}
In general, religion has been found to have "both a protective and a risk increasing effect" for schizophrenia.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.
A common report from those with schizophrenia is some type of religious belief that many medical practitioners consider to be delusional{{emdash}}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.{{cite journal|last=Siddle|first=Ronald |author2=Haddock, Gillian |author3=Tarrier, Nicholas |author4=Faragher, E. Brian |title=Religious delusions in patients admitted to hospital with schizophrenia|journal=Social Psychiatry and Psychiatric Epidemiology|date=1 March 2002|volume=37|issue=3|pages=130–138|doi=10.1007/s001270200005|pmid=11990010}}{{cite journal|last=Mohr|first=Sylvia |author2=Borras, Laurence |author3=Betrisey, Carine |author4=Pierre-Yves, Brandt |author5=Gilliéron, Christiane |author6=Huguelet, Philippe|title=Delusions with Religious Content in Patients with Psychosis: How They Interact with Spiritual Coping|journal=Psychiatry: Interpersonal and Biological Processes|date=1 June 2010|volume=73|issue=2|pages=158–172|doi=10.1521/psyc.2010.73.2.158|pmid=20557227 }}{{cite journal|last=Siddle|first=R|author2=Haddock, G |author3=Tarrier, N |author4=Faragher, EB |title=Religious delusions in patients admitted to hospital with schizophrenia.|journal=Social Psychiatry and Psychiatric Epidemiology|date=March 2002|volume=37|issue=3|pages=130–8|pmid=11990010|doi=10.1007/s001270200005}} Active and adaptive coping skills in subjects with residual schizophrenia are associated with a sound spiritual, religious, or personal belief system.Shah, Ruchita, et al. "Relationship between spirituality/religiousness and coping in patients with residual schizophrenia." Quality of Life Research 20.7 (2011): 1053-1060.
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.{{cite journal |vauthors=Tateyama M, Asai M, Hashimoto M, Bartels M, Kasper S |title=Transcultural study of schizophrenic delusions. Tokyo versus Vienna and Tübingen (Germany) |journal=Psychopathology |volume=31 |issue=2 |pages=59–68 |year=1998 |pmid=9561549 |doi= 10.1159/000029025}}{{cite journal |vauthors=Stompe T, Friedman A, Ortwein G, Strobl R, Chaudhry HR, Najam N, Chaudhry MR |title=Comparison of delusions among schizophrenics in Austria and in Pakistan |journal=Psychopathology |volume=32 |issue=5 |pages=225–34 |year=1999 |pmid=10494061 |doi= 10.1159/000029094}} By comparison, patients in Japan much more commonly have delusions surrounding matters of shame and slander, and in Pakistan matters of paranoia regarding relatives and neighbors.
Background
{{Main|Schizophrenia}}
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.{{cite journal|last=van Os|first=J|author2=Kapur, S |title=Schizophrenia.|journal=Lancet|date=2009-08-22|volume=374|issue=9690|pages=635–45|pmid=19700006|doi=10.1016/S0140-6736(09)60995-8}}{{cite journal|last=Picchioni|first=MM|author2=Murray, RM |title=Schizophrenia.|journal=BMJ (Clinical Research Ed.)|date=2007-07-14|volume=335|issue=7610|pages=91–5|pmid=17626963|doi=10.1136/bmj.39227.616447.BE|pmc=1914490}}
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.{{cite web|last1=Page|first1=Dan|title=UCLA Researchers Map How Schizophrenia Engulfs Teen Brains|url=http://newsroom.ucla.edu/releases/UCLA-Researchers-Map-How-Schizophrenia-2701}} Symptoms usually appear around the onset of early adulthood.
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{{cite web|last1=McLeod|first1=Saul|title=Egocentrism|url=https://www.simplypsychology.org/preoperational.html|website=simplepsychology.org|access-date=April 17, 2017}} 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.{{Cite web|url=https://psychcentral.com/lib/atypical-antipsychotics-for-schizophrenia/|title=Grohol, John M., Dr. "Atypical Antipsychotics for Schizophrenia." Psych Central. N.p., 17 July 2016. Web. 14 Apr. 2017.}}
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.{{cite journal|last=Mohr|first=S.|title=Toward an Integration of Spirituality and Religiousness Into the Psychosocial Dimension of Schizophrenia|journal=American Journal of Psychiatry|date=1 November 2006|volume=163|issue=11|pages=1952–1959|doi=10.1176/appi.ajp.163.11.1952}} 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.{{cite journal|last=Danbolt|first=Lars J.|title=The Personal Significance of Religiousness and Spirituality in Patients With Schizophrenia|journal=International Journal for the Psychology of Religion|date=31 March 2011|volume=21|issue=2|pages=145–158|doi=10.1080/10508619.2011.557009}}{{cite journal|last=Helman|first=DS|title=Recovery from schizophrenia: An autoethnography|journal=Deviant Behavior|date=2018|volume=39|issue=3|pages=380–399|doi=10.1080/01639625.2017.1286174}} 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.{{Cite journal|last=Koenig|first=Harold G.|title=Religion, spirituality and psychotic disorders|journal=Archives of Clinical Psychiatry (São Paulo)|volume=34|pages=95–104|doi=10.1590/S0101-60832007000700013|issn=0101-6083|year=2007|doi-access=free}}
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.{{cite journal|last=Mohr|first=S|author2=Huguelet P|title=The relationship between schizophrenia and religion and its implications for care|journal=Swiss Medical Weekly|url=http://www.smw.ch/docs/pdf200x/2004/25/smw-10322.pdf|access-date=2012-04-26|archive-date=2016-03-27|archive-url=https://web.archive.org/web/20160327092739/http://www.smw.ch/docs/pdf200x/2004/25/smw-10322.pdf|url-status=dead}}
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.{{Cite journal|title=The relationship between schizophrenia and religion and its implications for care|first1=Sylvia|last1=Mohr|first2=Philippe|last2=Huguelet|journal=Swiss Medical Weekly|year=2004|volume=134|pages=369–376|citeseerx = 10.1.1.117.217}}
These symptoms may cause violent behavior, either toward others or themselves.{{Cite journal|title=The relationship between schizophrenia and religion and its implications for care|first1=Sylvia|last1=Mohr|first2=Philippe|last2=Huguelet|journal=Swiss Medical Weekly|year=2004|volume=134|pages=369–376|citeseerx = 10.1.1.117.217}} In some instances, they may also experience distressing symptoms if they believe a god is inducing illness as punishment. The patient may refuse treatment based on religious speculation. In certain instances, one might believe that the delusions and hallucinations are a divine experience, and therefore deny medical treatment.{{cite journal|last=Mohr|first=Sylvia |author2=Borras, Laurence |author3=Rieben, Isabelle |author4=Betrisey, Carine |author5=Gillieron, Christiane |author6=Brandt, Pierre-Yves |author7=Perroud, Nader |author8=Huguelet, Philippe|title=Evolution of spirituality and religiousness in chronic schizophrenia or schizo-affective disorders: a 3-years follow-up study|journal=Social Psychiatry and Psychiatric Epidemiology|date=11 October 2009|volume=45|issue=11|pages=1095–1103|doi=10.1007/s00127-009-0151-0|pmid=19821066 |url=http://doc.rero.ch/record/314252/files/127_2009_Article_151.pdf}}