The Role of Spirituality and Religiosity in the Maintenance and Recovery of Psychosis: A Systematic Review

Objective

Many individuals with psychosis consider themselves religious or spiritual and report using religion as a means of coping with their illness. However, research exploring the impact of religiosity and spirituality on the experience of psychosis is sparse, with most studies focusing on delusions or hallucinations with religious content.

Methods

A systematic review examined the evidence regarding the role of religiosity/spirituality in the maintenance and recovery of psychosis.

Results

A total of 35 studies were eligible for inclusion. In terms of maintenance, religiosity and spirituality were positively correlated with positive symptoms of psychosis. Individualised religious practice was associated with more severe delusions, while high intrinsic religiosity was associated with an increased severity of auditory and visual hallucinations. In terms of recovery, Positive Religious Coping (PRC) was found to improve wellbeing, quality of life, treatment expectancy, and medication adherence, while Negative Religious Coping (NRC) increased suicidality, positive symptom severity, and illness duration, and reduced social functioning. Holding religious/spiritual explanatory models was correlated with increased psychosis symptom severity and delayed recovery, while holding a bio-psychosocial explanatory model assisted with recovery.

Conclusions

Religiosity/spirituality appears to play a significant role in the maintenance and recovery of positive symptoms of psychosis. CBTp could be enhanced by integrating religiosity and spirituality into assessment, formulation, and the development of targeted interventions. This approach would promote more culturally adapted CBTp and improved engagement with clients from diverse cultural backgrounds in Early Intervention Services.