Mohr Sylvia, Brandt Pierre-Yves, Borras Laurence, Gilliéron Christiane, Huguelet Philippe
University Hospital of Geneva, Department of Psychiatry, Geneva, Switzerland.
Am J Psychiatry. 2006 Nov;163(11):1952-9. doi: 10.1176/ajp.2006.163.11.1952.
Spirituality and religiousness have been shown to be highly prevalent among patients with schizophrenia. However, clinicians are rarely aware of the importance of religion and understand little of the value or difficulties it presents to treatment. This study aimed to assess the role of religion as a mediating variable in the process of coping with psychotic illness.
Semistructured interviews about religious coping were conducted with a sample of 115 outpatients with psychotic illness.
For some patients, religion instilled hope, purpose, and meaning in their lives (71%), whereas for others, it induced spiritual despair (14%). Patients also reported that religion lessened (54%) or increased (10%) psychotic and general symptoms. Religion was also reported to increase social integration (28%) or social isolation (3%). It may reduce (33%) or increase (10%) the risk of suicide attempts, reduce (14%) or increase (3%) substance use, and foster adherence to (16%) or be in opposition to (15%) psychiatric treatment.
Our results highlight the clinical significance of religion in the care of patients with schizophrenia. Religion is neither a strictly personal matter nor a strictly cultural one. Spirituality should be integrated into the psychosocial dimension of care. Our results suggest that the complexity of the relationship between religion and illness requires a highly sensitive approach to each unique story.
精神性与宗教信仰在精神分裂症患者中极为普遍。然而，临床医生很少意识到宗教的重要性，对其在治疗中所呈现的价值或困难了解甚少。本研究旨在评估宗教在应对精神病性疾病过程中作为中介变量的作用。
对115名患有精神病性疾病的门诊患者进行了关于宗教应对的半结构式访谈。
对一些患者而言，宗教为他们的生活注入了希望、目标和意义（71%），而对另一些患者来说，宗教引发了精神绝望（14%）。患者还报告称，宗教减轻了（54%）或加重了（10%）精神病性症状及一般症状。宗教还被报告能增强社会融合（28%）或导致社会隔离（3%）。宗教可能降低（33%）或增加（10%）自杀未遂风险，减少（14%）或增加（3%）物质使用，促进（16%）或反对（15%）精神科治疗。
我们的结果凸显了宗教在精神分裂症患者护理中的临床意义。宗教既非严格意义上的个人事务，也非严格意义上的文化事务。精神性应融入护理的社会心理层面。我们的结果表明，宗教与疾病之间关系的复杂性需要针对每个独特案例采取高度敏感的方法。
