Religião, espiritualidade e transtornos psicóticos

Abstract

Background: Religion is often included in the beliefs and experiences of psychotic patients, and therefore becomes the target of psychiatric interventions. Objectives: This article examines religious beliefs and activities among nonpsychotic persons in the United States, Brazil and other areas of the world; discusses historical factors contributing to the wall of separation between religion and psychiatry today; reviews studies on the prevalence of religious delusions in patients with schizophrenia, bipolar disorder, and other severe mental disorders; discusses how clinicians can distinguish pathological from non-pathological religious involvement; explores how persons with severe mental illness use non-pathological religious beliefs to cope with their disorder; examines the effects of religious involvement on disease course, psychotic exacerbations, and hospitalization; and describes religious or spiritual interventions that may assist in treatment. Methods: Literature review. Findings: While about one-third of psychoses have religious delusions, not all religious experiences are psychotic. In fact, they may even have positive effects on the course of severe mental illness, forcing clinicians to make a decision on whether to treat religious beliefs and discourage religious experiences, or to support them. Conclusions: Clinicians should understand the negative and positive roles that religion plays in those with psychotic disorders.

Religiosidade e espiritualidade no transtorno bipolar do humor

“…Entretanto, existe na literatura de grande parte do século XX um fator complicador no diagnósti-co diferencial entre esquizofrenia e TBH, com o TBH subdiagnosticado por muitas décadas. Na medida em que o TBH vem sendo mais frequentemente identificado também sua relação com R/E tem se tornado mais clara [5][6][7][8][9][14][15][16]17 .…”

“…Koenig 17 defende, em recente revisão, que delírios religiosos existem em um continuum entre crenças normais e fantásticas. Sua maior ocorrência estaria ligada a fatores como diagnóstico, gravidade do transtorno mental e intensidade do envolvimento religioso do indivíduo.…”

“…Vários autores têm identificado problemas para pacientes que têm um modelo de doença muito diferente de seus médicos, resultando em pior adesão ao tratamento. Os resultados sugerem ser essa uma área que merece esforços no sentido de reduzir as incertezas existentes 15,17 .…”

O diagnóstico diferencial entre experiências espirituais e transtornos mentais de conteúdo religioso

“…IV -A critical attitude exists regarding the objective reality of the experience 11,15,16,21,22,29,31,32,33 A healthy consciousness, surprised by the spiritual or religious experience, will need to reflect on the feeling for one's own self and life. As long as the individual does not develop a new comprehension of the experience that he is going through, he will need to consider this new experience suspect, until it can be comprehended.…”

“…Koenig 22 , commenting on the medical literature about the differentiating criteria between spiritual experiences and mental disturbances, proposed that the former do not impair social or occupational performance, do not disrupt the relationship with a social-cultural reference group, and are not associated with other mental pathologies, promoting psychological growth with time.…”