Brazilian Psychiatric Association guidelines on the integration of spirituality into mental health clinical practice: Part 1. Spiritual history and differential diagnosis

Abstract

Objectives: To present evidence-based guidelines for clinical practice regarding religiosity and spirituality in mental health care in Brazil. Methods: A systematic review was conducted to identify potentially eligible articles indexed in the PubMed, PsycINFO, SciELO, LILACS, and Cochrane databases. A summary of recommendations and their levels of evidence was produced in accordance with Oxford Centre for Evidence-Based Medicine guidelines. Results: The systematic review identified 6,609 articles, 41 of which satisfied all inclusion criteria. Taking a spiritual history was found to be an essential part of a compassionate and culturally sensitive approach to care. It represents a way of obtaining relevant information about the patient’s religiosity/spirituality, potential conflicts that could impact treatment adherence, and improve patient satisfaction. Consistent evidence shows that reported perceptual experiences are unreliable for differentiating between anomalous experiences and psychopathology. Negative symptoms, cognitive and behavioral disorganization, and functional impairment are more helpful for distinguishing pathological and non-pathological anomalous experiences. Conclusion: Considering the importance of religiosity/spirituality for many patients, a spiritual history should be routinely included in mental health care. Anomalous experiences are highly prevalent, requiring a sensitive and evidence-based approach to differential diagnosis.

Spirituality as a Therapeutic Approach for Severe Mental Illness: Insights from Neural Networks

“…The intersection of spirituality, mental illness, and neuroscience is a complex and evolving field of research. There is an increasing emphasis on the significance of spirituality in mental health, as evidenced by studies exploring its connections, potential advantages, and therapeutic implications (Koenig 2012;Zimmer et al 2016;Mosqueiro et al 2023;van Nieuw Amerongen et al 2024). Studies are increasingly examining the potential connections between spiritual practices, meditation, brain function, and mental health (van Elk and Aleman 2017).…”