Religious beliefs in schizophrenia: Their relevance for adherence to treatment

The study examined how religious beliefs and practices im-pact upon medication and illness representations in chronic schizophrenia. One hundred three stabilized patients were included in Geneva’s outpatient public psychiatric facility in Switzerland. Interviews were conducted to investigate spiritual and religious beliefs and religious practices and re-ligious coping. Medication adherence was assessed through questions to patients and to their psychiatrists and by a sys-tematic blood drug monitoring. Thirty-two percent of patients were partially or totally nonadherent to oral med-ication. Fifty-eight percent of patients were Christians, 2% Jewish, 3 % Muslim, 4 % Buddhist, 14 % belonged to various minority or syncretic religious movements, and 19 % had no religious affiliation. Two thirds of the total sample consid-ered spirituality as very important or even essential in every-day life. Fifty-seven percent of patients had a representation of their illness directly influenced by their spiritual beliefs (positively in 31 % and negatively in 26%). Religious re-presentations of illness were prominent in nonadherent pa-tients. Thirty-one percent of nonadherent patients and 27% of partially adherent patients underlined an incompatibility or contradiction between their religion and taking medica-tion, versus 8 % of adherent patients. Religion and spiritu-ality contribute to shaping representations of disease and attitudes toward medical treatment in patients with schizo-phrenia. This dimension should be on the agenda of psychia-trists working with patients with schizophrenia. Key words: schizophrenia/religion/spirituality/ treatment adherenc