ferences when confronted with peopl

ferences when confronted with people from different
backgrounds than ours [47–50]. In Switzerland,
7% of the people belong to protestant subcultures
and present a high salience of religiousness
[4]. Among them, the belief that demons are
the cause of mental health problems is a common
phenomenon: 82% of highly religious patients
suffering from psychotic disorders said they believed
in the influence of evil spirits and two-thirds
of them sought help through ritual prayers for deliverance
or exorcism. Many patients subjectively
experienced the rituals as positive, allowed other
explanatory models, consulted a physician and
took medication without problems, but without an
improvement in the outcome of psychiatric symptoms.
Negative outcome (such as psychotic relapse)
was associated with the exclusion of medical
treatment and coercive forms of exorcism [51],
as some religious healing systems exclude conventional
medicine [52]. A psychiatrist working
mainly in developing countries reached the same
conclusions about the outcomes of deliverance rituals
[38]. Thus, it seems that magical explanations
for psychopathology do not automatically lead to
non-compliance with psychiatric treatment, being
rather a part of the “help-seeking pathways” of religious
patients [53]. In a case study, neuroleptics
relieved symptoms after exorcisms by Hindu,
Muslim and Christian priests [54]. For example,
three of our patients said: “I believed I was possessed
by demons, I’d go to an exorcist priest, he
taught me the gospel and he cast out the demons,
he encouraged me to go to the psychiatrist. Now I
believe half is schizophrenia, half is demonic possession,
so I go on with the priest and I take half of
my medication” (subject 25); “I don’t know if what
I see are the spirits of the dead or if I am crazy, so
I have to learn more about spiritualism and go on
with psychiatric treatment” (subject 32); “I don’t
know why I suffer from deep anxiety and hallucinations,
the psychiatrist told me it was nerves, and
the pastor and the members of my church pray for
me to be delivered from bad things in the name of
Jesus … it is God who gives wisdom to psychiatrists
for medication, I pray for caregivers, I put my hope
in God and I take my medication” (subject 81).
Finally, religious experience is brain-based,
like every human experience. With the development
of neuroscience, scientists are able now to explore
the neural basis of spirituality and feelings
[55]. Among some results, such studies have shown
that the temporolimbic system is a substrate of religious-numinous
experience [55]; the right temporal
lobe is activated during mystical states [57],
versus the left temporal lobe in religious delusion
[58]; the serotonin system may serve as a biological
basis for spiritual experiences [59]; the relatives
of schizophrenic patients feature a greater risk for
mental illness, but they also show a tendency for
an increased creativity, more numerous achievements
in many fields, as well as an intense interest
in religion [60].
Schizophrenia and spirituality 372
Impact of spirituality and religious practices on the comorbidity
of substance abuse and suicidal attempts in schizophrenia
In the precedent section, we detailed some
links between religion and the psychopathology of
schizophrenia. Religion may also exert a protective
factor against problematic behaviours among people
with schizophrenia. Most religions disapprove
or forbid toxic substance abuse and dependence
[61, 62]. This protective role of religion has been
observed for the comorbidity of alcohol dependence
among depressive inpatients [63]. Comorbidity
of drug abuse and dependence occurs in
about one out of three people with schizophrenia.
No studies have examined the influence of religion
on this comorbidity, although religion may play
this protective role: “God delivered me from
smoking” (subject 68). On the other hand, drug dependence
may hinder patients from belonging to
religious communities: “I went to the spirit center
for 10 years, I had all my friends there. Once I
smoked hashish and I went there drunk. They were
amazed, and I couldn’t go again because they forbid
drinking and smoking … I don’t know what I
believe in anymore, I don’t know who is right, the
spirits, the Buddhists, the Christians, I am spiritually
lost” (subject 70).
Religious commitment has also been associated
with lower rates of suicidal attempts and suicidal
deaths [64]. Unfortunately, religious issues
have been neglected with regards to suicidality [65]
in psychiatric research, even if a few studies have
been conducted with schizophrenic patients. In
this population, a high suicidal rate of 10% and a
suicidal attempt rate of 40% are observed. In this
context, religion is sometimes the only protective
factor against suicide as reported by people suffering
from schizophrenia [66]. Religious values may
protect against suicide: “even in the lowest moments
of my life, I forbid myself suicide because of
my religious background” (subject 72). But this is
not always the case: “I have had spiritual experiences,
they make me feel unique, but when I see
and hear the voice telling me ‘kill yourself!’ it
doesn’t help me, I have made numerous suicidal attempts”
(subject 56); it may even lead to suicide: “I
want to live the eternal life today, what do you
think about being injected to rejoin God?“ (Subject
18). Consequently, this complex relationship
between religion and suicidal behavior in schizophrenia
still remains to be elicited.
Compared to secular methods of coping, religion
and spirituality can offer an answer to the
problems of human insufficiency [67]. Thus, it is
not surprising that so many people suffering from
mental illness use religion to cope. People with
schizophrenia have the same spiritual needs as any
other human being. The studies on religion and
schizophrenia bear essentially on the acute phase
of the illness; only a few studies examine patients
in remitted states when this aspect can be ascertained.
Even if their spirituality is distorted at certain
times, this doesn’t mean that their spiritual experience
is always illegitimate or the product of
distorted thinking [68]. In London, 61% of psychotic
patients used religion among their strategies
to cope and 30% of them increased their religious
faith after the onset of their illness. Religious
coping was associated with better insight and good
compliance with medication [6]. In a comparison
of strategies to cope with auditory hallucinations,
Saudi patients were more likely to use methods associated
with religion than British patients (43%
vs. 3%) [69]. In North America, 80% of the patients
used religion to cope with their symptoms
and daily difficulties, but only 35% attended
church services [70]. In the same trend, the religious
needs of psychiatric inpatients were comparable
to those of medical/surgical inpatients in
North America, but their integration into a faith
community was far less common [71]. Religious
coping strategies also help families to care for their
ill relatives [72].
Patients with schizophrenia are particularly
sensitive to stress [2]. The role of religion in coping
strategies for stressful life events has been studied
in different populations. Through a meta-analysis,
helpful, harmful and mixed forms of religious
coping were outlined, but the value of religious
coping in different life circumstances are still to be
determined [67]. In our ongoing study, more than
half of the outpatients use spirituality on a large
scale to cope with schizophrenia [3]. In general,
helpful forms of coping include spiritual support:
“Jesus is my only shield, I ask Him to help me in
my daily activities, I feel that I am not alone, He
shows me the way” (subject 16); congregational
and clergy support: “the Buddhist monk teaches
me how to meditate, to distance myself from my
hallucinations” (subject 25); benevolent religious
reframing (attribution of negative events to the
will of God or to a loving God): “God puts you to
the test, He sends you something for your search
for spirituality to win against illness … without
spirituality, there is a terrible emptiness, and even
anxieties, deep anxieties, if you search for spirituality,
it is greater, it is important to base your life
on spirituality” (subject 60). In general, harmful
forms of coping can be related to some discontent
with a congregation or with God “God cannot help
me, He can’t help anybody. At the beginning of my
illness, I prayed a lot, now I don’t pray anymore,
religion is just a system, it is not useful” (subject
10); “I am angry with some members of my community
because I have not found any help at the
human level, they moralized without knowing
what I felt deep inside me” (subject 68); negative
religious reframing “my illness is a plan from the
devil or perhaps a punishment for my sins” (subject
77); “I had psychotic relapses, I felt guilty, having
done bad things. It is in relation with good and
bad, it is there. If I read the Bible, it disrupts me,
I believe I am evil, so I shouldn’t read the Bible”
(subject 74). Forms of religious coping with mixed
implications are religious rituals [51] and styles of
religious coping. Self-directing coping emphasizes
the individual’s personal responsibility and active
role in problem solving: “I have strongly believed
in God since my childhood … for my illness, my
relatives and my medication help me” (subject 62);
some patients may defer the responsibility of problem
solving to God or a figure of God: “the physicians
told me they cannot cure me, I hope for E.T
to cure me” (subject 2); in a collaborative style,
both God and the individual are responsible for
problem solving: “Help yourself, and heaven will
help you … To cope with the voices, I read the
bible, it helps me to put a measure on the voices:
logically, if you say to yourself that you have eternity
in front of you, the voices are nothing in fact,

ผลลัพธ์ (ไทย) 1:

ferences เมื่อเผชิญกับบุคคลอื่นพื้นหลังกว่าเรา [47-50] ในสวิสเซอร์แลนด์7% ของคนเป็นสมาชิกของ protestant subculturesและนำเสนอ salience สูงของ religiousness[4] กันในหมู่พวกเขา ความเชื่อว่าเป็นปีศาจสาเหตุของปัญหาสุขภาพจิตเป็นการทั่วไปปรากฏการณ์: 82% ของผู้ป่วยทางศาสนาสูงทุกข์ทรมานจากโรค psychotic กล่าวว่า พวกเขาเชื่อว่าในอิทธิพลของวิญญาณร้ายและสองในสามพวกเขาขอความช่วยเหลือผ่านพิธีสวดมนต์ช่วยหรือ exorcism ผู้ป่วย subjectivelyมีประสบการณ์การทำพิธีกรรมที่เป็นบวก อนุญาตอื่น ๆอธิบายโมเดล ขอคำปรึกษาแพทย์ และใช้ยา โดยไม่มีปัญหา แต่ไม่ต้องการปรับปรุงในผลของอาการทางจิตเวชผลลบ (เช่นการกลับไปเสพ psychotic)เชื่อมโยงกับข้อยกเว้นของแพทย์รักษาและรูปแบบ coercive exorcism [51],เป็นระบบบำบัดบางศาสนาแยกธรรมดายา [52] จิตแพทย์ที่ทำงานส่วนใหญ่ในประเทศกำลังพัฒนาถึงเหมือนกันบทสรุปเกี่ยวกับผลลัพธ์ของพิธีกรรมช่วย[38] . ดังนั้น เหมือนที่วิเศษคำอธิบายสำหรับ psychopathology ไม่นำไปไม่ใช่สอดคล้องกับการรักษาทางจิตเวช การแทนที่จะเป็นส่วนหนึ่งของการ "แสวงหาความช่วยเหลือทางเดิน" ของศาสนาผู้ป่วย [53] ในกรณีศึกษา neurolepticsอาการเบาหลังจาก exorcisms โดยฮินดูมุสลิมและคริสเตียนปุโรหิต [54] ตัวอย่างสามของผู้ป่วยกล่าวว่า: "ผมเชื่อว่า ผมมอบby demons, I’d go to an exorcist priest, hetaught me the gospel and he cast out the demons,he encouraged me to go to the psychiatrist. Now Ibelieve half is schizophrenia, half is demonic possession,so I go on with the priest and I take half ofmy medication” (subject 25); “I don’t know if whatI see are the spirits of the dead or if I am crazy, soI have to learn more about spiritualism and go onwith psychiatric treatment” (subject 32); “I don’tknow why I suffer from deep anxiety and hallucinations,the psychiatrist told me it was nerves, andthe pastor and the members of my church pray forme to be delivered from bad things in the name ofJesus … it is God who gives wisdom to psychiatristsfor medication, I pray for caregivers, I put my hopein God and I take my medication” (subject 81).Finally, religious experience is brain-based,like every human experience. With the developmentof neuroscience, scientists are able now to explorethe neural basis of spirituality and feelings[55]. Among some results, such studies have shownthat the temporolimbic system is a substrate of religious-numinousexperience [55]; the right temporallobe is activated during mystical states [57],versus the left temporal lobe in religious delusion[58]; the serotonin system may serve as a biologicalbasis for spiritual experiences [59]; the relativesof schizophrenic patients feature a greater risk formental illness, but they also show a tendency foran increased creativity, more numerous achievementsin many fields, as well as an intense interestin religion [60].Schizophrenia and spirituality 372Impact of spirituality and religious practices on the comorbidityof substance abuse and suicidal attempts in schizophreniaIn the precedent section, we detailed somelinks between religion and the psychopathology ofschizophrenia. Religion may also exert a protectivefactor against problematic behaviours among peoplewith schizophrenia. Most religions disapproveor forbid toxic substance abuse and dependence[61, 62]. This protective role of religion has beenobserved for the comorbidity of alcohol dependenceamong depressive inpatients [63]. Comorbidityof drug abuse and dependence occurs inabout one out of three people with schizophrenia.No studies have examined the influence of religionon this comorbidity, although religion may playthis protective role: “God delivered me fromsmoking” (subject 68). On the other hand, drug dependencemay hinder patients from belonging toreligious communities: “I went to the spirit centerfor 10 years, I had all my friends there. Once Ismoked hashish and I went there drunk. They wereamazed, and I couldn’t go again because they forbiddrinking and smoking … I don’t know what Ibelieve in anymore, I don’t know who is right, thespirits, the Buddhists, the Christians, I am spirituallylost” (subject 70).Religious commitment has also been associatedwith lower rates of suicidal attempts and suicidaldeaths [64]. Unfortunately, religious issueshave been neglected with regards to suicidality [65]in psychiatric research, even if a few studies havebeen conducted with schizophrenic patients. Inthis population, a high suicidal rate of 10% and asuicidal attempt rate of 40% are observed. In thiscontext, religion is sometimes the only protectivefactor against suicide as reported by people sufferingfrom schizophrenia [66]. Religious values mayprotect against suicide: “even in the lowest momentsof my life, I forbid myself suicide because ofmy religious background” (subject 72). But this isnot always the case: “I have had spiritual experiences,they make me feel unique, but when I seeand hear the voice telling me ‘kill yourself!’ itdoesn’t help me, I have made numerous suicidal attempts”(subject 56); it may even lead to suicide: “Iwant to live the eternal life today, what do youthink about being injected to rejoin God?“ (Subject18). Consequently, this complex relationshipbetween religion and suicidal behavior in schizophreniastill remains to be elicited.Compared to secular methods of coping, religionand spirituality can offer an answer to theproblems of human insufficiency [67]. Thus, it isnot surprising that so many people suffering frommental illness use religion to cope. People withschizophrenia have the same spiritual needs as anyother human being. The studies on religion andschizophrenia bear essentially on the acute phaseof the illness; only a few studies examine patientsin remitted states when this aspect can be ascertained.Even if their spirituality is distorted at certaintimes, this doesn’t mean that their spiritual experienceis always illegitimate or the product ofdistorted thinking [68]. In London, 61% of psychoticpatients used religion among their strategiesto cope and 30% of them increased their religiousfaith after the onset of their illness. Religiouscoping was associated with better insight and goodcompliance with medication [6]. In a comparisonof strategies to cope with auditory hallucinations,Saudi patients were more likely to use methods associatedwith religion than British patients (43%vs. 3%) [69]. In North America, 80% of the patientsused religion to cope with their symptomsand daily difficulties, but only 35% attendedchurch services [70]. In the same trend, the religiousneeds of psychiatric inpatients were comparableto those of medical/surgical inpatients inNorth America, but their integration into a faithcommunity was far less common [71]. Religiouscoping strategies also help families to care for theirill relatives [72].Patients with schizophrenia are particularlysensitive to stress [2]. The role of religion in copingstrategies for stressful life events has been studiedin different populations. Through a meta-analysis,
helpful, harmful and mixed forms of religious
coping were outlined, but the value of religious
coping in different life circumstances are still to be
determined [67]. In our ongoing study, more than
half of the outpatients use spirituality on a large
scale to cope with schizophrenia [3]. In general,
helpful forms of coping include spiritual support:
“Jesus is my only shield, I ask Him to help me in
my daily activities, I feel that I am not alone, He
shows me the way” (subject 16); congregational
and clergy support: “the Buddhist monk teaches
me how to meditate, to distance myself from my
hallucinations” (subject 25); benevolent religious
reframing (attribution of negative events to the
will of God or to a loving God): “God puts you to
the test, He sends you something for your search
for spirituality to win against illness … without
spirituality, there is a terrible emptiness, and even
anxieties, deep anxieties, if you search for spirituality,
it is greater, it is important to base your life
on spirituality” (subject 60). In general, harmful
forms of coping can be related to some discontent
with a congregation or with God “God cannot help
me, He can’t help anybody. At the beginning of my
illness, I prayed a lot, now I don’t pray anymore,
religion is just a system, it is not useful” (subject
10); “I am angry with some members of my community
because I have not found any help at the
human level, they moralized without knowing
what I felt deep inside me” (subject 68); negative
religious reframing “my illness is a plan from the
devil or perhaps a punishment for my sins” (subject
77); “I had psychotic relapses, I felt guilty, having
done bad things. It is in relation with good and
bad, it is there. If I read the Bible, it disrupts me,
I believe I am evil, so I shouldn’t read the Bible”
(subject 74). Forms of religious coping with mixed
implications are religious rituals [51] and styles of
religious coping. Self-directing coping emphasizes
the individual’s personal responsibility and active
role in problem solving: “I have strongly believed
in God since my childhood … for my illness, my
relatives and my medication help me” (subject 62);
some patients may defer the responsibility of problem
solving to God or a figure of God: “the physicians
told me they cannot cure me, I hope for E.T
to cure me” (subject 2); in a collaborative style,
both God and the individual are responsible for
problem solving: “Help yourself, and heaven will
help you … To cope with the voices, I read the
bible, it helps me to put a measure on the voices:
logically, if you say to yourself that you have eternity
in front of you, the voices are nothing in fact,

ผลลัพธ์ (ไทย) 3:

ferences เมื่อเผชิญหน้ากับผู้คนจากภูมิหลังที่แตกต่างกัน
กว่าเรา [ 47 - 50 ] ในประเทศสวิสเซอร์แลนด์ ,
7 % ของคนเป็นของโปรเตสแตนต์ subcultures
และนําเสนอความเด่นสูงเกี่ยวกับศาสนา
[ 4 ] ในหมู่พวกเขาเชื่อว่าปีศาจ
สาเหตุของปัญหาสุขภาพจิตเป็นปกติ
ปรากฏการณ์ : 82 % ของผู้ป่วยที่ทุกข์ทรมานจากความผิดปกติทางจิตสูงทางศาสนา

กล่าวว่าพวกเขาเชื่อว่าในอิทธิพลของวิญญาณชั่วร้าย และสองในสาม
ของพวกเขาขอความช่วยเหลือผ่านพิธีกรรมอธิษฐานเพื่อปลดปล่อย
หรือไล่ผี ผู้ป่วยหลายคนอย่าง
มีประสบการณ์พิธีกรรมเป็นบวก ให้รุ่นอื่น ๆ การปรึกษาแพทย์และ

เอายาได้โดยไม่มีปัญหา แต่ไม่มีการพัฒนาในผลของอาการทางจิต
ผลเชิงลบ ( เช่น โรคจิตกำเริบ )
ที่เกี่ยวข้องกับการยกเว้นของการรักษาทางการแพทย์
การให้รูปแบบของผี [ 51 ] ,
เป็นบางระบบประสานทางศาสนารวมปกติ
ยา [ 52 ] จิตแพทย์ทำงาน
ส่วนใหญ่ในประเทศกำลังพัฒนาถึงเหมือนกัน
ข้อสรุปเกี่ยวกับผลของการประกอบพิธีกรรม
[ 38 ] ดังนั้นดูเหมือนว่า
คำอธิบายวิเศษ จิตไม่นำ

โดยอัตโนมัติไม่ปฏิบัติตามด้วยการบำบัดทางจิต ถูก
แทนที่จะเป็นส่วนหนึ่งของ " ช่วยหาเส้นทางสู่ " ศาสนา
ผู้ป่วย [ 53 ] ในกรณีศึกษา ยากล่อมประสาท
โล่งใจอาการหลังจากพิธีไล่ผี โดยชาวฮินดู , มุสลิมและคริสเตียนพระ
[ 54 ] ตัวอย่างเช่น
3 ของคนไข้ กล่าวว่า " ผมเชื่อว่าผมสิง
โดยปีศาจ ฉันไปทำพิธีสงฆ์ เขา
สอนพระวรสารและโยนออกปีศาจเขา
เขาสนับสนุนให้ฉันไปจิตแพทย์ ตอนนี้ผม
เชื่อครึ่งหนึ่งเป็นจิตเภท ครึ่งหนึ่งถูกปีศาจเข้าสิง
ดังนั้นฉันไปกับพระและฉันใช้เวลาครึ่งหนึ่งของ
ยา " ( เรื่องที่ 25 ) ; " ผมไม่รู้ว่าอะไร
ที่เห็นคือวิญญาณของคนตาย หรือ ถ้าผมบ้า แล้ว
ฉันมีเพื่อเรียนรู้เพิ่มเติม เกี่ยวกับ ความเชื่อ และไปรักษาทางจิตเวช "
( เรื่อง 32 ) ; " ฉันไม่
รู้มั้ยว่าทำไมฉันถึงประสบทุกข์ลึกและภาพหลอน
จิตแพทย์บอกว่ามันสมอง และ
อาจารย์และสมาชิกของโบสถ์สวด
ฉันให้พ้นจากสิ่งไม่ดี ในชื่อของพระเยซูเป็นพระเจ้า
. . . . . . . ผู้ที่ให้ปัญญา จิตแพทย์
ยา ฉันภาวนาให้ผู้ดูแลผม ใส่
ความหวังในพระเจ้าและฉันกินยาของฉัน " ( เรื่องที่ 81 ) .
ในที่สุดประสบการณ์ทางศาสนา
สมองตามเหมือนมนุษย์ทุกประสบการณ์ กับการพัฒนา
สมองนักวิทยาศาสตร์สามารถที่จะสำรวจ
พื้นฐานประสาทของจิตวิญญาณและความรู้สึก
[ 55 ] ระหว่างผลลัพธ์บางอย่าง เช่น มีการศึกษาแสดงให้เห็นว่า temporolimbic
ระบบพื้นผิวของศาสนา ซึ่งเป็นเรื่องเหนือธรรมชาติเกี่ยวกับพระเจ้า
- [ 55 ] ; ขมับขวาใช้งานได้ในระหว่างรัฐลึกลับ

[ 57 ]