The role of religious support in social functioning, social support and stigma in patients with psychotic disorders

Abstract

Aims: Psychosis is associated with serious stigma, impacting a person's psychosocial functioning. Religious group membership may provide social support for patients recovering from psychosis, while there may also be additional clinically beneficial effects of religiosity. We test the primary hypothesis that patients with religious group membership have better social support and functioning, compared with patients who are not attached to any religious group, with or without other group activities. The qualities that may contribute to clinical and social improvements in patients with religion are explored. Methods: This study uses a cross-sectional design with semi-structured interviews and questionnaires. A total of 63 participants were recruited from out-patient clinics: (1) 12 patients with religious group background (Catholic or Protestant); (2) 16 patients with no religious background participating in other community groups; (3) 15 patients with no religious background and other community activities; and (4) 20 healthy controls without religious background for comparison of social support and social functioning. Results: ANOVA analyses show that religious group was significantly better than community-activity group, followed by non-religious group in interpersonal functioning and social support. Healthy controls, though, had advantages in social functioning over the community-activity and non-religious groups, they were not significantly better than the religious group in interpersonal functioning, perceived social functioning or social support. This study discovers that the internal qualities, namely private practice, intrinsic experience, and subjective importance of religion, predict the clinical outcomes and social functioning, instead of the collective features of religion. Discussion: The findings confirm that the religious group had better social functioning and social support than the community-activity group, suggesting that apart from the emphasis on community activities, religion is also valuable in building up social functioning and support. Among different areas of religion, frequency of private practice, intrinsic experience and subjective importance significantly correlated with clinical outcome, medication compliance, social functioning, social support, perceived stigma and experienced stigma. It may imply that the internal qualities have a greater impact on functioning and outcomes than the communal activities. The semi-structured interviews revealed that patients obtained positive aspects of religion, namely, comfort, support, sense of control, and meanings of illness. Ways of dealing with mental illness through religion were mentioned in the interviews. Significance: The study shows that religion and religiosity also play an important role in social functioning and mental health even more so than community activities. The ways of living with symptoms may also be helpful to patients with psychotic symptoms. The spiritual interventions in treatment of psychosis could be considered in case management.