Spirituality and clinical outcomes in schizophrenia: an integrative review of the last decade
DOI:
https://doi.org/10.25118/2763-9037.2025.v15.1475Keywords:
Spirituality, Schizophrenia, treatment adherence, Therapeutics, suicide, treatment adherence and compliance, patient compliance, treatment outcomeAbstract
Introduction: Spirituality is an important factor in the treatment of any mental pathology, however, due to the presence of delirium and hallucinations with religious content, this pillar of treatment is often ignored in patients with Schizophrenia. Objectives: This study is an integrative literature review on the relationship between spirituality and patients with schizophrenia. Methods: Following PROSPERO registration, a search was conducted in PubMed, Cochrane, and SciELO using the terms “schizophrenia” and “spirituality,” limited to English-language articles published in the last 10 years. Ten articles met inclusion criteria. Exclusions included articles not primarily addressing the topic, duplicates, unavailable full texts, or those linking spirituality to other disorders. Results: High spirituality was associated with greater remission rates (85.7% vs. 53.3%; p < 0.001) and fewer suicidal thoughts (16.3% vs. 33.3%; p = 0.03). There was no evidence that spiritual intensity caused psychotic exacerbations. On the contrary, spiritual and religious engagement correlated with reduced suicide mortality. Discussion: Findings regarding faith and adherence were mixed. Yet, positive spirituality was linked to improved functioning, reduced psychopathology, and enhanced coping. Beliefs contributed to social reintegration and lower mortality, especially when supported by resilience, meaning, and social networks. Methodological limitations, including small samples and heterogeneous measures, limit generalizability. Conclusion: High spirituality is associated with better clinical outcomes—higher remission and fewer suicidal ideations. Nonetheless, it appears to affect emotional and psychological domains rather than treatment adherence directly
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Copyright (c) 2025 Letícia Ruthes Niz, Eduarda Kroenke de Vasconcellos Almeida, Débora Zolet Boneta, Isabella Patricia Lando Dacroce; Mariana Sampaio Silva Ferelli; Roberto Ratzke
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