Religious Beliefs and Their Relevance for Treatment Adherence in Mental Illness: A Review

Paweł Zagożdżon,Magdalena Wrotkowska

doi:10.3390/rel8080150

Abstract

Approximately 50% of patients do not adhere to medical therapy. Religious and spiritual factors may play an important role in determining medication compliance in mental illness. The aim of this paper is to review published evidence documenting a relationship between religion/spirituality (R/S) and treatment adherence in mental illness, in particular in schizophrenia, depression and substance abuse. This review summarizes, categorizes and defines the role of religious beliefs as a factor improving medication compliance in mental illness. Randomized controlled trials and observational studies were eligible for the review if they were published in December 2015 or earlier, analyzed the effects of religious beliefs or spirituality on medication compliance, or adherence to other therapeutic interventions in mental illness. The vast majority of published studies analyzed the effects of religion on medication compliance in schizophrenia and addiction. In schizophrenia patients, religious beliefs turned out to be a predictor of worse treatment adherence. However, spiritual orientation was shown to play an important role in the recovery from addiction, and to improve adherence in patients with this condition. Furthermore, better treatment adherence was observed in more religious patients diagnosed with depression. While religious beliefs and spirituality may represent an important source of hope and meaning, they often interfere with treatment adherence. Therefore, psychiatrists should consider religious and spiritual beliefs of their patients, and verify if and to what extent they improve their medication compliance.

Highlights

While lack of medication adherence may be observed in essentially all chronic conditions, it is challenging in mental disorders
During the first stage of screening, abstracts were grouped according to the following outcomes of interest: (1) religiosity or spirituality as an intervention or co-variate, and (2) treatment adherence or medication compliance
This review showed that published evidence documenting the effects of religiosity on medication compliance in mental illness is quite limited

Summary

Introduction

While lack of medication adherence may be observed in essentially all chronic conditions, it is challenging in mental disorders. The latter are typically associated with social isolation, stigmatization, comorbid substance abuse, lack of insight, depression and cognitive impairment. Treatment adherence may be affected by both positive and negative symptoms of the mental illness itself. The key therapeutic objectives in mental illness is to adequately control its symptoms and to ensure treatment adherence of the patient. Treatment adherence improves mental health and facilitates resolution of the underlying illness. If religious beliefs promote self-care for somatic and mental health as a manifestation of good overall status, they may exert a beneficial effect on medication

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