A Randomized Trial of Spiritual Assessment of Outpatients With Schizophrenia: Patients' and Clinicians' Experience
Open accessAbstract
OBJECTIVE: Recovery-oriented care for patients with schizophrenia involves consideration of cultural issues, such as religion and spirituality. However, there is evidence that psychiatrists rarely address such topics. This study examined acceptance of a spiritual assessment by patients and clinicians, suggestions for treatment that arose from the assessment, and patient outcomes--in terms of treatment compliance and satisfaction with care (as measured by treatment alliance). METHODS: Outpatients with psychosis were randomly assigned to two groups: an intervention group that received traditional treatment and a religious and spiritual assessment (N=40) and a control group that received only traditional treatment (N=38). Eight psychiatrists were trained to administer the assessment to their established and stable patients. After each administration, the psychiatrist attended a supervision session with a psychiatrist and a psychologist of religion. Baseline and three-month data were collected. RESULTS: The spiritual assessment was well accepted by patients. During supervision, psychiatrists reported potential clinical uses for the assessment information for 67% of patients. No between-group differences in medication adherence and satisfaction with care were found at three months, although patients in the intervention group had significantly better appointment attendance during the follow-up period. Their interest in discussing religion and spirituality with their psychiatrists remained high. The process was not as well accepted by psychiatrists. CONCLUSIONS: Spiritual assessment can raise important clinical issues in the treatment of patients with chronic schizophrenia. Cultural factors, such as religion and spirituality, should be considered early in clinical training, because many clinicians are not at ease addressing such topics with patients.
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Taking a SH can identify R/S beliefs or struggles that might affect mental health, decision-making, and important issues in psychiatric treatment.
“it can identify R/S beliefs or struggles that might affect mental health, decision-making, and important issues in psychiatric treatment14,29”
In that trial, those who were asked about SH had better attendance at appointments during follow-up.
“Nevertheless, those who were asked about SH had better attendance at appointments during follow-up.29”
In that trial, patients welcomed the assessment, with more than one-quarter being very open to discussing R/S issues with their psychiatrists.
“Patients welcomed the assessment, with more than one-quarter being very open to discussing R/S issues with their psychiatrists.”
In that trial, after three month follow-up, no differences in care satisfaction or medication adherence were observed between patients who had and had not been asked about their SH.
“after the three month follow-up period, no differences in care satisfaction or medication adherence were observed between patients who had and had not been asked about their SH.”
In a randomized controlled trial at the University Hospital of Geneva (n=84) with outpatients with schizophrenia or other non-affective psychoses, taking a SH during regular psychiatric appointments had potential clinical usefulness in 67% of patients.
“a randomized controlled trial at the University Hospital of Geneva (n=84) investigated the impact of taking a SH during regular psychiatric appointments for outpatients with schizophrenia or other non-affective psychoses, finding potential clinical usefulness in 67% of patients.”
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“…; v) it can identify R/S beliefs or struggles that might affect mental health, decision-making, and important issues in psychiatric treatment 14,29 ; vi) it can help in the differential diagnosis between R/S experiences and psychopathology 30 ; and vii) it can identify individuals who might…”
- Authors
- Huguelet, P., Mohr, S., Betrisey, C., Borras, L., Gillieron, C., Marie, A. M., Rieben, I., Perroud, N., & Brandt, P.-Y.
- Affiliations
- University of Geneva (CH)
- Dr. Huguelet, Dr. Mohr, Ms. Betrisey, Dr. Borras, Dr. Marie, and Dr. Perroud are affiliated with the Department of Psychiatry, University Hospitals of Geneva and University of Geneva, 36 Rue de 31 Décembre, Geneva 1207, Switzerland (e-mail: ).
- Dr. Gillieron is with the Psychology and Education Sciences Faculty, University of Geneva.
- University of Lausanne (CH)
- Venue
- Psychiatric Services
- Published
- 2011-01
- Volume
- 62
- Issue
- 1
- Pages
- 79-86
- ISSN
- 0022-1597 (ISSN-L)
- 1075-2730
- 1557-9700
- OpenAlex
- W2119127680
- Cited by
- 147
- References
- 8
- Citations by year
- 2026: 5 · 2025: 2 · 2024: 6 · 2023: 45 · 2022: 5 · 2021: 7 · 2020: 11 · 2019: 7 · 2018: 13 · 2017: 6 · 2016: 7 · 2015: 5 · 2014: 13 · 2013: 4 · 2012: 7
- FWCI
- 9.21
- Type
- journal article
- Language
- en
- Open access
- Licence
- other-oa
- Locations
- Psychiatric Services (publishedVersion)
- PubMed (publishedVersion)
- Archive ouverte UNIGE (University of Geneva) (submittedVersion, other-oa)
- IRIS (submittedVersion)
- SERVAL (Université de Lausanne) (submittedVersion)
- Archive ouverte UNIGE (University of Geneva) (submittedVersion, cc-by)
- Funders
- National Science Foundation
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (114136)
- Topics
- Social Sciences › Health › Religion, Spirituality, and Psychology
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Sociology and Political Science › Cultural Competency in Health Care
- Keywords
- spiritual assessment, schizophrenia, religion and spirituality, psychosis, outpatients, treatment alliance, medication adherence, patient satisfaction, appointment attendance, clinician attitudes, cultural competence, recovery-oriented care
- MeSH terms
- Adult, Female, Humans, Male, Patient Acceptance of Health Care, Patient Care Planning, Physician-Patient Relations, Psychological Tests, Schizophrenia, Switzerland, Likelihood Functions, Linear Models, Patient Satisfaction, Spirituality, Medication Adherence
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