A preliminary survey on the religious profile of Brazilian psychiatrists and their approach to patients' religiosity in clinical practice
Open accessAbstract
Background: Although there is evidence of a relationship between religion/ spirituality and mental health, it remains unclear how Brazilian psychiatrists deal with the religion/spirituality of their patients. Aims: To explore whether Brazilian psychiatrists enquire about religion/spirituality in their practice and whether their own beliefs influence their work. Method: Four hundred and eighty-four Brazilian psychiatrists completed a cross-sectional survey on religion/spirituality and clinical practice. Results: Most psychiatrists had a religious affiliation (67.4%) but more than half of the 484 participants (55.5%) did not usually enquire about patients' religion/spirituality. The most common reasons for not assessing patients' religion/spirituality were ‘being afraid of exceeding the role of a doctor’ (30.2%) and ‘lack of training’ (22.3%). Conclusions: Very religious/spiritual psychiatrists were the most likely to ask about their patients' religion/spirituality. Training in how to deal with a patient's religiosity might help psychiatrists to develop better patient rapport and may contribute to the patient's quicker recovery.
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Written from the paper’s full text.
TL;DR
In a cross-sectional survey of 484 Brazilian psychiatrists, most had a religious affiliation (67.4%) but more than half (55.5%) did not usually enquire about patients’ religion/spirituality. Very religious/spiritual psychiatrists were the most likely to enquire, while fear of exceeding the doctor’s role and lack of training were common barriers.
Key findings
- 67.4% of respondents had a religious affiliation and 71.4% believed in God; 30.6% considered themselves very spiritual and 13.7% very religious.
- 45.5% frequently enquired about patients’ religious/spiritual issues, while 55.5% did not usually do so; 76.8% considered it very or reasonably important to integrate patients’ religion/spirituality into clinical practice, and 71.1% considered it important to include religion/spirituality in medical training.
- Barriers to addressing patients’ religion/spirituality were fear of exceeding the role of a doctor (30.2%), lack of training (22.3%), and lack of time (16.3%); 40.3% reported no barriers.
- Very religious psychiatrists were almost five times more likely to enquire about patients’ religion/spirituality (adjusted OR=4.58, 95% CI 2.39–8.80), and very spiritual psychiatrists were also more likely (adjusted OR=1.87, 95% CI 1.05–3.35); having a religious affiliation itself was not associated with enquiring after adjustment.
Methods
- Cross-sectional online survey emailed to 3120 psychiatrists belonging to the Brazilian Association of Psychiatry between 12 September 2013 and 6 February 2014, with up to 10 reminder emails; 1779 emails were acknowledged, 492 questionnaires were completed (28%), and 484 were analysed after exclusions.
- The questionnaire was adapted and translated into Portuguese from the “Religion and Spirituality in Medicine: Doctors’ Perspectives” survey by Curlin et al, assessing sociodemographic/professional features, religious/spiritual characteristics, opinions and behaviours about religion/spirituality in clinical practice and medical training, and barriers.
- Analysis used Stata 12.1 with logistic regression models adjusted for age, gender, and marital status, reporting odds ratios with 95% confidence intervals.
Limitations
- The paper states that the cross-sectional design and self-report data are limitations; the 28% response rate means generalisation should be made carefully, although the authors note this is within the expected range for electronic surveys.
- The paper states possible selection bias, as those more passionate for or against the issue may have been more inclined to respond, and that religion/spirituality were not defined, allowing respondents to apply their own definitions.
- Evident from the text: the sample was drawn only from ABP members, and enquiry frequency was self-reported rather than objectively verified.
Model-written summary. Check it against the paper before relying on it.
Integrity signals
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Cites
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Claims the paper makes
0 of 69 cited sources checked · 0 supported · 0 flagged
- Findingown data
Fear of exceeding the role of a doctor was the most commonly cited barrier to addressing patients' religion/spirituality, reported by 30.2%.
“The most common reasons for not assessing patients’ religion/spirituality were ‘being afraid of exceeding the role of a doctor’ (30.2%) and ‘lack of training’ (22.3%).”
- Also stated in: § Sociodemographic, professional and religious characteristics of Brazilian psychiatrists · plain
“the most cited difficulties were the fear of exceeding the role of the doctor (30.2%)”
Quote in the paperNot a substantial claim- Rests on an assumption: Brazilian psychiatrists belonging to the ABP are representative of Brazilian psychiatrists in general.
- Rests on an assumption: The self-reported questionnaire responses accurately reflect the psychiatrists' actual beliefs and behaviours.
- Rests on an assumption: Non-response bias does not substantially affect the results.
- Also stated in: § Sociodemographic, professional and religious characteristics of Brazilian psychiatrists · plain
- Findingown data
Psychiatrists who declared themselves slightly spiritual were less likely to enquire about patients' religious/spiritual issues (OR=0.49, 95% CI 0.24-0.97) compared to those not at all spiritual.
“The psychiatrists who declared themselves to be slightly spiritual were less likely (OR=0.49, 95% CI 0.24–0.97) to enquire about patients’ religious/spiritual issues, when compared to psychiatrists who were not at all spiritual.”
Quote in the paperNot a substantial claim- Rests on an assumption: Brazilian psychiatrists belonging to the ABP are representative of Brazilian psychiatrists in general.
- Rests on an assumption: The self-reported questionnaire responses accurately reflect the psychiatrists' actual beliefs and behaviours.
- Rests on an assumption: Non-response bias does not substantially affect the results.
- Findingown data
13.7% of psychiatrists considered themselves very religious.
“13.7% of the psychiatrists, considered themselves to be very religious”
Quote in the paperNot a substantial claim- Rests on an assumption: Brazilian psychiatrists belonging to the ABP are representative of Brazilian psychiatrists in general.
- Rests on an assumption: The self-reported questionnaire responses accurately reflect the psychiatrists' actual beliefs and behaviours.
- Rests on an assumption: Non-response bias does not substantially affect the results.
- Findingown data
Lack of training was a barrier to addressing patients' religion/spirituality, reported by 22.3%.
“The most common reasons for not assessing patients’ religion/spirituality were ‘being afraid of exceeding the role of a doctor’ (30.2%) and ‘lack of training’ (22.3%).”
- Also stated in: § Sociodemographic, professional and religious characteristics of Brazilian psychiatrists · plain
“lack of training (22.3%)”
Quote in the paperSubstantial claim- Rests on an assumption: Brazilian psychiatrists belonging to the ABP are representative of Brazilian psychiatrists in general.
- Rests on an assumption: The self-reported questionnaire responses accurately reflect the psychiatrists' actual beliefs and behaviours.
- Rests on an assumption: Non-response bias does not substantially affect the results.
- Also stated in: § Sociodemographic, professional and religious characteristics of Brazilian psychiatrists · plain
- Findingown data
Very religious psychiatrists were more likely to ask patients about religious/spiritual issues (OR=4.58, 95% CI 2.39-8.80) compared to those not religious at all.
“the great majority of these (74.2%) were almost five times more likely (OR=4.58, 95% CI 2.39–8.80) to ask their patients about their religious/spiritual issues than those who saw themselves as not religious at all.”
Quote in the paperSubstantial claim- Rests on an assumption: Brazilian psychiatrists belonging to the ABP are representative of Brazilian psychiatrists in general.
- Rests on an assumption: The self-reported questionnaire responses accurately reflect the psychiatrists' actual beliefs and behaviours.
- Rests on an assumption: Non-response bias does not substantially affect the results.
- Findingown data
Very spiritual psychiatrists tended to ask patients more often about their religion/spirituality (OR=1.87, 95% CI 1.05-3.35).
“On the contrary, those who were very spiritual (30.6%) tended to ask patients more often about their religion/spirituality (OR=1.87, 95% CI 1.05–3.35) (Tables 1, 4 and Fig. 1).”
Quote in the paperSubstantial claim- Rests on an assumption: Brazilian psychiatrists belonging to the ABP are representative of Brazilian psychiatrists in general.
- Rests on an assumption: The self-reported questionnaire responses accurately reflect the psychiatrists' actual beliefs and behaviours.
- Rests on an assumption: Non-response bias does not substantially affect the results.
- Findingown data
Psychiatrists who considered it important to integrate patients' religion/spirituality into clinical practice were more likely to have a religious affiliation (OR=4.33, 95% CI 2.75-6.81).
“In both cases, these participants were four times more likely (OR=4.33, 95% CI 2.75–6.81 and OR=4.14, 95% CI 2.69–6.36) to have a religious affiliation than those who considered it a little or not important to integrate religiosity in clinical practice or include it in medical training (Table 3).”
Quote in the paperSubstantial claim- Rests on an assumption: Brazilian psychiatrists belonging to the ABP are representative of Brazilian psychiatrists in general.
- Rests on an assumption: The self-reported questionnaire responses accurately reflect the psychiatrists' actual beliefs and behaviours.
- Rests on an assumption: Non-response bias does not substantially affect the results.
- Findingown data
71.1% of psychiatrists considered it very or reasonably important to include religion/spirituality in medical training.
“71.1% considered it very or reasonably important to include religion/spirituality in medical training”
Quote in the paperNot a substantial claim- Rests on an assumption: Brazilian psychiatrists belonging to the ABP are representative of Brazilian psychiatrists in general.
- Rests on an assumption: The self-reported questionnaire responses accurately reflect the psychiatrists' actual beliefs and behaviours.
- Rests on an assumption: Non-response bias does not substantially affect the results.
- Findingown data
345 (71.4%) of the surveyed psychiatrists said they believed in God.
“345 (71.4%) said that they believed in God”
Quote in the paperNot a substantial claim- Rests on an assumption: Brazilian psychiatrists belonging to the ABP are representative of Brazilian psychiatrists in general.
- Rests on an assumption: The self-reported questionnaire responses accurately reflect the psychiatrists' actual beliefs and behaviours.
- Rests on an assumption: Non-response bias does not substantially affect the results.
- Findingown data
Psychiatrists working in forensic psychiatry were more likely to have a religious affiliation (OR=1.86, 95% CI 1.02-3.39).
“Only those working in forensic psychiatry were more likely to have a religious affiliation (OR=1.86, 95% CI 1.02–3.39) (Table 2).”
Quote in the paperNot a substantial claim- Rests on an assumption: Brazilian psychiatrists belonging to the ABP are representative of Brazilian psychiatrists in general.
- Rests on an assumption: The self-reported questionnaire responses accurately reflect the psychiatrists' actual beliefs and behaviours.
- Rests on an assumption: Non-response bias does not substantially affect the results.
- Findingown data
Almost half (45.5%) of psychiatrists surveyed said they frequently enquired about patients' religious/spiritual issues.
“Almost half (45.5%) of the psychiatrists surveyed said they frequently enquired about their patients’ religious/spiritual issues (Table 1).”
Quote in the paperSubstantial claim- Rests on an assumption: Brazilian psychiatrists belonging to the ABP are representative of Brazilian psychiatrists in general.
- Rests on an assumption: The self-reported questionnaire responses accurately reflect the psychiatrists' actual beliefs and behaviours.
- Rests on an assumption: Non-response bias does not substantially affect the results.
- Findingown data
Participants' sociodemographic background, years of experience, and psychiatric sub-specialisation were not associated with enquiring about patients' religion/spirituality.
“The participants’ sociodemographic background, the number of years of experience and psychiatric sub-specialisation were not associated with enquiring about the patients’ religion/spirituality.”
Quote in the paperNot a substantial claim- Rests on an assumption: Brazilian psychiatrists belonging to the ABP are representative of Brazilian psychiatrists in general.
- Rests on an assumption: The self-reported questionnaire responses accurately reflect the psychiatrists' actual beliefs and behaviours.
- Rests on an assumption: Non-response bias does not substantially affect the results.
- Findingown data
Psychiatrists who had worked longer were less likely to have a religious affiliation (OR=0.39, 95% CI 0.18-0.83).
“Those who had worked longer were less likely to have a religious affiliation (OR=0.39, 95% CI 0.18–0.83) (Table 2).”
Quote in the paperNot a substantial claim- Rests on an assumption: Brazilian psychiatrists belonging to the ABP are representative of Brazilian psychiatrists in general.
- Rests on an assumption: The self-reported questionnaire responses accurately reflect the psychiatrists' actual beliefs and behaviours.
- Rests on an assumption: Non-response bias does not substantially affect the results.
- Findingown data
43.3% of respondents considered themselves very or moderately religious.
“43.3% of the respondents considered themselves to be very or moderately religious”
Quote in the paperNot a substantial claim- Rests on an assumption: Brazilian psychiatrists belonging to the ABP are representative of Brazilian psychiatrists in general.
- Rests on an assumption: The self-reported questionnaire responses accurately reflect the psychiatrists' actual beliefs and behaviours.
- Rests on an assumption: Non-response bias does not substantially affect the results.
- Findingown data
Of the 158 psychiatrists without a religious affiliation, 45 (28.5%) said they believed in God.
“Of the 158 without a religious affiliation, 45 (28.5%) said they believed in God (see Table 1).”
Quote in the paperNot a substantial claim- Rests on an assumption: Brazilian psychiatrists belonging to the ABP are representative of Brazilian psychiatrists in general.
- Rests on an assumption: The self-reported questionnaire responses accurately reflect the psychiatrists' actual beliefs and behaviours.
- Rests on an assumption: Non-response bias does not substantially affect the results.
- Findingown data
Psychiatrists who reported some barriers were more likely to have a religious affiliation (OR=2.82, 95% CI 1.75-4.54).
“those participants who reported some barriers were more likely to have a religious affiliation (OR=2.82, 95% CI 1.75–4.54) (Table 3).”
Quote in the paperSubstantial claim- Rests on an assumption: Brazilian psychiatrists belonging to the ABP are representative of Brazilian psychiatrists in general.
- Rests on an assumption: The self-reported questionnaire responses accurately reflect the psychiatrists' actual beliefs and behaviours.
- Rests on an assumption: Non-response bias does not substantially affect the results.
- Findingown data
Psychiatrists who reported having no barriers were less likely to have a religious affiliation (OR=0.47, 95% CI 0.32-0.70).
“Those psychiatrists who reported having no barriers were less likely to have a religious affiliation (OR=0.47, 95% CI 0.32–0.70)”
Quote in the paperSubstantial claim- Rests on an assumption: Brazilian psychiatrists belonging to the ABP are representative of Brazilian psychiatrists in general.
- Rests on an assumption: The self-reported questionnaire responses accurately reflect the psychiatrists' actual beliefs and behaviours.
- Rests on an assumption: Non-response bias does not substantially affect the results.
- Findingown data
More than half of the surveyed Brazilian psychiatrists did not usually enquire about patients' religion/spirituality.
“more than half of the 484 participants (55.5%) did not usually enquire about patients’ religion/spirituality”
Quote in the paperSubstantial claim- Rests on an assumption: Brazilian psychiatrists belonging to the ABP are representative of Brazilian psychiatrists in general.
- Rests on an assumption: The self-reported questionnaire responses accurately reflect the psychiatrists' actual beliefs and behaviours.
- Rests on an assumption: Non-response bias does not substantially affect the results.
- Findingown data
40.3% of the total sample reported not having any barriers to addressing patients' religion/spirituality.
“We also found that 40.3% of the total sample reported not having any barriers.”
Quote in the paperNot a substantial claim- Rests on an assumption: Brazilian psychiatrists belonging to the ABP are representative of Brazilian psychiatrists in general.
- Rests on an assumption: The self-reported questionnaire responses accurately reflect the psychiatrists' actual beliefs and behaviours.
- Rests on an assumption: Non-response bias does not substantially affect the results.
- Findingown data
Most Brazilian psychiatrists surveyed had a religious affiliation (67.4%).
“Most psychiatrists had a religious affiliation (67.4%)”
- Also stated in: § Sociodemographic, professional and religious characteristics of Brazilian psychiatrists · plain
“of which 326 (67.4%) declared a religious affiliation”
Quote in the paperNot a substantial claim- Rests on an assumption: Brazilian psychiatrists belonging to the ABP are representative of Brazilian psychiatrists in general.
- Rests on an assumption: The self-reported questionnaire responses accurately reflect the psychiatrists' actual beliefs and behaviours.
- Rests on an assumption: Non-response bias does not substantially affect the results.
- Also stated in: § Sociodemographic, professional and religious characteristics of Brazilian psychiatrists · plain
- Findingown data
68.7% of respondents considered themselves very or moderately spiritual.
“68.7% considered themselves to be very or moderately spiritual”
Quote in the paperNot a substantial claim- Rests on an assumption: Brazilian psychiatrists belonging to the ABP are representative of Brazilian psychiatrists in general.
- Rests on an assumption: The self-reported questionnaire responses accurately reflect the psychiatrists' actual beliefs and behaviours.
- Rests on an assumption: Non-response bias does not substantially affect the results.
- Findingown data
Psychiatrists who considered it important to include religion/spirituality in medical training were more likely to have a religious affiliation (OR=4.14, 95% CI 2.69-6.36).
“In both cases, these participants were four times more likely (OR=4.33, 95% CI 2.75–6.81 and OR=4.14, 95% CI 2.69–6.36) to have a religious affiliation than those who considered it a little or not important to integrate religiosity in clinical practice or include it in medical training (Table 3).”
Quote in the paperSubstantial claim- Rests on an assumption: Brazilian psychiatrists belonging to the ABP are representative of Brazilian psychiatrists in general.
- Rests on an assumption: The self-reported questionnaire responses accurately reflect the psychiatrists' actual beliefs and behaviours.
- Rests on an assumption: Non-response bias does not substantially affect the results.
- Findingown data
76.8% of psychiatrists considered it very or reasonably important to integrate patients' religion/spirituality into clinical practice.
“76.8% considered it very or reasonably important to integrate patients’ religion/spirituality into clinical practice”
Quote in the paperSubstantial claim- Rests on an assumption: Brazilian psychiatrists belonging to the ABP are representative of Brazilian psychiatrists in general.
- Rests on an assumption: The self-reported questionnaire responses accurately reflect the psychiatrists' actual beliefs and behaviours.
- Rests on an assumption: Non-response bias does not substantially affect the results.
- Findingown data
Psychiatrists who considered themselves very religious and/or spiritual were the most likely to enquire into their patients' religion/spirituality in clinical practice.
“However, psychiatrists who considered themselves to be very religious and/or spiritual were the most likely to enquire into their patients’ religion/spirituality in clinical practice.”
- Also stated in: § Discussion · plain
“However, considering oneself very spiritual, and especially very religious, is associated with this.”
Quote in the paperSubstantial claim - Also stated in: § Discussion · plain
- Findingown data
Psychiatrists who reported no barriers were less likely to have a religious affiliation.
“The psychiatrists who declared that they did not have any barriers in addressing religion/spirituality in clinical practice were the most likely to enquire about these issues with their patients and less tending to have religious affiliation”
Quote in the paperSubstantial claim - Findingown data
71.4% of Brazilian psychiatrists who responded to the survey believed in God.
“However, Brazilian psychiatrists showed a greater percentage of belief in God (71.4%), when compared with American (65%),17 German (56%),11 Canadian (54%)10 and British (23%) psychiatrists.9”
Quote in the paperNot a substantial claim - Findingown data
Psychiatrists who declared themselves very religious were almost five times more likely to enquire into their patients' religious and spiritual issues compared with those who declared themselves not religious at all.
“Although the psychiatrists in our study who declared themselves to be very religious were relatively few (17%), they were almost five times more likely to enquire into their patients’ religious and spiritual issues, when compared with those who declared themselves to be not religious at all.”
Quote in the paperSubstantial claim - Findingown data
About half (45.5%) of responding Brazilian psychiatrists reported frequently asking or often discussing religion/spirituality with their patients.
“Half of them declared they frequently asked their patients about their religious and spiritual beliefs.”
- Also stated in: § Discussion · plain
“In our study, 45.5% of the participants stated they often discussed religion/spirituality with their patients”
- Also stated in: § Final remarks · hedged
“Two-thirds of the participants of this survey had a religious affiliation, and almost half enquired frequently about their patients’ religion/spirituality.”
Quote in the paperSubstantial claim - Also stated in: § Discussion · plain
- Findingown data
The great majority of Brazilian psychiatrists who responded to the survey considered it important to integrate patients' religion/spirituality into clinical practice.
“The results demonstrated that the great majority of Brazilian psychiatrists who replied to the survey considered it important to integrate religion/spirituality into clinical practice and into medical training.”
- Also stated in: § Discussion · plain
“the vast majority of psychiatrists in this study considered it to be very or reasonably important to integrate their patients’ religion/spirituality into their practice.”
Quote in the paperSubstantial claim - Also stated in: § Discussion · plain
- Findingown data
Psychiatrists who reported that they feared exceeding the doctor's role were less likely to enquire about their patients' religious/spiritual issues (OR=0.45, 95% CI 0.30-0.67).
“whereas those who reported that they feared exceeding the doctor’s role were less likely (OR=0.45, 95% CI 0.30–0.67) to enquire about their patients’ religious/spiritual issues (Table 4).”
Quote in the paperSubstantial claim - Findingown data
Psychiatrists who reported not having any barriers to addressing religion/spirituality in clinical practice were more likely to enquire about their patients' religious/spiritual issues (OR=3.25, 95% CI 2.21-4.77).
“The psychiatrists who considered it very or reasonably important to integrate religion/spirituality into clinical practice (OR=2.17, 95% CI 1.38–3.43) and medical training (OR=1.91, 95% IC 1.26–2.90), as well as those who reported not having any barriers to address religion/spirituality in clinical practice (OR=3.25, 95% CI 2.21–4.77), were more likely to enquire about their patients’ religious/sp”
- Also stated in: § Discussion · plain
“The psychiatrists who declared that they did not have any barriers in addressing religion/spirituality in clinical practice were the most likely to enquire about these issues with their patients”
Quote in the paperSubstantial claim - Also stated in: § Discussion · plain
- Findingown data
Most participants were in favour of establishing training programmes to improve the skills of psychiatrists in respect of their approach towards patients' religion/spirituality.
“Most of the participants are in favour of establishing training programmes to improve the skills of psychiatrists in respect of their approach towards patients’ religion/spirituality.”
Quote in the paperSubstantial claim - Findingown data
67.4% of Brazilian psychiatrists who responded to the survey had a religious affiliation.
“Regarding religious and spiritual characteristics, 67.4% of Brazilian psychiatrists who responded to our survey had a religious affiliation, in comparison with 92% of the Brazilian population.16”
- Also stated in: § Final remarks · plain
“Two-thirds of the participants of this survey had a religious affiliation”
Quote in the paperNot a substantial claim - Also stated in: § Final remarks · plain
- Findingown data
There was no association between having a religious affiliation and enquiring about religion/spirituality in clinical practice among responding Brazilian psychiatrists.
“The results also showed that there was no association between having a religious affiliation and enquiring about religion/spirituality in the clinical practice.”
- Also stated in: § Discussion · plain
“The Brazilian psychiatrists, as in studies with South African12 and British psychiatrists,9 showed that having a religious affiliation itself was not associated with psychiatrists asking about their patients’ religion/spirituality.”
Quote in the paperSubstantial claim - Also stated in: § Discussion · plain
- Findingown data
Psychiatrists who indicated having barriers were less likely to inquire about patients' religion/spirituality.
“and, unsurprisingly, less likely to inquire about patients’ religion/spirituality.”
Quote in the paperSubstantial claim - Findingown data
Psychiatrists who considered it very or reasonably important to integrate religion/spirituality into clinical practice were more likely to enquire about their patients' religious/spiritual issues (OR=2.17, 95% CI 1.38-3.43).
“The psychiatrists who considered it very or reasonably important to integrate religion/spirituality into clinical practice (OR=2.17, 95% CI 1.38–3.43) and medical training (OR=1.91, 95% IC 1.26–2.90), as well as those who reported not having any barriers to address religion/spirituality in clinical practice (OR=3.25, 95% CI 2.21–4.77), were more likely to enquire about their patients’ religious/sp”
Quote in the paperSubstantial claim - Findingown data
The great majority of Brazilian psychiatrists who responded to the survey considered it important that issues of religion/spirituality be included in medical training.
“The results demonstrated that the great majority of Brazilian psychiatrists who replied to the survey considered it important to integrate religion/spirituality into clinical practice and into medical training.”
Quote in the paperSubstantial claim - Findingown data
Those working in forensic psychiatry were the most likely to declare a religious affiliation.
“An interesting observation in this survey was that those working in forensic psychiatry were the most likely to declare a religious affiliation.”
Quote in the paperNot a substantial claim - Findingown data
Psychiatrists who indicated having barriers such as fear of exceeding the doctor's role and lack of training were more likely to declare a religious affiliation.
“whereas those who indicated having barriers such as the fear of exceeding the doctor’s role and lack of training were the most likely to declare a religious affiliation”
Quote in the paperSubstantial claim - Findingown data
More years working in psychiatry was associated with a lower likelihood of having a religious affiliation.
“We also found that not only the subspecialty but also the number of years working in psychiatry could be associated with having or not having a religious affiliation, with those with more time in the profession less likely to have any religious affiliation.”
Quote in the paperSubstantial claim - Findingown data
Psychiatrists who considered it important that issues of religion/spirituality are included in medical training were more likely to enquire about their patients' religious/spiritual issues (OR=1.91, 95% CI 1.26-2.90).
“The psychiatrists who considered it very or reasonably important to integrate religion/spirituality into clinical practice (OR=2.17, 95% CI 1.38–3.43) and medical training (OR=1.91, 95% IC 1.26–2.90), as well as those who reported not having any barriers to address religion/spirituality in clinical practice (OR=3.25, 95% CI 2.21–4.77), were more likely to enquire about their patients’ religious/sp”
Quote in the paperSubstantial claim - Findingown data
Women psychiatrists were more likely to declare a religious affiliation.
“The results also indicated that women were more likely to declare a religious affiliation.”
Quote in the paperSubstantial claim - Findingcitation
More participants in this study considered themselves to be spiritual than religious.
“In addition, as in the studies of Canadian10 and American psychiatrists,17 more participants in this study considered themselves to be spiritual than religious.”
Quote in the paperNot a substantial claim - Interpretationown data
Very religious/spiritual psychiatrists were the most likely to ask about their patients' religion/spirituality.
“Very religious/spiritual psychiatrists were the most likely to ask about their patients’ religion/spirituality.”
Quote in the paperSubstantial claim- Rests on an assumption: Brazilian psychiatrists belonging to the ABP are representative of Brazilian psychiatrists in general.
- Rests on an assumption: The self-reported questionnaire responses accurately reflect the psychiatrists' actual beliefs and behaviours.
- Rests on an assumption: Non-response bias does not substantially affect the results.
- Study design and conductown data
The response rate was 28% (492 of 1779 acknowledged emails).
“From those 1779 email addresses, 492 completed the questionnaire (28%).”
Quote in the paperNot a substantial claim - Interpretationcitation
Brazilian psychiatrists who responded to the survey had a lower rate of religious affiliation than the Brazilian population (67.4% vs 92%).
“Regarding religious and spiritual characteristics, 67.4% of Brazilian psychiatrists who responded to our survey had a religious affiliation, in comparison with 92% of the Brazilian population.16”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [16] Instituto Brasileiro de Geografia e Estatística (IBGE). Censo Demográfico 2010: características gerais da população, religião e pessoas com deficiência [Demographic Census 2010: general characteristics of the population, religion and people with disabilities]. IBGE, 2010 (http://biblioteca.ibge.gov.br/biblioteca-catalogo?view=detalhes&id=794).
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Premisecitation
The rate of response for studies involving business people, psychiatrists, and oncologists is not usually more than 20%.
“The rate of response for studies involving business people,33 psychiatrists30 and oncologists34 is not usually more than 20%.”
Quote in the paperSubstantial claim0 of 3 sources checked- cites [33] Harzing A. Response rates in international mail surveys: results of a 22 country study. Int Bus Rev 1997; 6: 641– 65.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [30] Banzato C, Pereira M, Santos A Jr, Silva F, Loureiro J Jr, Barros B. What do Brazilian psychiatrists want from diagnostic classifications? J Bras Psiquiatr 2007; 56: 88– 93.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [34] Samano E, Ribeiro L, Camos A, Lewin F, Filho E, Goldenstein P, et al Use of complementary and alternative medicine by Brazilian oncologists. Eur J Cancer Care 2005; 14: 143– 8. 15842462 source
Not checked in the free run.
- Premisecitation
Response rates for surveys performed via the Internet are lower than those conducted by face-to-face, mail, or telephone methods.
“Moreover, the response rates for surveys performed via the Internet are lower in relation to those conducted by face-to-face, mail or telephone methods.31”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [31] Nulty D. The adequacy of response rates to online and paper surveys: what can be done? Assess Eval High Educ 2008; 33: 301– 14.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Interpretationown data
Brazilian psychiatrists who responded to the survey had a greater percentage of belief in God than American, German, Canadian, and British psychiatrists.
“However, Brazilian psychiatrists showed a greater percentage of belief in God (71.4%), when compared with American (65%),17 German (56%),11 Canadian (54%)10 and British (23%) psychiatrists.9”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites [17] Curlin F, Odell S, Lawrence R, Chin M, Lantos J, Meador K, et al The relationship between psychiatry and religion among US physicians. Psychiatr Serv 2007; 58: 1193– 8. 17766565 PMC2867459 source
Not checked in the free run.
- cites [11] Lee E, Baumann K. German psychiatrists’ observation and interpretation of religiosity/spirituality. Evid Based Complement Alternat Med 2013; 2013: 280168 (Epub). 24348695 PMC3847966 source
Not checked in the free run.
- cites [10] Baetz M, Griffin R, Bowen R, Marcoux G. Spirituality and psychiatry in Canada: psychiatric practice compared with patient expectations. Can J Psychiatry 2004; 49: 265– 71. 15147025 source
Not checked in the free run.
- Premisecitation
In the study by Curlin et al., a higher proportion (87%) of American psychiatrists reported always asking about their patients' religion/spirituality.
“In our study, 45.5% of the participants stated they often discussed religion/spirituality with their patients, a much lower figure than that reported in the study by Curlin et al,13 where a higher proportion (87%) of American psychiatrists reported always asking about their patients’ religion/spirituality.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [13] Curlin F, Lawrence R, Odell S, Chin M, Lantos J, Koenig HG, et al Religion, spirituality, and medicine: Psychiatrists’ and other physicians’ differing observations, interpretations, and clinical approaches. Am J Psychiatry 2007; 164: 1825– 31. 18056237 PMC2861911 source
Not checked in the free run.
- Premisecitation
The reply rate of 28% is in the expected range for research that uses electronic methods of data collection (email).
“However, the reply rate is in the expected range for research that uses electronic methods of data collection (email).”
Quote in the paperNot a substantial claim - Interpretationown data
Brazilian psychiatrists who responded to the survey tended to have less religious affiliation than psychiatrists in the United States, Germany, and South Africa.
“They also tended to have less religious affiliation when compared with psychiatrists in the United States (82%),17 Germany (70.7%)11 and South Africa (84%).12”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites [17] Curlin F, Odell S, Lawrence R, Chin M, Lantos J, Meador K, et al The relationship between psychiatry and religion among US physicians. Psychiatr Serv 2007; 58: 1193– 8. 17766565 PMC2867459 source
Not checked in the free run.
- cites [11] Lee E, Baumann K. German psychiatrists’ observation and interpretation of religiosity/spirituality. Evid Based Complement Alternat Med 2013; 2013: 280168 (Epub). 24348695 PMC3847966 source
Not checked in the free run.
- cites [12] Welgemoed M, Staden C. Does religious identification of South African psychiatrists matter in their approach to religious matters in clinical practice? S Afr J Psychiatr 2014; 20: 140– 5. source
Not checked in the free run.
- May combine two claims. 16
- Classified as probably not a substantial claim. 34
May combine two claims.
FindingcitationThe most commonly mentioned barriers to addressing religion/spirituality with patients were fear of exceeding the role of a doctor, lack of training, and lack of time.
“Although a high proportion of psychiatrists declared that they do not have any barriers in addressing their patients’ religion/spirituality, the most commonly mentioned barriers were similar to those of previous studies:13,27 the fear of exceeding the role of a doctor, lack of training and lack of time.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataRespondents supported the idea of creating a course related to religion/spirituality for undergraduate medical students.
“Respondents also support the idea of creating a course related to religion/spirituality for undergraduate medical students.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataIn the sample, Catholics comprised the largest group, followed by Spiritists, then Evangelicals.
“in our sample, Catholics comprise, as expected, the largest group, with Spiritists second, followed by Evangelicals.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationFurther research has been carried out to investigate the religious and spiritual profiles of psychiatrists and their attitudes towards including religion/spirituality into the management and care of their patients.
“In response to the increased importance of religion/spirituality in clinical practice, further research has been carried out, with the purpose of investigating the religious and spiritual profiles of psychiatrists and their attitudes towards including religion/spirituality into the management and care of their patients.9–14”
Quote in the paperNot a substantial claim0 of 6 sources checked- cites [9] Neeleman J, King M. Psychiatrists religious attitudes in relation to their clinical-practice – a survey of 231 psychiatrists. Acta Psychiatr Scand 1993; 88: 420– 4. 8310849 source
Not checked in the free run.
- cites [10] Baetz M, Griffin R, Bowen R, Marcoux G. Spirituality and psychiatry in Canada: psychiatric practice compared with patient expectations. Can J Psychiatry 2004; 49: 265– 71. 15147025 source
Not checked in the free run.
- cites [11] Lee E, Baumann K. German psychiatrists’ observation and interpretation of religiosity/spirituality. Evid Based Complement Alternat Med 2013; 2013: 280168 (Epub). 24348695 PMC3847966 source
Not checked in the free run.
- cites [12] Welgemoed M, Staden C. Does religious identification of South African psychiatrists matter in their approach to religious matters in clinical practice? S Afr J Psychiatr 2014; 20: 140– 5. source
Not checked in the free run.
- cites [13] Curlin F, Lawrence R, Odell S, Chin M, Lantos J, Koenig HG, et al Religion, spirituality, and medicine: Psychiatrists’ and other physicians’ differing observations, interpretations, and clinical approaches. Am J Psychiatry 2007; 164: 1825– 31. 18056237 PMC2861911 source
Not checked in the free run.
- cites [14] Lawrence R, Head J, Christodoulou G, Andonovska B, Karamat S, Duggal A, et al Clinicians’ attitudes to spirituality in old age psychiatry. Int Psychogeriatr 2007; 19: 962– 73. 17018180 source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductreasoningThe final number of completed questionnaires was 484.
“The final number of completed questionnaires was 484.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
Study design and conductown dataAll patterns were adjusted for age, gender, and marital status.
“All the patterns were adjusted by age, gender, and marital status and are presented as odds ratios with a 95% confidence interval.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationThe WPA has published a Position Statement on Spirituality and Religion in Psychiatry acknowledging the importance of considering the spiritual dimension in psychiatric training, research, and clinical practice.
“The WPA has recently published its ‘Position Statement on Spirituality and Religion in Psychiatry’ which acknowledges the importance of considering the spiritual dimension in psychiatric training, research and clinical practice.5–8”
Quote in the paperNot a substantial claim0 of 4 sources checked- cites [5] American Psychiatric Association (APA), Committee on Religion and Psychiatry. Guidelines regarding possible conflict between psychiatrists’ religious commitments and psychiatric practice. Am J Psychiatry 1990; 147: 542. 11642759 source
Not checked in the free run.
- cites [6] Royal College of Psychiatrists. Spirituality and Psychiatry Special Interest Group. RCP, 1999 (http://www.rcpsych.ac.uk/college/specialinterestgroups/spirituality.aspx).
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [7] Cordeiro Q. Creation of the section on spirituality and mental health at the Brazilian Psychiatric Association. Psyche Spirit 2014; 1: 2– 3.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [8] Moreira-Almeida A, Sharma A, Rensburg B, Verhagen P, Cook C. WPA position statement on spirituality and religion in psychiatry. World Psychiatry 2016; 15: 87– 8. 26833620 PMC4780301 source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationThe majority of psychiatrists agree on the importance and need to integrate religious/spiritual aspects in clinical practice.
“What was interesting to observe from those studies was that the majority of psychiatrists agree on the importance and the need to integrate religious/spiritual aspects in clinical practice.9,10,14”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites [9] Neeleman J, King M. Psychiatrists religious attitudes in relation to their clinical-practice – a survey of 231 psychiatrists. Acta Psychiatr Scand 1993; 88: 420– 4. 8310849 source
Not checked in the free run.
- cites [10] Baetz M, Griffin R, Bowen R, Marcoux G. Spirituality and psychiatry in Canada: psychiatric practice compared with patient expectations. Can J Psychiatry 2004; 49: 265– 71. 15147025 source
Not checked in the free run.
- cites [14] Lawrence R, Head J, Christodoulou G, Andonovska B, Karamat S, Duggal A, et al Clinicians’ attitudes to spirituality in old age psychiatry. Int Psychogeriatr 2007; 19: 962– 73. 17018180 source
Not checked in the free run.
Classified as probably not a substantial claim.
PremisecitationReligion and spirituality are generally associated with better coping skills and positive health indicators, particularly with respect to mental health.
“Over the past few decades, numerous studies have reported that religion and spirituality are generally associated with better coping skills and positive health indicators, particularly with respect to mental health.1,2”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [1] Koenig HG, McCullough ME, Larson DB. Handbook of Religion and Health. Oxford University Press, 2001. source
Not checked in the free run.
- cites [2] Koenig HG, King D, Carson VB. Handbook of Religion and Health (2nd edn). Oxford University Press, 2012.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Classified as probably not a substantial claim.
Study design and conductcitationThe survey was based on the questionnaire 'Religion and Spirituality in Medicine: Doctors' Perspectives' developed by Curlin et al.
“The survey presented in this study was based on the questionnaire Religion and Spirituality in Medicine: Doctors’ Perspectives developed by Curlin et al,15 which evaluates doctors’ religious/spiritual characteristics and their influence, if any, on clinical practice and their patients’ health.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Curlin et al,15
Not checked in the free run.
Classified as probably not a substantial claim. May combine two claims.
PremisecitationReligion/spirituality has been associated with lower rates of suicide, depression, anxiety, and substance misuse, better recovery in cases of depression, and greater overall well-being.
“Religion/spirituality has been associated, for example, with lower rates of suicide, depression, anxiety, and substance misuse, better recovery in cases of depression and greater overall well-being.1–4”
Quote in the paperSubstantial claim0 of 4 sources checked- cites [1] Koenig HG, McCullough ME, Larson DB. Handbook of Religion and Health. Oxford University Press, 2001. source
Not checked in the free run.
- cites [2] Koenig HG, King D, Carson VB. Handbook of Religion and Health (2nd edn). Oxford University Press, 2012.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [3] Koenig HG. Research on religion, spirituality, and mental health: a review. Can J Psychiatry 2009; 54: 283– 91. 19497160 source
Not checked in the free run.
- cites [4] Bonelli R, Koenig HG. Mental disorders, religion and spirituality 1990 to 2010: a systematic evidence-based review. J Relig Health 2013; 52: 657– 73. 23420279 source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisereasoningMedical organisations including the WPA, RCPsych, APA, and ABP have created specific committees to handle matters related to the inclusion of religion/spirituality in clinical practice, medical training, and continuing education.
“Based on these growing number of studies supporting the relevance of religion/spirituality, medical organisations, among them the World Psychiatric Association (WPA), the Royal College of Psychiatrists (RCPsych), the American Psychiatric Association (APA) and more recently the Associação Brasileira de Psiquiatria (Brazilian Association of Psychiatry – ABP), have created specific committees to hand”
Quote in the paperNot a substantial claim0 of 4 sources checked- cites [5] American Psychiatric Association (APA), Committee on Religion and Psychiatry. Guidelines regarding possible conflict between psychiatrists’ religious commitments and psychiatric practice. Am J Psychiatry 1990; 147: 542. 11642759 source
Not checked in the free run.
- cites [6] Royal College of Psychiatrists. Spirituality and Psychiatry Special Interest Group. RCP, 1999 (http://www.rcpsych.ac.uk/college/specialinterestgroups/spirituality.aspx).
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [7] Cordeiro Q. Creation of the section on spirituality and mental health at the Brazilian Psychiatric Association. Psyche Spirit 2014; 1: 2– 3.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [8] Moreira-Almeida A, Sharma A, Rensburg B, Verhagen P, Cook C. WPA position statement on spirituality and religion in psychiatry. World Psychiatry 2016; 15: 87– 8. 26833620 PMC4780301 source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenParticipants had to agree and confirm electronically their free and informed decision to participate before completing the questionnaire.
“Before completing the questionnaire, the participants had to agree and confirm electronically their free and informed decision to participate in the survey.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenThe study was approved by the Research Ethics Committee of the University of São Paulo Medical School.
“The current project was approved by the Research Ethics Committee of the University of São Paulo Medical School.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim. May combine two claims.
Study design and conductown dataThe study was cross-sectional and collected information through self-reports of psychiatrists.
“This study has some methodological limitations. Among them, perhaps the most important, is its cross-sectional nature, with information being collected through the self-reports of psychiatrists.”
Quote in the paperSubstantial claimMay combine two claims.
Study design and conductown dataThe response rate was 28% (n=484 from a total of 1779), which could be considered relatively low and limits generalisation.
“In addition, a generalisation of the data has to be carried out carefully since the response rate could be considered as relatively low (28%), despite the overall sample size (n=484 from a total of 1779).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationCurlin et al. suggested that non-religious doctors might have been more inclined to participate in the research.
“Curlin et al28 suggested that non-religious doctors might have been more inclined to participate in the research.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [28] Curlin F, Chin M, Sellergren S, Roach C, Lantos J. The association of physicians’ religious characteristics with their attitudes and self-reported behaviors regarding religion and spirituality in the clinical encounter. Med Care 2006; 44: 446– 53. 16641663 source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationIn a recent Brazilian Internet survey involving 365 spiritist centres in São Paulo, only 15% agreed to participate.
“In a more recent example in Brazil of a survey through the Internet, involving 365 spiritist centres in the city of São Paulo,35 only 15% agreed to participate.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [35] Lucchetti AL, Lucchetti G, Leão FC, Peres MFP, Vallada H. Mental and physical health and spiritual healing: an evaluation of complementary religious therapies provided by spiritist centers in the city of São Paulo, Brazil. Cult Med Psychiatry 2016; 40: 404– 21. 26525690 source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationAn American study with general practitioners showed that the more they identified themselves as spiritual and religious, the more likely they were to enquire about their patients' religious/spiritual issues.
“These findings are similar to an American study28 performed with general practitioners, which showed the more they identified themselves as spiritual and religious, the more likely they were to enquire about their patients’ religious/spiritual issues.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [28] Curlin F, Chin M, Sellergren S, Roach C, Lantos J. The association of physicians’ religious characteristics with their attitudes and self-reported behaviors regarding religion and spirituality in the clinical encounter. Med Care 2006; 44: 446– 53. 16641663 source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationSome studies show that although psychiatrists consider it important to integrate religion/spirituality in the therapeutic context, in practice this does not often happen unless patients themselves took the initiative.
“Some studies show that although psychiatrists consider it important to integrate religion/spirituality in the therapeutic context, in practice this does not often happen,9,10 unless the patients themselves took the initiative.27”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites [9] Neeleman J, King M. Psychiatrists religious attitudes in relation to their clinical-practice – a survey of 231 psychiatrists. Acta Psychiatr Scand 1993; 88: 420– 4. 8310849 source
Not checked in the free run.
- cites [10] Baetz M, Griffin R, Bowen R, Marcoux G. Spirituality and psychiatry in Canada: psychiatric practice compared with patient expectations. Can J Psychiatry 2004; 49: 265– 71. 15147025 source
Not checked in the free run.
- cites [27] Durà-Vilà G, Hagger M, Dein S, Gerard L. Ethnicity, religion and clinical practice: a qualitative study of beliefs and attitudes of psychiatrists in the United Kingdom. Ment Health Relig Cult 2011; 14: 53– 64. source
Not checked in the free run.
May combine two claims.
PremisecitationStudies show that psychiatrists are often reluctant to participate in opinion polls and generally present a low return to surveys, including in Brazil.
“Studies show that psychiatrists are often reluctant to participate in opinion polls29 and generally present a low return to surveys, including in Brazil.30”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [29] Cunningham CT, Quan H, Hemmelgarn B, Noseworthy T, Beck CA, Dixon E, et al Exploring physician specialist response rates to web-based surveys. BMC Med Res Methodol 2015; 15: 32. 25888346 PMC4404667 source
Not checked in the free run.
- cites [30] Banzato C, Pereira M, Santos A Jr, Silva F, Loureiro J Jr, Barros B. What do Brazilian psychiatrists want from diagnostic classifications? J Bras Psiquiatr 2007; 56: 88– 93.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationPsychiatry was strongly influenced by Freudian views that referred to religious ideas as illusions, a product of neurosis and close to being 'psychiatric delusions'.
“For instance, it is worth remembering that psychiatry was strongly influenced by Freudian views that referred to religious ideas as being illusions, a product of neurosis and close to being ‘psychiatric delusions’.21”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [21] Freud S. The future of an illusion, civilization and its discontents. Reprinted (1953–1974). In The Standard Edition of the Complete Psychological Works of Sigmund Freud (trans & ed J Strachey): vol. 21, p. 31 Hogarth Press.
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenThe sample may have selected individuals who are more passionate about the issue both for and against, so that those who are more religious and those who are not religious may have felt more inclined to respond to the questionnaire.
“Another possible limitation of the sample is that it may have selected individuals who are more passionate about the issue both for and against, so that those who are more religious and those who are not religious may have felt more inclined to respond to the questionnaire.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationThe ability to differentiate the pathological from the non-pathological contents of some manifestations of religiosity/spirituality sometimes depends on specific training.
“They show that the ability to differentiate the pathological from the non-pathological contents of some manifestations of religiosity/spirituality sometimes depends on specific training.25”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [25] Moreira-Almeida A, Cardena E. Differential diagnosis between non-pathological psychotic and spiritual experiences and mental disorders: a contribution from Latin American studies to the ICD-11. Rev Bras Psiquiatr 2011; 33: 21– 36. 21845333 source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationSome authors have emphasised the importance of discussing religion/spirituality in the therapeutic context and distinguished between their positive and negative aspects.
“In addition, some authors have emphasised the importance of discussing religion/spirituality in the therapeutic context and distinguished between their positive and negative aspects.23,24”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [23] Koenig HG. Religion and mental health: what should psychiatrists do? Psychiatr Bull 2008; 32: 201– 3.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [24] Moreira-Almeida A, Koenig HG, Lucchetti G. Clinical implications of spirituality to mental health: review of evidence and practical guidelines. Rev Bras Psiquiatr 2014; 36: 176– 82. 24839090 source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductreasoningThe terms religion and spirituality were not defined in the present work, allowing respondents to apply their own definitions, and therefore the survey results should be interpreted with caution.
“In the present work, the terms religion and spirituality were not defined, allowing the respondents to apply their own definitions, and therefore, the survey results should be interpreted with caution.”
Quote in the paperNot a substantial claim- Rests on an assumption: There is no universal definition accepted by researchers for spirituality and religiosity.
May combine two claims.
Interpretationcitation28% of those contacted completed the survey, a participation percentage higher than in other studies using a similar methodology.
“However, 28% of those contacted completed the survey, a participation percentage higher than in other studies using a similar methodology.31,32”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [31] Nulty D. The adequacy of response rates to online and paper surveys: what can be done? Assess Eval High Educ 2008; 33: 301– 14.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [32] Duarte G, Osis M, Faúndes A, De Sousa M. Brazilian abortion law: the opinion of judges and prosecutors. Rev Saúde Pública 2010; 44: 406– 20. 20464265 source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationThe majority of the Brazilian population is Catholic.
“Although the majority of the Brazilian population is Catholic, it has been characterised by an increasing diversity of religious groups since the early 20th century.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [16] Instituto Brasileiro de Geografia e Estatística (IBGE). Censo Demográfico 2010: características gerais da população, religião e pessoas com deficiência [Demographic Census 2010: general characteristics of the population, religion and people with disabilities]. IBGE, 2010 (http://biblioteca.ibge.gov.br/biblioteca-catalogo?view=detalhes&id=794).
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationThere is a lack of empirical studies and a satisfactory theoretical basis to explain gender differences in religiosity.
“Despite the good empirical evidence to support these observations, there is a lack of empirical studies and a satisfactory theoretical basis to explain these differences.19”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [19] Francis LJ. The psychology of gender differences in religion: a review of empirical research. Religion 1997; 27: 81– 96.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationThe Brazilian population is 92% religious affiliation.
“in comparison with 92% of the Brazilian population.16”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [16] Instituto Brasileiro de Geografia e Estatística (IBGE). Censo Demográfico 2010: características gerais da população, religião e pessoas com deficiência [Demographic Census 2010: general characteristics of the population, religion and people with disabilities]. IBGE, 2010 (http://biblioteca.ibge.gov.br/biblioteca-catalogo?view=detalhes&id=794).
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
May combine two claims.
PremisecitationAmerican psychiatrists have 82% religious affiliation, German 70.7%, and South African 84%.
“They also tended to have less religious affiliation when compared with psychiatrists in the United States (82%),17 Germany (70.7%)11 and South Africa (84%).12”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites [17] Curlin F, Odell S, Lawrence R, Chin M, Lantos J, Meador K, et al The relationship between psychiatry and religion among US physicians. Psychiatr Serv 2007; 58: 1193– 8. 17766565 PMC2867459 source
Not checked in the free run.
- cites [11] Lee E, Baumann K. German psychiatrists’ observation and interpretation of religiosity/spirituality. Evid Based Complement Alternat Med 2013; 2013: 280168 (Epub). 24348695 PMC3847966 source
Not checked in the free run.
- cites [12] Welgemoed M, Staden C. Does religious identification of South African psychiatrists matter in their approach to religious matters in clinical practice? S Afr J Psychiatr 2014; 20: 140– 5. source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationA Canadian study reported that female psychiatrists had higher rates of religious beliefs, religious practices and intrinsic religiosity than male colleagues.
“For example, a Canadian study10 reported that female psychiatrists had higher rates of religious beliefs, religious practices and intrinsic religiosity than male colleagues.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [10] Baetz M, Griffin R, Bowen R, Marcoux G. Spirituality and psychiatry in Canada: psychiatric practice compared with patient expectations. Can J Psychiatry 2004; 49: 265– 71. 15147025 source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationThe Catholic religion is still by far the largest in Brazil.
“However, the Catholic religion is still by far the largest in Brazil”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [16] Instituto Brasileiro de Geografia e Estatística (IBGE). Censo Demográfico 2010: características gerais da população, religião e pessoas com deficiência [Demographic Census 2010: general characteristics of the population, religion and people with disabilities]. IBGE, 2010 (http://biblioteca.ibge.gov.br/biblioteca-catalogo?view=detalhes&id=794).
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationThe Brazilian census shows an increase in Evangelical religions and Spiritism at the expense of Catholicism.
“The Brazilian census shows an increase in Evangelical religions and Spiritism (a religious and philosophical movement initiated in the second half of the 19th century), at the expense of Catholicism.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [16] Instituto Brasileiro de Geografia e Estatística (IBGE). Censo Demográfico 2010: características gerais da população, religião e pessoas com deficiência [Demographic Census 2010: general characteristics of the population, religion and people with disabilities]. IBGE, 2010 (http://biblioteca.ibge.gov.br/biblioteca-catalogo?view=detalhes&id=794).
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationSpiritism has been popular amongst liberal professionals in Brazil but Evangelicals are usually more prevalent in the middle-low and low socioeconomic levels.
“Spiritism has been popular amongst liberal professionals in Brazil but the Evangelicals are usually more prevalent in the middle-low and low socioeconomic levels.16”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [16] Instituto Brasileiro de Geografia e Estatística (IBGE). Censo Demográfico 2010: características gerais da população, religião e pessoas com deficiência [Demographic Census 2010: general characteristics of the population, religion and people with disabilities]. IBGE, 2010 (http://biblioteca.ibge.gov.br/biblioteca-catalogo?view=detalhes&id=794).
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationA Canadian study about psychiatrists shows that as the years of professional practice increased, the importance attributed by psychiatrists to religion/spirituality in psychiatry decreased.
“A similar observation is presented in a Canadian study about psychiatrists10 which shows that as the years of professional practice increased, the importance attributed by psychiatrist to religion/spirituality in psychiatry decreased.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [10] Baetz M, Griffin R, Bowen R, Marcoux G. Spirituality and psychiatry in Canada: psychiatric practice compared with patient expectations. Can J Psychiatry 2004; 49: 265– 71. 15147025 source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationAmerican psychiatrists have 65% belief in God, German 56%, Canadian 54%, and British 23%.
“when compared with American (65%),17 German (56%),11 Canadian (54%)10 and British (23%) psychiatrists.9”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites [17] Curlin F, Odell S, Lawrence R, Chin M, Lantos J, Meador K, et al The relationship between psychiatry and religion among US physicians. Psychiatr Serv 2007; 58: 1193– 8. 17766565 PMC2867459 source
Not checked in the free run.
- cites [11] Lee E, Baumann K. German psychiatrists’ observation and interpretation of religiosity/spirituality. Evid Based Complement Alternat Med 2013; 2013: 280168 (Epub). 24348695 PMC3847966 source
Not checked in the free run.
- cites [10] Baetz M, Griffin R, Bowen R, Marcoux G. Spirituality and psychiatry in Canada: psychiatric practice compared with patient expectations. Can J Psychiatry 2004; 49: 265– 71. 15147025 source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationIn the UK, a quarter of the population and 73% of psychiatrists have no religion.
“These levels are even more relevant when compared with the UK figures, in which a quarter of the population18 and 73% of psychiatrists have no religion.9”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [18] Office of National Statistics UK. Religion in England and Wales 2011 (https://www.ons.gov.uk/peoplepopulationandcommunity/culturalidentity/religion/articles/religioninenglandandwales2011/2012-12-11#measuring-religion).
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [9] Neeleman J, King M. Psychiatrists religious attitudes in relation to their clinical-practice – a survey of 231 psychiatrists. Acta Psychiatr Scand 1993; 88: 420– 4. 8310849 source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationNeeleman & King in the UK found that the rate of female psychiatrists who believed in God was higher.
“Neeleman & King9 in the UK also found that the rate of female psychiatrists who believed in God was higher.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [9] Neeleman J, King M. Psychiatrists religious attitudes in relation to their clinical-practice – a survey of 231 psychiatrists. Acta Psychiatr Scand 1993; 88: 420– 4. 8310849 source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationPsychiatry has been described as the least religious among medical specialties.
“Among the medical specialties, psychiatry has been described as the least religious.13,20”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [13] Curlin F, Lawrence R, Odell S, Chin M, Lantos J, Koenig HG, et al Religion, spirituality, and medicine: Psychiatrists’ and other physicians’ differing observations, interpretations, and clinical approaches. Am J Psychiatry 2007; 164: 1825– 31. 18056237 PMC2861911 source
Not checked in the free run.
- cites [20] Robinson K, Cheng M, Hansen P, Gray R. Religious and Spiritual Beliefs of Physicians (http://link.springer.com/article/10.1007/s10943-016-0233-8). 27071796 source
Not checked in the free run.
The paper relies on this without support.
There is a lack of information about how Brazilian psychiatrists deal with religion/spirituality.
“Owing to the lack of information about how Brazilian psychiatrists deal with religion/spirituality, the present work attempts to assess their current view on religion/spirituality”
The paper relies on this without support.
This study is the first systematic evaluation of religion/spirituality in psychiatric practice carried out in Brazil.
“Apart from being the first systematic evaluation into religion/spirituality in psychiatric practice to be carried out in Brazil”
The paper relies on this without support.
Brazilian psychiatrists belonging to the ABP are representative of Brazilian psychiatrists in general.
“This was a cross-sectional study of 3120 psychiatrists belonging to the ABP who were emailed information on the study and invited to participate by completing a confidential online questionnaire.”
The paper relies on this without support.
The self-reported questionnaire responses accurately reflect the psychiatrists' actual beliefs and behaviours.
“It consists of self-reported questions to assess the following three main areas.”
The paper relies on this without support.
Non-response bias does not substantially affect the results.
“From those 1779 email addresses, 492 completed the questionnaire (28%).”
The paper relies on this without support.
The adapted Portuguese version of the questionnaire is a valid measure for Brazilian psychiatrists.
“The survey was adapted and translated into Portuguese by one of the authors (M.F.P.P.) and revised by another (M.C.M.-C.).”
The paper relies on this without support.
This is the first systematic Brazilian survey asking psychiatrists about religion/spirituality in their practice and whether their own beliefs influence their clinical work.
“This is the first systematic Brazilian survey asking psychiatrists about religion/spirituality in their practice, and whether their own beliefs influence their clinical work.”
The paper relies on this without support.
There are no studies addressing the relationship between subspecialties in psychiatry and religion/spirituality.
“To our knowledge, there are no studies addressing the relationship between subspecialties in psychiatry and religion/spirituality, making it an interesting subject for further investigation.”
The paper relies on this without support.
There is no universal definition accepted by researchers for spirituality and religiosity.
“In addition, since there is no universal definition accepted by researchers, this lack of consensus also causes difficulty and requires caution when comparing the results between studies.”
The paper relies on this without support.
The Brazilian population is characterised by religious syncretism.
“Perhaps, since they belong to a society characterised by religious syncretism, it may be more difficult for them to relate to a specific religion, but they still reflect the high degree of religiosity of the Brazilian population.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
A survey of 484 Brazilian psychiatrists revealed that most (76.8%) consider it very, or reasonably, important to integrate patient R/S into clinical practice, although more than half (55.5%) do not usually inquire about patient R/S.
“A survey of 484 Brazilian psychiatrists revealed that most (76.8%) consider it very, or reasonably, important to integrate patient R/S into clinical practice, although more than half (55.5%) do not usually inquire about patient R/S.”
From Brazilian Psychiatric Association guidelines on the integration of spirituality into mental health clinical practice: Part 1. Spiritual history and differential diagnosis (2023) · cites this paper as [32]
The Results report 484 respondents and say 76.8% considered integration very or reasonably important. The Results also report that 45.5% frequently enquired about patients’ religion/spirituality, implying 54.5% did not—not the claimed 55.5%. The paper’s Abstract gives 55.5%, but that figure is inconsistent with the detailed Results. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThe main reported barriers to addressing R/S in clinical practice were concerns about overstepping ethical boundaries (30.2%), a lack of training in R/S (22.3%), and a lack of time (16.3%).
“The main reported barriers to addressing R/S in clinical practice were: i) concerns about overstepping ethical boundaries (30.2%), ii) a lack of training in R/S (22.3%), and iii) a lack of time (16.3%).32”
The most common reasons for not enquiring about patients' R/S included fear of exceeding the role of the doctor (30.2%) and lack of training (22.3%).
“The most common reasons for not doing so included being afraid of exceeding the role of the doctor (30.2%) and lack of training (22.3%).16”
From How psychiatrists think about religious and spiritual beliefs in clinical practice: findings from a university hospital in São Paulo, Brazil (2019) · cites this paper as [16]
In a survey of 484 Brazilian psychiatrists, more than half (55.5%) did not enquire frequently about their patients' R/S.
“In a recent survey of 484 Brazilian psychiatrists, all members of the ABP, Menegatti-Chequini et al. found that more than half of the participants (55.5%) did not enquire frequently about their patients’ R/S.”
From How psychiatrists think about religious and spiritual beliefs in clinical practice: findings from a university hospital in São Paulo, Brazil (2019) · cites this paper as [16]
When psychiatrists consider themselves more religious or spiritual, they are more likely to ask patients about R/S and to see integration of R/S into clinical practice as important.
“When psychiatrists consider themselves to be more religious or spiritual, they are also more likely to ask their patients about their R/S and to see the integration of R/S into clinical practice as important.16”
From How psychiatrists think about religious and spiritual beliefs in clinical practice: findings from a university hospital in São Paulo, Brazil (2019) · cites this paper as [16]
The data are in accordance with previous reports that psychiatrists are less likely to believe in God and declare a religious affiliation than the general population or physicians from other specialties.
“Our data are in accordance with previous reports in which psychiatrists were less likely to believe in God and declare a religious affiliation than the general population16-18,30 or physicians from other specialties.31”
From How psychiatrists think about religious and spiritual beliefs in clinical practice: findings from a university hospital in São Paulo, Brazil (2019) · cites this paper as [16]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Two different percentages are given for very religious psychiatrists
MinorThe discussion gives 17%, whereas the results and Table 1 give 13.7% (66 respondents) for the same category.
“the psychiatrists in our study who declared themselves to be very religious were relatively few (17%)”
“| Very religious | 66 (13.7) |”
Non-enquiry percentage conflicts with the reported response counts
MinorThe table records 168 occasional, 67 rare and 28 never responses: 263 of the 483 psychiatrists who answered the question, or 54.5%, did not enquire frequently. The abstract reports 55.5%.
“more than half of the 484 participants (55.5%) did not usually enquire about patients’ religion/spirituality.”
“| Frequently | 220 (45.5) | | Occasionally | 168 (34.8) | | Rarely | 67 (13.9) | | Never | 28 (5.8) | | mv | 1 |”
Overall partnered percentage exceeds both subgroup percentages
MinorThe affiliated and unaffiliated groups partition the sample. Their reported partnered percentages are 70.3% and 70.1%, so the overall percentage among respondents cannot be 70.9%.
“The majority (70.9%) were married or in a stable relationship, both in the group who had a religious affiliation (70.3%) and in the group who did not have a religious affiliation (70.1%).”
“| With partner | 338 (70.9) | 111 (70.1) | 227 (70.3) | 0.97 (0.63–1.51) |”
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Koenig, H. G., VanderWeele, T. J., & Peteet, J. R. (2023) · Oxford University Press eBooks · doi:10.1093/oso/9780190088859.002.0004
Personality Traits and Disorders
Koenig, H. G., VanderWeele, T. J., & Peteet, J. R. (2023) · Oxford University Press eBooks · doi:10.1093/oso/9780190088859.003.0011
Schizophrenia and Other Psychoses
Koenig, H. G., VanderWeele, T. J., & Peteet, J. R. (2023) · Oxford University Press eBooks · doi:10.1093/oso/9780190088859.003.0009
Koenig, H. G., VanderWeele, T. J., & Peteet, J. R. (2023) · Oxford University Press eBooks · doi:10.1093/oso/9780190088859.003.0004
Koenig, H. G., VanderWeele, T. J., & Peteet, J. R. (2023) · Oxford University Press eBooks · doi:10.1093/oso/9780190088859.003.0018
Koenig, H. G., VanderWeele, T. J., & Peteet, J. R. (2023) · Oxford University Press eBooks · doi:10.1093/oso/9780190088859.003.0003
Koenig, H. G., VanderWeele, T. J., & Peteet, J. R. (2023) · Oxford University Press eBooks · doi:10.1093/oso/9780190088859.003.0013
Koh, H. K. (2023) · Oxford University Press eBooks · doi:10.1093/oso/9780190088859.002.0006
Koenig, H. G., VanderWeele, T. J., & Peteet, J. R. (2023) · Oxford University Press eBooks · doi:10.1093/oso/9780190088859.003.0028
Koenig, H. G., VanderWeele, T. J., & Peteet, J. R. (2023) · Oxford University Press eBooks · doi:10.1093/oso/9780190088859.003.0022
Studies on Religion and Health
Koenig, H. G., VanderWeele, T. J., & Peteet, J. R. (2023) · Oxford University Press eBooks · doi:10.1093/oso/9780190088859.005.0001
Menegatti-Chequini, M. C., Loch, A. A., Leão, F. C., Peres, M. F. P., & Vallada, H. (2020) · Figshare · doi:10.6084/m9.figshare.13279173
Self-citationPreferences for Religious and Spiritual Discussion in Saudi Psychiatric Care
Bogari, M. H., Maddah, M., & Mamdouh, B. (2026) · Cureus · doi:10.7759/cureus.116059
- Authors
- Menegatti-Chequini, M. C., Gonçalves, J. P. B., Leão, F. C., Peres, M. F. P., & Vallada, H.
- Affiliations
- Universidade de São Paulo (BR)
- Corresponding author
- Menegatti-Chequini, Maria Cecilia
- Venue
- BJPsych Open
- Publisher
- Royal College of Psychiatrists
- Published
- 2016-11
- Volume
- 2
- Issue
- 6
- Pages
- 346-352
- ISSN
- 2056-4724 (ISSN-L)
- PMC
- PMC5099984
- OpenAlex
- W2546418622
- Semantic Scholar
- e194135a76f21180e600b9c0b9f9107c3a3278e5
- Cited by
- 65
- References
- 35
- Citations by year
- 2026: 1 · 2025: 1 · 2023: 44 · 2022: 2 · 2021: 4 · 2020: 5 · 2019: 1 · 2018: 4 · 2017: 3
- FWCI
- 3.52
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BJPsych Open (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Topics
- Social Sciences › Health › Religion, Spirituality, and Psychology
- Social Sciences › Demography › Workplace Spirituality and Leadership
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- religion and spirituality, physician-patient rapport
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-09.
Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-09.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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