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Cited by 28Religion, Spirituality, and PsychologyWorkplace Spirituality and LeadershipStudy and Philosophy of Religion

How psychiatrists think about religious and spiritual beliefs in clinical practice: findings from a university hospital in São Paulo, Brazil

Open access
Menegatti-Chequini, Maria C., Maraldi, Everton de O., Peres, Mario F.P., Leão, Frederico C., Vallada, Homero·2019·Brazilian Journal of Psychiatry
DOI 10.1590/1516-4446-2017-2447PMC PMC6781700
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Abstract

OBJECTIVE: To examine the relationship between psychiatrists' religious/spiritual beliefs and their attitudes regarding religion and spirituality in clinical practice. METHODS: A cross-sectional survey of religion/spirituality (R/S) in clinical practice was conducted with 121 psychiatrists from the largest academic hospital complex in Brazil. RESULTS: When asked about their R/S beliefs, participants were more likely to consider themselves as spiritual rather than religious. A total of 64.2% considered their religious beliefs to influence their clinical practice and 50% reported that they frequently enquired about their patients' R/S. The most common barriers to approaching patients' religiosity were: lack of time (27.4%), fear of exceeding the role of the doctor (25%), and lack of training (19.1%). Those who were less religious or spiritual were also less likely to find difficulties in addressing a patient's R/S. CONCLUSION: Differences in psychiatrists' religious and spiritual beliefs are associated with different attitudes concerning their approach to R/S. The results suggest that medical practice may lead to a religious conflict among devout psychiatrists, making them question their faith. Training might be of importance for handling R/S in clinical practice and for raising awareness about potential evaluative biases in the assessment of patients' religiosity.

AI snapshot

Written from the paper’s full text.

TL;DR

In a cross-sectional survey of 84 psychiatrists at a Brazilian university hospital, participants were more likely to identify as spiritual than religious, and their religious/spiritual characteristics were associated with how they approached patients’ religion/spirituality (R/S). About two-thirds said their beliefs influenced clinical practice, half frequently asked about patients’ R/S, and common barriers included lack of time, fear of exceeding the doctor’s role, and lack of training.

Key findings

  • Participants were slightly more spiritual (mean = 2.43, SD ± 0.92) than religious (mean = 1.96, SD ± 0.95); 53.5% considered themselves very or moderately spiritual, while 31% considered themselves very or moderately religious.
  • 64.2% said their religious/spiritual beliefs influenced their clinical practice, and 50% reported frequently enquiring about patients’ R/S; 88.1% considered enquiring about patient R/S something the psychiatrist can or should do.
  • The most common barriers to addressing patient R/S were lack of time (27.4%), fear of exceeding the role of the doctor (25%), and lack of training (19.1%).
  • Less religious or spiritual psychiatrists were less likely to report difficulties addressing patient R/S; in regression, the strongest predictors of less frequent enquiry were “it is not the doctor’s job” (β = -0.42), “do not know why” (β = -0.30), and lack of time (β = -0.25).

Methods

  • Cross-sectional survey of psychiatrists working at IPq-HC-FMUSP, the largest academic psychiatric hospital in Brazil; 121 psychiatrists were approached, 86 responded (71%), and 84 questionnaires were analyzed. Data collection occurred December 2013 to May 2014.
  • A self-report questionnaire based on Curlin et al.’s “Religion and Spirituality in Medicine: Physicians’ Perspectives” was translated into Portuguese and pilot-tested with 30 health professionals and 20 psychiatry residents.
  • Analyses used SPSS version 17, including chi-square tests, t-tests, ANOVA, Pearson correlations, and stepwise multiple regression.

Limitations

  • The paper states that the range of religious and spiritual beliefs covered was very limited; the sample was restricted to one institution and cannot be generalized to all Brazilian psychiatrists; and self-report questionnaires are vulnerable to response bias.
  • The text makes evident that the cross-sectional design cannot establish causal direction between psychiatrists’ R/S characteristics and their clinical attitudes or behaviors.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1590/1516-4446-2017-2447

Cites

33 of 33 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 40 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    50% of participants reported frequently enquiring about their patients' R/S.

    “50% reported that they frequently enquired about their patients’ R/S.”
    • Also stated in: § Attitudes and behaviors related to the approach to R/S in clinical practice · plain
      “Half of the sample (50%) answered that they frequently ask their patients about their religious/spiritual beliefs”
    Quote in the paperNot a substantial claim
  • Findingown data

    64.2% of participants considered their religious and spiritual beliefs to influence their clinical practice.

    “A total of 64.2% considered their religious beliefs to influence their clinical practice”
    • Also stated in: § Attitudes and behaviors related to the approach to R/S in clinical practice · plain
      “More than half of the sample (64.2%) considered their religious and spiritual beliefs to influence their clinical practice.”
    Quote in the paperSubstantial claim
  • Findingown data

    Participants in the sample were more likely to consider themselves spiritual rather than religious.

    “When asked about their R/S beliefs, participants were more likely to consider themselves as spiritual rather than religious.”
    • Also stated in: § Religious and spiritual beliefs · plain
      “the participants in this sample were slightly more spiritual (mean [M] = 2.43; standard deviation [SD] ± 0.92) than religious (M = 1.96; SD ± 0.95).”
    • Also stated in: § Discussion · plain
      “Similar to what was observed in previous investigations,15,17 the psychiatrists in this sample consider themselves more spiritual than religious.”
    Quote in the paperNot a substantial claim
  • Findingown data

    Psychiatrists who were less religious or spiritual were less likely to find difficulties in addressing a patient's R/S.

    “Those who were less religious or spiritual were also less likely to find difficulties in addressing a patient’s R/S.”
    • Also stated in: § Attitudes and behaviors related to the approach to R/S in clinical practice · hedged
      “Almost half of the sample stated that they have no difficulty in addressing the religiosity and spirituality of their patients, and they were more likely to be male than female (Fisher’s exact test, p = 0.041; adjusted residual = 2.2), as well as less spiritual (M = 2.19; SD ± 0.97; t [82] = 2.16; p = 0.034) and less religious (M = 1.68; SD ± 0.81; t [82] = 2.55; p = 0.013).”
    • Also stated in: § Discussion · plain
      “Accordingly, those who were less religious and less spiritual were less likely to find difficulties in addressing the patient’s R/S.”
    Quote in the paperSubstantial claim
  • Findingown data

    Psychiatrists dedicated to child psychiatry presented higher levels of spirituality.

    “Those dedicated to child psychiatry presented higher levels of spirituality (Table 1).”
    Quote in the paperNot a substantial claim
  • May combine two claims. 26
  • Classified as probably not a substantial claim. 15

  • May combine two claims.

    Findingown data

    The most common barriers to approaching patients' R/S were lack of time (27.4%), fear of exceeding the role of the doctor (25%), and lack of training (19.1%).

    “The most common barriers to approaching patients’ religiosity were: lack of time (27.4%), fear of exceeding the role of the doctor (25%), and lack of training (19.1%).”
    • Also stated in: § Attitudes and behaviors related to the approach to R/S in clinical practice · plain
      “The most commonly reported barriers to approaching patient R/S in clinical practice were lack of time, fear of exceeding the role of the doctor, and lack of training”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Almost two-thirds of the participants were male.

    “Almost two-thirds of the participants were male.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    More than half of the psychiatrists (57.7%) said they had a religion, of which the majority was Catholic.

    “More than half of the psychiatrists (57.7%) said they had a religion, of which the majority was Catholic (Table 2).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Only 31% of respondents considered themselves very or moderately religious, whereas 53.5% considered themselves very or moderately spiritual.

    “Only 31% of the respondents considered themselves to be very or moderately religious, whereas 53.5% considered themselves to be very or moderately spiritual.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    58.3% of respondents look for God as a source of strength, support and guidance, while 83.3% decide what to do without relying on God.

    “Regarding religious coping, 58.3% of the respondents look for God as a source of strength, support and guidance, while 83.3% decide what to do without relying on God.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Almost half of the sample stated they have no difficulty addressing patients' R/S; they were more likely to be male, less spiritual, and less religious.

    “Almost half of the sample stated that they have no difficulty in addressing the religiosity and spirituality of their patients, and they were more likely to be male than female (Fisher’s exact test, p = 0.041; adjusted residual = 2.2), as well as less spiritual (M = 2.19; SD ± 0.97; t [82] = 2.16; p = 0.034) and less religious (M = 1.68; SD ± 0.81; t [82] = 2.55; p = 0.013).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingnone given

    Although there were no R/S differences between genders, women appeared to give particular relevance to such topics, in a way different from male psychiatrists.

    “Although there were no R/S differences between genders, women appeared to give particular relevance to such topics, in a way that is different from male psychiatrists, which should be further investigated.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Questioning of faith showed moderate correlations with different religious and spiritual characteristics, indicating that the more religious or spiritual the psychiatrists were, the more their work as physicians made them question their religious and spiritual beliefs.

    “Questioning of faith showed moderate correlations with different religious and spiritual characteristics (Table 4), indicating that the more religious or spiritual the psychiatrists were, the more their work as physicians made them question their religious and spiritual beliefs.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    The percentage of participants with a religious affiliation in this sample was lower than that of Brazilian physicians from other specialties (94.9%) and medical students from 12 different schools of medicine (66.1%).

    “The percentage in our sample was also lower than that of Brazilian physicians from other specialties (94.9%)28 and that of medical students from 12 different schools of medicine (66.1%).29”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [28] Lucchetti G, 2016, Spirituality, religiosity, and health: a comparison of physicians' attitudes in Brazil, India, and Indonesia, Int J Behav Med source

      Not checked in the free run.

    • cites [29] Lucchetti G, 2013, Medical students, spirituality and religiosity-results from the multicenter study SBRAME, BMC Med Educ source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Compared to medical students, this sample showed lower percentages for belief in God (59.5% vs 84.2%), belief in life after death (28.6% vs 66.8%), and belief in reincarnation (19% vs 36.9%).

    “Compared to medical students, our sample also showed lower percentages for belief in God (59.5% vs. 84.2%), belief in life after death (28.6% vs. 66.8%), and belief in reincarnation (19% vs. 36.9%).29”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [29] Lucchetti G, 2013, Medical students, spirituality and religiosity-results from the multicenter study SBRAME, BMC Med Educ source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    More than half of the participants reported a religious affiliation, a percentage significantly lower than that of the Brazilian population, of which only 8% said they had no religion.

    “More than half of the participants reported a religious affiliation, a percentage significantly lower than that of the Brazilian population, of which only 8% said they had no religion.24”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [24] 2010

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    Although half of the psychiatrists in this study often address their patients' R/S, most report difficulties in approaching this topic and almost half report that their beliefs strongly or moderately influence their medical practice.

    “In conclusion, although half of the psychiatrists in this study often address their patients’ R/S, most report difficulties in approaching this topic and almost half report that their beliefs strongly or moderately influence their medical practice.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    A large majority of physicians consider it important to integrate R/S into their practice, but most face difficulties in addressing such topics due to lack of time and lack of appropriate training.

    “The evidence shows that a large majority of physicians consider it important to integrate R/S into their practice, but most of them face difficulties in addressing such topics with their patients, due to a lack of time and a lack of appropriate training.13,14”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [13] Curlin FA, 2006, The association of physicians' religious characteristics with their attitudes and self-reported behaviors regarding religion and spirituality in the clinical encounter, Med Care source

      Not checked in the free run.

    • cites [14] Moreira-Almeida A, 2014, Clinical implications of spirituality to mental health: review of evidence and practical guidelines, Rev Bras Psiquiatr source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The benefits of R/S include patients with severe mental illness.

    “Such benefits are not restricted to mild and moderate conditions, but also include patients with severe mental illness.6”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [6] Pargament KI, 2013, Understanding and addressing religion among people with mental illness, World Psychiatry source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    R/S is associated with improved well-being, feelings of meaning and peace, and reductions in suicide rates, depression, anxiety, and substance abuse.

    “Overall, research in the mental health area indicates that R/S is associated with improved well-being, feelings of meaning and peace,3 and reductions in suicide rates, depression, anxiety, and substance abuse.4,5”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [3] Peres MF, 2017

      Not checked in the free run.

    • cites [4] Koenig HG, 2012

      Not checked in the free run.

    • cites [5] Bonelli RM, 2013, Mental disorders, religion and spirituality 1990 to 2010: a systematic evidence-based review, J Relig Health source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Evidence indicates a positive relationship between religious involvement/spirituality and physical health, mental health, and coping capacity.

    “The evidence obtained so far indicates a positive relationship between religious involvement/spirituality (R/S) and physical health on one side and mental health and R/S on the other, including an increase in coping capacity.2”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [2] Moreira-Almeida A, 2006, Religiousness and mental health: a review, Rev Bras Psiquatr source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    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”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [16] Menegatti-Chequini MC, 2016, A preliminary survey on the religious profile of Brazilian psychiatrists and their approach to patients' religiosity in clinical practice, BJPsych Open 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 conductown data

    The questionnaire was translated into Portuguese and pilot tested with 30 health professionals and 20 psychiatry residents; the questions were considered clear and no additional adaptation was necessary.

    “The questionnaire was translated into Portuguese and tested in a pilot study with two groups: initially with 30 health professionals (from different specialties) and with 20 psychiatrists in training (residents) at IPq-HC-FMUSP. The questions were considered clear and no additional adaptation was necessary during the testing phase.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    IPq-HC-FMUSP is the largest academic psychiatric hospital in Brazil and a national reference in psychiatry.

    “The IPq-HC-FMUSP is the largest academic psychiatric hospital in Brazil and a national reference in psychiatry.21”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [21] Seixas A, 2012, O Instituto de psiquiatria do Hospital das Clinicas - FMUSP, História da psiquiatria: ciências, prática e tecnologias de uma especialidade médica. São Paulo: Casa de Soluções e Editora

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Psychiatrists reported having fewer difficulties and more experience in handling patients' R/S, but these attitudes have not always been reflected in practice, and they face the same barriers as other medical specialists.

    “Even though psychiatrists reported having fewer difficulties and more experience in handling their patients’ R/S, these attitudes and perceptions have not always been reflected in their practice, and they face the same barriers as other medical specialists when approaching patients’ R/S.15”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [15] Curlin FA, 2007, Religion, spirituality, and medicine: psychiatrists' and other physicians' differing observations, interpretations, and clinical approaches, Am J Psychiatry source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Although the sample is not representative of Brazilian psychiatrists, the obtained results reflect the beliefs, attitudes, and behaviors of influential professionals in this area regarding R/S.

    “In this respect, although not representative of Brazilian psychiatrists, the obtained results reflect the beliefs, attitudes, and behaviors of influential professionals in this area regarding R/S.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Of 121 psychiatrists employed by IPq-HC-FMUSP, 86 answered the questionnaire (71%); two response forms were eliminated due to incompleteness, and 84 were analyzed.

    “Of the 121 psychiatrists employed by IPq-HC-FMUSP, 86 answered the questionnaire (71%). Two response forms were eliminated due to incompleteness. The remaining 84 were analyzed.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    The finding that psychiatrists consider themselves more spiritual than religious may reflect an understanding of spirituality as a broader category than religion or religiosity.

    “This finding may reflect an understanding of spirituality as a broader category than religion or religiosity.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Spirituality has been found in many studies to be related to a sense of well-being, a sense of purpose in life, and experiences of life satisfaction without necessarily depending on commitment to a religious community.

    “Spirituality was found in many studies to be related to a sense of well-being, a sense of purpose in life and experiences of life satisfaction without necessarily depending on commitment to a religious community.3,27”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [3] Peres MF, 2017

      Not checked in the free run.

    • cites [27] Goldim J, 2007, Bioética e espiritualidade, Porto Alegre: EDIPUCRS

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Curlin et al. reported that family physicians and pediatricians are more religious than physicians from other specialties.

    “Interestingly, Curlin et al.26 reported that family physicians and pediatricians are more religious than physicians from other specialties.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [26] Curlin FA, 2005, Religious characteristics of U.S. physicians: a national survey, J Gen Intern Med source

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    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”
    Quote in the paperNot a substantial claim0 of 5 sources checked
    • cites [16] Menegatti-Chequini MC, 2016, A preliminary survey on the religious profile of Brazilian psychiatrists and their approach to patients' religiosity in clinical practice, BJPsych Open source

      Not checked in the free run.

    • cites [17] Neeleman J, 1993, Psychiatrists religious attitudes in relation to their clinical-practice - a survey of 231 psychiatrists, Acta Psychiatr Scand source

      Not checked in the free run.

    • cites [18] Baetz M, 2004, Spirituality and psychiatry in Canada: psychiatric practice compared with patient expectations, Can J Psychiatry source

      Not checked in the free run.

    • cites [30] Bergin AE, 1990, Religiosity of psychotherapists: a national survey, Psychotherapy (Chic) source

      Not checked in the free run.

    • cites [31] Curlin FA, 2007, The relationship between psychiatry and religion among US physicians, Psychiatr Serv source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    According to Curlin et al., historical tensions between psychiatry and religion influenced many psychiatrists in the past century and continue to be influential today.

    “According to Curlin et al.,31 the historical tensions between psychiatry and religion influenced many psychiatrists in the past century and continue to be influential today.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [31] Curlin FA, 2007, The relationship between psychiatry and religion among US physicians, Psychiatr Serv source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Some authors attribute the finding of psychiatrists' lower religiosity to the influence of psychological theories, such as Freud's psychoanalysis, which pathologized religious behavior.

    “Some authors33,34 attribute this finding to the influence of psychological theories, such as Sigmund Freud's35 psychoanalysis, which is known to have pathologized religious behavior.”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [33] Neeleman J, 1995, Why do psychiatrists neglect religion, Br J Med Psychol source

      Not checked in the free run.

    • cites [34] Koenig HG, 2009, Research on religion, spirituality, and mental health: a review, Can J Psychiatry source

      Not checked in the free run.

    • cites [35] Freud S, The future of an illusion, civilization and its discontents., The Standard Edition of the Complete Psychological Works of Sigmund Freud (trans & ed. Strachey)

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    More recently, a culturally sensitive understanding of trance and possession experiences has emerged, and specific diagnostic criteria have been developed to differentiate pathological from culturally accepted and healthy spiritual manifestations.

    “More recently, a culturally sensitive understanding of these experiences has emerged, and specific diagnostic criteria have been developed to help differentiate pathological from culturally accepted and healthy spiritual manifestations.37”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [37] Moreira-Almeida A, 2011, 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

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The range of religious and spiritual beliefs covered in the questionnaire is very limited.

    “First, the range of religious and spiritual beliefs covered in the questionnaire is very limited.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Mental health professionals do not generally receive adequate training to address the R/S aspects of their patients, including experiences of possession, which is important for avoiding erroneous diagnoses and iatrogenic symptoms.

    “Still, mental health professionals do not generally receive adequate training to address the R/S aspects of their patients,38 including experiences of possession, which would be of paramount importance for avoiding erroneous diagnoses and iatrogenic symptoms.37,39”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [38] Moreira-Almeida A, 2017, Methodological guidelines to investigate altered states of consciousness anomalous experiences, Int Rev Psychiatry source

      Not checked in the free run.

    • cites [37] Moreira-Almeida A, 2011, 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

      Not checked in the free run.

    • cites [39] Maraldi EO, 2017, Dissociation from a cross-cultural perspective: implications of studies in Brazil, J Nerv Ment Dis source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductreasoning

    The sample was restricted to psychiatrists from only one institution, and the results could not be generalized as a representation of what most Brazilian psychiatrists think.

    “Second, the sample was restricted to psychiatrists from only one institution and, despite being one of the most respectable academic organizations in Brazil, the results could not be generalized as a representation of what most Brazilian psychiatrists think.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S4 (based).

    Study design and conductnone given

    Self-report measures and questionnaires are vulnerable to response bias.

    “Finally, self-report measures and questionnaires are vulnerable to response bias.”
    Quote in the paperNot a substantial claim
33 of 33

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?

  • Several barriers limit addressing R/S, including the lack of training by health professionals and the lack of clear defined concepts.

    “several barriers limit addressing R/S, including the lack of training by health professionals and the lack of clear defined concepts (Best et al., 2015; Menegatti-Chequini et al., 2019).”

    From Defining spirituality in healthcare: a systematic review and conceptual framework. (2021) · cites this paper as Menegatti-Chequini et al., 2019

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.

  • Reported spirituality mean contradicts claim of higher spirituality

    Major

    Psychiatrists who cited fear of exceeding the doctor's role are said to have higher spirituality, but their reported mean (2.29) is below the overall mean (2.43). If both means describe the same measure, the psychiatrists who did not cite that barrier must have a higher mean.

1 of 1

Cites

Flagged first, then by citations

Research works printed but not linked: 5

  1. Cordeiro Q, 2014, Creation of the section on spirituality and mental health at the Brazilian psychiatric association, Psyche Spirit, 1, 2
  2. Seixas A, 2012, O Instituto de psiquiatria do Hospital das Clinicas - FMUSP, História da psiquiatria: ciências, prática e tecnologias de uma especialidade médica. São Paulo: Casa de Soluções e Editora, 177
  3. Goldim J, 2007, Bioética e espiritualidade, Porto Alegre: EDIPUCRS
  4. Freud S, The future of an illusion, civilization and its discontents., The Standard Edition of the Complete Psychological Works of Sigmund Freud (trans & ed. Strachey), vol. 21, 1953
  5. Moreira-Almeida A, 2011, 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, 33, S21

Cited by

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Related

Authors
Menegatti-Chequini, M. C., Maraldi, E. D. O., Peres, M. F. P., Leão, F. C., & Vallada, H.
Affiliations
  • Universidade de São Paulo (BR)
  • Faculdade de Medicina da Universidade de São Paulo (FMUSP), Brazil; Hospital Albert Einstein, Brazil
ORCID
Venue
Brazilian Journal of Psychiatry
Publisher
EDITORA SCIENTIFIC
Published
2019-02
Volume
41
Issue
1
Pages
58-65
ISSN
  • 1516-4446 (ISSN-L)
  • 1809-452X
DOI
10.1590/1516-4446-2017-2447
PMC
PMC6781700
OpenAlex
W2901162793
Semantic Scholar
19cd072ea387a91a752134def48dffefa8616819
Cited by
28
References
33
Citations by year
2026: 2 · 2025: 3 · 2024: 1 · 2023: 5 · 2022: 6 · 2021: 7 · 2020: 3 · 2019: 1
FWCI
2.94
Type
journal article
Language
en
Open access
Licence
Locations
  • Brazilian Journal of Psychiatry (publishedVersion, cc-by-nc)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (publishedVersion, other-oa)
  • LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, other-oa)
  • Americanae (AECID Library) (submittedVersion, cc-by-nc)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • Fundação de Amparo à Pesquisa do Estado de São Paulo (2015/05255-2, 2015/)
  • Faculdade de Medicina da Universidade de São Paulo
Topics
  • Social Sciences › Health › Religion, Spirituality, and Psychology
  • Social Sciences › Demography › Workplace Spirituality and Leadership
  • Social Sciences › Arts and Humanities › Philosophy › Study and Philosophy of Religion
Keywords
religious beliefs, spiritual beliefs, psychiatrists' attitudes, religious conflict
MeSH terms
Brazil, Cross-Sectional Studies, Culture, Female, Hospitals, University, Humans, Male, Middle Aged, Physician-Patient Relations, Psychiatry, Surveys and Questionnaires, Religion and Medicine, Religion and Psychology, Spirituality

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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