Objective: This paper aims to explore the interface between religion and psychosis, and to comment on its relevance in clinical practice.
Method: The context of religious psychotic phenomena is briefly discussed, leading to an examination of the biological substrates of religious experiences, the hypothesized process of religious psychotic symptom formation, and the clinical implications when assessing religious delusions. A PubMED search was conducted to identify original research and review articles of relevance to the discussion.
Results: Religion is an enduring theme in psychosis, the understanding of which can be assisted by distinguishing between religion as a culture and religiosity as pathology. There are strong arguments for the involvement of temporolimbic instability in the generation of religious psychotic symptoms.
Conclusions: Psychosis can be conceptualized as the manifestation of aberrant perceptual and/or integrative processes. The prevalence of religion as a psychotic theme may be explained by its central cultural role, the implication of temporolimbic overactivity in the pathogenesis of some cases of psychosis, and the tendency to interpret intense or discrepant perceptual events as spiritual. In the clinical setting, the determination of religious delusions can be challenging at times. In addition to seeking advice on unfamiliar religions, a thorough assessment of the dimensions of religious beliefs and symptoms of neurocognitive dysfunction can be useful.