Researchers Explore the Relationship Between Religiosity and Psychotic Experiences

Individuals who identify as religious may be more likely to have psychotic experiences.


A study recently published in Acta Psychiatrica Scandinavica examines the association between religiosity and psychotic experiences (PEs) from a large, global sample based on responses from WHO World Mental Health Surveys. Religiosity was measured by five distinct indicators and PEs were determined by 6 descriptors, two related to hallucinatory experiences and four related to delusional experiences. The results of the cross-national analysis indicate no direct association between religious affiliation and PEs, but that individuals identified as religious were more likely to have PEs.

The researchers, led by Kovess-Masfety, write, “While there was no association between religious affiliation status and psychotic experiences (PEs), within the subgroup having a religious affiliation, four of five indices of religiosity were significantly associated with increased odds of PEs.”

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Religiosity, or the “degrees of adherence and intensity of belief” with a religious denomination, has been increasingly connected to better health outcomes, particularly for patients with “cancer, cardiovascular, respiratory, and neurological disorders associated with reduced mortality.” Likewise, other studies have shown individuals with higher religiosity suffer less from “depression, anxiety, substance use and suicide attempts.” These studies often link religious beliefs and their subsequent social networks as protective factors during stressful times. Yet, Kovess-Masfety et al. declare that these relationships are “more nuanced and multifaceted,” and “not all studies have found that increased religiosity is associated with better outcomes.” Essentially, the evidence is mixed when it comes to religiosity and psychotic experiences.

The researchers acknowledge the exclusion of clinical delusions that are “solely attributable to shared religious (doctrinal) teachings,” and demarcate their aim to investigate associations between five indices of religiosity and six PE types. They include measures that assess associations between religiosity and the roles of mental health as well as general medical conditions.

While various other studies have shown increased religiosity associated with higher prevalence of PEs, such as in a community of young adults, among in-patients, and with adolescents, Kovess-Masfety examined this relationship on a global level. WHO World Mental Health (WMH) surveys were conducted in the homes of adult respondents in the following 18 countries: Argentina, Brazil (Sao Paulo), Colombia, Mexico, Peru, USA, Nigeria, Iraq, Lebanon, People’s Republic of China (Shenzhen), Belgium, France, Germany, Italy, the Netherlands, Portugal, Romania, and Spain. The surveys incorporate both a psychosis module and questions in regards to religiosity.

A fully-structured diagnostic interview, the WHO Composite International Diagnostic Interview (CIDI), was administered in order to “assess prevalence and correlates of a wide range of mental disorders according to the definitions and criteria of both the DSM-IV and ICD-10 diagnostic systems.” To ensure validity, the CIDI was adapted for each participating country through translation, back-translation, and harmonization protocols. Psychotic experiences due to dreaming, half-sleep state, or drugs were excluded among the six types.

Religious affiliations included Protestantism (16.4%), Catholicism (45.7%), Judaism (0.2%), Islam (21%), no religion (14.4%), and other (2.3%). Of those declaring a religion, the following five additional items were asked regarding the indices of religiosity:

  1. “How important was religion in your life when you were growing up?”
  2. “How often do you usually attend religious services?”
  3. “How important are religious or spiritual beliefs in your daily life?”
  4. “How often do you seek comfort through religious or spiritual means when you have problems or difficulties in your family, work for personal life?”
  5. “When making decisions in your daily life, how often do you think about what your religious or spiritual beliefs suggest you should do?”

Finally, a history of DSM-IV mental disorders was assessed along with general medical conditions.The results showed 85.6% of the 25, 542 respondents affiliate with a religion. Indices of religiosity varied within the subset of 21,860 respondents who declared a religious affiliation.

The researchers write, “In the basic model, we found that four (of five) indices of religiosity (those who consider ‘religion was very important when growing up, or ‘religion was very important in their daily life,’ or ‘often seek comfort when experiencing problems,’ or ‘often think about religion to help with decision-making in daily life’) were significantly associated with increased odds of PEs.”

Kovess-Masfety et al. acknowledge the study’s need of multidisciplinary collaborations and mixed method studies, such as “qualitative and anthropologically focused studies,” in order to better grasp the relationship between religiosity and mental health, e.g. the connections between cultural beliefs and PEs. Another limitation includes the lack of temporal knowledge that might result in reverse causality, i.e. that religiosity occurring as a result of PEs. Furthermore, the participants were mostly Christian, meaning the results may not generalize across other religions.  The researchers call for broader research questions that account for more variables such as socioeconomic influence, e.g. the lower prevalence of PEs in low-income countries in comparison with middle- and high-income countries.

Kovess-Masfety and colleagues summarize the usefulness of the results in order to facilitate a better understanding of mental health processes:

“Based on 18 cross-national surveys, we found that about 85% of the people had declared religious affiliations, and within this group, about half of them found religion to be very important in their daily life and for making decision and looking for comfort when experiencing problem. Of those with a religious affiliation, about a third attended a religious service more than once a week, demonstrating how religion is important in the daily life of many people around the world and thus its relevance for understanding risk and protective factors for mental health.”



Kovess-Masfety et al. (2018). Psychotic experiences and religiosity: data from the WHO World Mental Health Surveys. Acta Psychiatrica Scandinavica, 137(4), 306-315. (Link)


  1. According to my medical records, my “mental health professionals” believe a religious dream query about what being ‘moved by the Holy Spirit’ means, is the same thing as a “Holy Spirit voice” which proves a person is “psychotic.” Dreams are NOT “voices.” But the antipsychotics create “voices,” via anticholinergic toxidrome poisoning, a psychiatric drug induced illness that should be listed in the DSM.

    And when dreams are classified as “psychosis,” that lowers the bar on the definition of “psychosis,” to the point where all humans are “psychotic,” since we all dream. I do understand how such an insane definition of “psychosis” is profitable for the “mental health professionals,” however I’m quite certain a less all inclusive definition of “psychosis” is needed.

    An ethical pastor confessed to me that a dream about being ‘moved by the Holy Spirit’ merely means God has chosen you to help Him with something. And that “the dirty little secret of the two original educated professions” is that the “mental health professionals” regularly claim belief in God is a mental illness, when their goal in life is profiteering off of malpractice suit prevention for the incompetent mainstream doctors, or covering up medical evidence of the sexual abuse of children for sick pastors and bishops, and their satanic, Bohemian Grove attending, child sacrificing, pedophile “soul mates.”

    My medical records are filled with “professionals” claiming “Don thought she was the second coming of Jesus,” “voices of God talk through her to other people,” “a man, Jesus, spoke through her.” When I called to question one of these “professionals,” who I didn’t even remember meeting because I’d been whacked out of my mind on a hypnotic drug prior to meeting her, about these weird statements written in my medical records. That “mental health professional” confessed she claimed thousands of people were Jesus. Apparently, claiming someone is Jesus, is doctor code for, crucify this person?

    That “mental health professional’s” claims of what Jesus supposedly said, she claimed he told her she was orchestrating the attempted murder of me, did come true, however. That “mental health professional” shipped me a long distance to this now FBI convicted, murderous doctor, who did try to “crucify me.”

    I do believe the “mental health professionals” and mainstream medical doctors should stop trying to murder the Christians for belief in God, since such behavior is illegal in the US. And the “mental health professionals” should also get out of the business of covering up child abuse, which is the number one function of today’s “mental health professionals,” according to your own medical literature, since that’s also illegal.

    Today, over 80% of those labeled as “depressed,” “anxious,” “bipolar,” or “schizophrenic” are child abuse victims. Over 90% of those labeled as “borderline” are child abuse victims. Child abuse is a crime, not a brain disease. Thus, drugs do NOT cure one of concerns related to the abuse of one’s child or symptoms of child abuse, especially once the medical evidence of the child abuse has been handed over.

    Today’s “mental health professionals” are misdiagnosing millions of child abuse victims and their parents with the other billable DSM disorders because “child abuse” is classified as a “V Code” in the DSM, and the “V Codes” are NOT billable disorders.

    This “flaw” in the DSM billing code/insurance reimbursement situation should be changed, if the “mental health professionals” want to ever actually help child abuse victims, rather than just continue to turn millions of child abuse victims into the “mentally ill” with the psychiatric drugs, which is what you’re doing now.

    “A society will be judged on the basis of how it treats its weakest members.” Child abuse victims are our “weakest members.” The first thing my psychiatrist wanted to do, once I’d told him the medical evidence of the abuse of my child had been handed over, was to drug my child. I had to leave that psycho psychiatrist at that point. But I will say I believe our society is in for a harsh judgement.

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  2. “While there was no association between religious affiliation status and psychotic experiences (PEs), within the subgroup having a religious affiliation, four of five indices of religiosity were significantly associated with increased odds of PEs.”

    In my opinion, it’s not difficult to see why this may be the case. There are numerous reasons for this. The “character” of Jesus is most famously portrayed as being nailed to a cross (which was done by other people in the “story”). A lot of people who have experienced extreme suffering that was not their fault can identify with this pain. The idea of a resurrection is symbolic of a transformation in character that is similarly felt to be experienced by some people who have been through extreme suffering. They can also find themselves puzzled by the “ethics” of what has happened to them. Society has a history of pointing people who are interested in understanding ethics towards religion, rather than philosophy.

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  3. if szasz and others are correct about psychiatry…in the sense that psychiatry, on top of all its other nefarious attributes, is a state-sponsored religion…then studies like this make me wonder if, perhaps, the shrinks are attempting to label and control -real- religions, in particular the ones (especially Christianity) that actually contribute to the world and provide guidance, forgiveness, redemption, etc. to their followers.

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    • Psychiatry already found it very easy to control the Christian religions. Psychiatry made a faustian deal to cover up the “zipper troubles” of the religious leaders and their wealthy contributors long ago. While filling up the religious hospitals with people who psychiatry has made sick. Psychiatry’s child abuse covering up services, particularly, are very profitable for the Christian hospitals, according to the “mental health” industry’s own medical literature.

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      • Plus psychiatry is an easy way to get rid of or brush off members who suffer extreme pain. Instead of hours of pastoral counseling to a depressed member going through divorce/job loss/loneliness, you can tell them to shut up and take their meds. Then pat yourself on the back for being a good Christian. 😛

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    • There is also the belief among the mystical movements of all the world religions, and among Buddhism that we are all one and the same and that we are all God because we contain the one, transcendent, and eternal consciousness. In other words we all contain the Universe inside of us. This is why Namaste is given to people by Hindus and many Buddhists.

      Anyway, there is a theory that if and when young adults come to this conclusion in their lives that it is very overwhelming, ego-shattering, and yet gives one a feeling of being in union with the Universe itself. This shattering is the psychotic experience, the experience of trying to incorporate this as well as the attempt to pull together the shattering that’s taken place. People like John Weir Perry and Alan Watts and many other famous people believe that young people who have this realization of what truly is can move through this difficult time with support and help and that they can re-integrate their lives. They can move through the psychosis and come out the other side even stronger than they were before the breaking.

      But of course, psychiatrists believe none of this and drug people to the gills stating that the longer that these young people go without being drugged the worse their schizophrenia will be. The problem is that if these young people are drugged it stops the re-integration and what would have probably been an episodic experience becomes something that is chronic. All the better for psychiatry and the “mental health” system!

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      • Perhaps when a “mentally ill” young person claims that they are God, they are absolutely correct. And if this is the case, how truly maddening it must be when no one, absolutely no one believes you. And then the psychiatrists start in on you about your “religiosity” and how it shows how “mentally ill” you are!

        We like to think that we know so much and yet we probably know so very little about any of this.

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  4. As an engineer who hears voices, one of which claimed to be god, asked me to rewrite the bible and declared me to be the second coming, like it or not… then became an evil god, I take a much more practical and less philosophical view.

    Trigger warning: beliefs are a touchy topic, which does not mean we cannot challenge them.

    The phenomenology I (and most other voice hearers) experience goes beyond ‘voices’. It has ‘supernatural’ (as in not yet explained) qualities (intent, clarity, direction, personality) that provoke the question “How is this happening?”. To which the answer is most likely to be commensurately supernatural… lending plausibility to the idea of an interaction with an ‘other’ entity… and therefore beliefs about what/who is delivering the special effects of the phenomenology. ‘Spirit’ interpretations being very common.

    Plausibility and provenance are not the same thing and we seem to miss the fact that a how question is leading us to what/who answers by INFERENCE, or by what voices claim (which is also without provenance). We easily look to cultural beliefs as a source of ‘evidence’ for our answers, since that brings a level of acceptance (vs acceptable logic), if not always comfort.

    We develop beliefs precisely because we lack evidence with provenance… and people experiencing similar phenomenology reach different who answers in the what = other or ‘spirit’ world theme, based largely on the behavior of the voices we hear. It goes without saying that we do not know what or who the voices are… and when they claim to be god… I take it with a tub of salt, especially when ‘it’ behaves badly and later claims to be the devil, then an evil god.

    In practice, I experience the phenomenology as a given, a presence that is a fait accompli about which I can do nothing. It behaves badly. From which I am more likely to describe the thing as a ‘demon’, because that is common language in our cultures – it is a behavioral descriptor. If it behaves well (really, the mere presence is disrespectful and discounts that interpretation in my book) we might call it an angel, or someone we know… which are simply different hypotheses that only have meaning in beliefs, not fact. We associate angels/demons with an ‘other’ world, which is described in many ways as inferential beliefs proliferate. To bring it back to basics, when someone tells me “it is my grandmother”, I ask, “why don’t we all hear grandma?” – it cannot be that only certain cultures do.

    Some manage to use the idea of “faith” to RATIONALIZE a difficult experience as having value – a spiritual crisis or emergence (which is it?)… a sign of a greater good to come. This is our cognitive bias helping us form an optimistic view of life. We are attributing good to a bad experience based on a belief, without provenance. In fact we are dismissing the evidence, the bad behavior, and describe the bad as good to fit our belief. It is the equivalent of scavenging value from bad experiences, saying “at least I learned xyz”.

    Which is why the opposite happens just as easily. When your culture believes that spirits intervene in our world and that some spirits are evil… then those beliefs easily confirm a person’s worst fears. Instead, the person, healer or tribe simply rationalize why the person is being attacked by an evil spirit. Here in S. Africa as just one example, ‘healers’ will perform rituals to ward the evil spirits off. Or, will cast a spell on an enemy, for a fee of course. Before dismissing this kind of belief system as ‘superstitious’, note that it at least takes the experience at face value… even if it confirms worst fears.

    In practice, our cultural beliefs are a source of support, rather than evidence. When the cultural belief is opposite to the experience, or confirms our worst fears, or expects us to transcend the experience and interpret as good, it aggravates rather than helps the situation.

    So, for the person in an African tribe who believes another tribesman has sought out a healer/witchdoctor to cast a spell against him/her… worst fears are confirmed in the belief system…
    Or, when I am declared the second coming to a god who claims to be evil and backs it up with torturing phenomenology… and my support group believes in a loving god, our beliefs are in conflict…

    We are both trapped in a Catch 22 – people around you cannot help and appealing to voices/spirits/god is an appeal to the abuser, who laughs and mocks, saying “no one will understand”. Neither the casting of spells nor prayer are good options.

    We have more evidence that this phenomenon is harmful than we have to support our wishful beliefs that it brings good. The experience is what it is. When we describe it using the language of beliefs we are adding murkiness not clarity, especially when the belief system gives agency and influence to the phenomenon.
    Calling the experience a spiritual emergence when it is experienced as a crisis… seems little different than blaming a psychiatrist for attaching a diagnostic label that does not gel with the experience.

    We are unlikely to find broad agreement at the level of beliefs. Beliefs are a component of the experience shaped by the phenomenology in quite predictable ways by the questions the phenomenology provokes. Our how answers locate the phenomenon, our what/who answers are inferences from that and our assessments of implications are inferences from inferences… as the quality of the evidence chain decays beliefs proliferate.

    More often than not our beliefs are in conflict with each other. More so when they are about and derived from this wicked phenomenon.

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    • Uh, an engineer, what do you think, is there a difference between a technicion and an engineer?

      Regarding beliefs… Don’t you think there is an ultimate truth out there regardless of belief? There is only one physics, as an engineer you cannot craft something that is impossible by physical laws. And yes, physics is also currently getting updated, but some laws are already proven to be true. Further, there is mathematics, queen of all sciences (hey, a feminine term), and mathematics is strict, it doesn’t allow for imprecision.

      Thus I think its wrong to claim that it is all about beliefs only. Beliefs only influence the entity who holds them, sort of if you are a telephone or (to go with a more modern principle) the Internet, you need ports and protocols to make communication possible. You also need standards and everything, like file formats, otherwise information cannot be exchanged but it stays incomprehensible. Shamans in my opinion are experimenting in a still poorly understood field to the best ability they can. And it seems that communicating to the ‘other realms’ is something quite difficult that holds many possibilities that can go wrong because of lack of meaningful communication which can lead to much confusion and misunderstanding and subsequently conflict.

      What do you think, greggieboy?

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      • Yes, I think we can say that the “voices” phenomenon is what it is… an ultimate truth as you put it, even though we do not yet know what it is.

        Beliefs are relevant in that not knowing what ‘it’ is, we have a proliferation of beliefs about what the phenomenon is, how it occurs, what the implications are (which we confuse by asking what does it ‘mean’?).

        For each individual, and culturally, our beliefs about the phenomenon shape our experience of it. As you put it “Beliefs only influence the entity who holds them…” and I would add, if expressed culturally, that means an entire culture… and adjacent cultures with opposing/conflicting/different beliefs. The effect of belief easily spreads beyond the one who holds it, because the resulting behavior/tolerance/acceptance spills over.

        People readily hold inconsistent beliefs about the phenomenon and believing one thing today and another next year is quite ordinary. So beliefs are even more open to updating than scientific ideas, precisely because we lack joined up evidence… and each new experience may update belief.

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    • LOL, I played at being the second coming for a while, with the voices I hear, simply as an alternative response to having to constantly reject them.

      The point is that voices made many other connected claims that made no sense in their entirety. One also claimed to be god. Then the devil. Then an evil god. In theory, those can all be true at the same time, I guess, but it didn’t lend credibility to the idea of me being the second coming.

      It was about voices dumping a heavy responsibility on me then making it impossible to live up to let alone keep up with their demands. The idea isn’t independent of the big picture context and progression of the experience.

      There is nothing symbolic about the voices I hear. They have a persistent and systematic approach to undermining my success. There is a structure to the phenomenology, to how it encourages or lends plausibility (not provenance) to particular themes of belief and there is a structure to the stories they engage us in. I tackle this story structure in this video if you are interested to hear more:

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  5. I hope I’m not off topic here, but I notice that most doctors don’t seem to know what an Auditory Hallucination is. I mean most doctors are not able to differentiate between normal social thought inside the head, and the hearing of voices outside the head .

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    • It is still difficult for me to differntiate that what I experienced. I didn’t have real auditory hallucination outside the head most of the times and as far as I remember it was always my own voice that I ‘heard’ but still different to that normal common constant inner talk that everyone experiences…

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  6. Phoenix
    I believe a lot of basically normal people accommodate “voices”, and the people in the
    Hearing Voices Network can help people to accommodate “voices”.

    I believe a lot of people taking “medication” take it because they can’t cope with their own “inner talk”.

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  7. This study is flawed and I will attempt to explain to you why.

    First off we need to define terms.
    1) “Psyche: This is a ancient Greek word that when translated means “Soul”. It is also the name of a Greek Goddess.
    2) “Psychosis”: Once again Greek, which when translated means “Soul Illness”.

    See, even within the domain of academia phrases such as “psychotic experience” have lost their initial meaning to accommodate a physicalist or materialistic philosophical bent. It is like in the book 1984 by George Orwell, in which the hierarchal power structure which has become dominate does not invent new words to evolve the conversation, but incorporates old words to applies new meanings to them, what ever benefits the current power structure.

    This is especially useful when you want to define the value and meaning of other peoples lives, especially those you consider an obstacle to your power structure and proliferation of it.

    It should be clear to anyone at this point that a study about the correlation of religiosity and psychosis, is bull shit. The very evolution of religion has happened to deal with soul illness. We are all in fact and in practice, psychotic as a species. Its known as the Human Condition. We have been this way ever since we divorced ourselves from an intimate relationship with first Nature and secondly with Spirituality. The two great divorces have wrecked not only countless human lives, but also one of the greatest extinctions of other species on this this planet, along with destruction of ecological systems which we rely on.

    I challenge everyone here to do an etymological study on the word “psychiatry”. Break the word down to its components and then look up those words and see what they mean in the original tongues they were orginated in. Once you have done that, you will see what is actually going on. One Class of Elites who wish work to supplant and replace another class of elites.

    There has been a power struggle since the break down of tribal societies and the rise of states and strong men and women who rule them.

    I submit for your consideration, that unless those of us who have non-ordinary states of consciousness spontaneously, those of us that are experienced and have been through hell and survived mostly intact, must in some way assert our authority in these matters and not allow any elitist power structure to define, label, or categorize what for us has been for us real experiences. Instead we need to actually understand what we experience and its meaning for ourselves and give that same capability to those of us who still struggle. I am not advocating some new power structure — Quite the opposite. If you give a girl a fish, she will ask you every day for one, but if you teach a girl to fish, she will teach others too.

    I think the biggest problem in our community and also with those who wish to dominate us and control us have, is that all of us are so eager to jump to conclusions. If a voice is being mean to me, then it must be demon, Etc. If a person experiences a non-ordinary experience, then they must be ill.

    In reality I feel and think that were all to quick to label, categorize, and “treat” — its not only the fault of psychiatrists, priests, or politicians. I think this goes right to the core of the human condition, our collective psychosis. Something that defines the struggle and our lack of self reflection, consideration, and thoughtfulness, and feeling for what is actually happening.

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