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Background: Religion and psychiatry may be both considered to be two different ways of explaining the unknown, of responding to questions about the meaning of life, and of bringing healing.
Results: Religious beliefs may affect behaviours and may been seen on a psychopathological continuum with overvalued ideas and delusions. There is an overlap between psychiatric and religious categories, in possession states described in research literature and by many cultural groups. Several studies suggest possible factors for differentiating schizophrenia from demonic influence and report on the efficacy of exorcism among possessed/psychotic subjects. Diagnostic criteria have been proposed for dissociative trance disorder or possession disorder.
We review scholarship that examines relationships - and distinctions - between religion and delusion. We begin by outlining and endorsing the position that both involve belief. Next, we present the prevailing psychiatric view that religious beliefs are not delusional if they are culturally accepted. While this cultural exemption has controversial implications, we argue it is clinically valuable and consistent with a growing awareness of the social - as opposed to purely epistemic - function of belief formation. Finally, we review research on continuities between religious and delusional cognition, which reveals that religious content is quite common in delusions and which provides tentative evidence for a positive relationship between religious belief and delusion-like belief in the general population.
Richard Dawkins, biologist and best-selling author, claims that belief in God is a "delusion" and that "religion" harms society. Dawkins contends that he has reason and evidence on his side, and he dismisses faith as unfounded, even irrational.
Dominican Thomas Crean tackles Dawkins' claims head-on. He presents straightforward arguments for God's existence, and he uses reason and evidence to defend such things as miracles and the authority of the Bible. He also shows how God is important for a coherent understanding of morality, and why Dawkins' approach winds up reducing morality to the individual's subjective likes and dislikes. By demonstrating how Dawkins' criticisms rest on misunderstandings, superficial readings, poor argumentation, a lack of historical awareness, and not a little prejudice, Crean reveals Dawkins to be out of his philosophical and theological depth, and his case against God to be fundamentally flawed.
Copyright: 2015 Gao et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
Data Availability: This study contains private information of the subjects. Due to ethical and legal restrictions data are available upon request. Interested researchers may contact Yihong Zhu via email: zh...@zju.edu.cn or Bin Gao via email: zjug...@163.com.
Exclusion criteria for participants were i) a history of head injury, neurological disease such as epilepsy, other serious illness, alcohol dependence, exposure to electroconvulsive therapy, and other psychiatric disorders (healthy controls with a history of schizophrenia and a family history of psychosis were also excluded), and ii) the intake of medication in 6 hours before the fMRI scan.
Each participant was scanned with a 1.5 Tesla Siemens Sonata scanner. Foam pads were used to reduce head motion. The functional T2*-weighted resting-state images were acquired using an echo planar imaging (EPI) sequence (TR/TE 2000/40 ms, FA 90, FOV 240 240 mm, matrix 64 64, slice thickness 5 mm with 1 a mm gap, 23 slices, scan time 8 min, 240 volumes). The participants were instructed to lie still with their eyes closed and not to think of anything in particular during RS-fMRI data acquisition [19, 27, 39].
Two sample t-tests (p < 0.05, corrected; see Fig 1 and Table 2) showed that ReHo in the right anterior cingulate gyrus (ACC), extending to left medial superior frontal gyrus (SFG), was higher in the patients group than in controls, while ReHo in the left superior occipital gyrus was lower in the patient group. The medial SFG is also named the dorsal medial prefrontal cortex (dMPFC) [44, 45]. The correlation analysis (p < 0.05, AlphaSim corrected; see Fig 2a and 2b controlling for medication) showed that CDRS score was negatively correlated with the ReHo in the left medial SFG (BA 9). There was no difference between with and without controlling for medication in the correlation analysis results. The correlation between antipsychotic dose and severity of delusion symptoms was significant (r = 0.867, p < 0.001). No significant correlation was found between PANSS delusions subscale score and mean ReHo values within the mask, either with or without the total PANSS score as a covariate.
(a) The left medial superior frontal gyrus (mSFG; 918 mm3, 34 voxels, with peak coordinates at [-3, 48, 30] in the Montreal Neurology Institute system). (b) The plot of negative correlation between scores of CDRS and mean ReHo values across the cluster shown in (a) in schizophrenic patients with delusions.
To the best of our knowledge, this is the first study analyzing the ReHo of spontaneous brain activity and delusions of schizophrenic patients by RS-fMRI. We found that ReHo in the right ACC, extending to left dMPFC, was higher in schizophrenic patients compared to controls, while ReHo in the left superior occipital gyrus was lower in the schizophrenic patients group. The ReHo of the left dMPFC (BA 9) was negatively correlated with CDRS scores. No significant correlation of ReHo with PANSS delusions subscale score was found.
The alteration of ACC and dMPFC in schizophrenic patients has been found in many studies. Decreased volume of the right ACC [46, 47] and left dMPFC [13] has been reported in schizophrenic patients. The right ACC and left dMPFC were activated by a task designed to evoke sensations similar to delusions of reference in schizophrenia patients experiencing prominent referencing delusions [48]. In the current study, the increased ReHo in schizophrenic patients indicated that an increased local synchronization of spontaneous activity may be related to delusions. A previous resting-state fMRI study on schizophrenic patients found decreased ReHo in the left medial frontal gyrus, (BA 2, MNI coordinates: -12, -45, -18) [31], which was close to the left dMPFC in the current study. One possible explanation for the seemingly contradictory results is a difference in the schizophrenic patients. In our study, all schizophrenic patients had delusions while in that study the delusion symptoms were not mentioned [31]. As schizophrenia is a highly heterogeneous disorder, it will be important for future studies to use the same method and similar patients to replicate previous results.
In this study, we found decreased ReHo in the left superior occipital gyrus of schizophrenic patients. However, in this area there was no significant correlation between ReHo values and CDRS scores. This was consistent with previous studies. Liu and colleagues also found decreased ReHo in the left inferior and middle occipital gyrus [31]. It seems that the decreased ReHo in the occipital area may not be closely related to delusions. Rather, an abnormal ReHo in the occipital area may be a more general abnormality in schizophrenic patients.
No significant correlation was found between ReHo maps and the PANSS delusions subscale, but a significant correlation with CDRS was found in schizophrenic patients with delusions. CDRS measures more dimensions of delusion than PANSS. Garety believed that delusion contained 11 dimensions, which were conviction, preoccupation, interference, resistance, dismissibility, absurdity, self-evidentness, reassurance, worry, unhappiness, and pervasiveness [38, 52]. However, the delusion subscale in PANSS only contains one item [37, 53]. This scale can only rate the severity of delusion in the most apparent aspects, such as conviction [54] or bizarreness [1]. It is quite plausible the CDRS provides more intrinsic information about delusions, which can be expressed in brain activity.
In summary, the increased ReHo demonstrated by RS-fMRI in schizophrenic patients with delusions in the dMPFC may suggest that increased local synchronization of spontaneous brain activity may underlie the delusions.
We thank very much too all subjects taking part in this study. The authors further wish to thank prof. Xiaowei Tang and all members of Bio-x laboratory of Zhejiang University for their help in fMRI data processing.
Conceived and designed the experiments: YHZ YQW ZYC YFZ. Performed the experiments: BG YHZ YQW ZYC JYY HSZ WBL. Analyzed the data: BG. Contributed reagents/materials/analysis tools: YHZ YQW ZYC JYY HSZ WBL. Wrote the paper: BG. Revised the manuscript: YHZ ZC YFZ.
N2 - Persecutory and grandiose delusions are the most commonly reported sub-types of delusions within inpatient populations. However, little is known about whether clinical profiles might differ between these sub-types, within a sample of patients who agree to engage in a psychological therapy during an acute inpatient admission. We report data on 41 participants who took part in the amBITION study, a randomised controlled trial of a brief talking therapy for psychosis on inpatient wards. Participants with persecutory and grandiose delusions were compared on i) clinical and demographic profiles, ii) psychotic and affective symptoms, and iii) inpatient treatment received (both psychological and pharmacological). Average ratings of frequency of delusions and believability/conviction at the start of therapy were similar between those with persecutory and grandiose delusions. Number of therapy sessions completed, satisfaction with therapy, and medication received, was similar between both groups. Our findings indicate that people with persecutory or grandiose delusions may report distress associated with their experiences, and so be willing to engage in a psychological therapy.
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