Religion can play an important role in the lives of psychiatric patients. We assessed how often a psychotic illness can lead to a change in the strength of religious faith and how commonly religion is used for coping with such illnesses in a sample of consecutively admitted patients. 52 patients with psychosis were interviewed regarding their religious beliefs after their index admission. 69.4% of the patients were religious, and 11 (22.4%) stated that religion was the most important part of their lives. 30.4% of the sample described that there had been an increase in their religiousness after the onset of illness. 61.2% of patients were using their religion for coping with the illness. Such patients had a better insight into their illness and were more compliant with antipsychotic medication. We conclude that the experience of a psychotic illness is likely to lead to an increase in religious beliefs. Such beliefs are commonly used for coping with the illness and some patients attach a great importance to them.

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The course of psychoses of schizophrenic type follows rules which are still not adequately understood. It is, however, clear that certain symptoms appear mostly early, others only late. With this hypothesis in mind, we studied 44 final phase patients whose main symptom was disordered thinking of the schizophasic type and whose illness was of at least 10 years’ standing. The most important finding of this study is that the varied and unspecific initial phase progresses into a highly specific syndrome. The symptoms initially registered include various disorders of thinking in less than one third of patients. In no case did these involve schizophasia. In a second phase symptoms were observed such as paralogism, echolalia, verbigeration, circumstantiality, neologism, hypotonic thinking, perseveration, blocking. The symptoms of schizophasia are only recognizable in a third phase and are highly specific. This enables us to confute the claim that psychiatric syndromes are not clinically specific. The three phases described above also provide evidence for the biological nature of this endogenous psychosis.

The hypothesis that some symptoms of schizophrenia only manifest in the early stages whereas others only appear later is tested with 33 inpatients in ‘terminal states’. It is found that while the onset shows no specificity, the outcome is very typical. The initial symptoms are polymorphous; thought disorders can be found in less than one third of the patients and frank incoherence approaching the severity of schizophasia not at all. Many years later appear symptoms registered as paralogism, echolalia, verbigeration, stilted speech, neologism, hypotonic thinking, retardation, derailment, and incongruous answers. Only then, sometimes 25 years after the onset of the illness, the peculiar and highly specific picture of the schizophasic disorder becomes established.