This review analyzes the works of Russian psychiatrists on the relationship between religion and clinical psychiatry. Beginning from the first half of the 19th century a lot of Russian psychiatrists in their writings dealt with the issues of religiosity and mental health as well as with psychopathology and clinical studies of mental states with a religious delusion. They studied psychopathological features of the phenomenon of 'hysterics', the syndromes of religious metaphysical intoxication and demon possession. One of the founders of social psychiatry D.E. Melekhov considered religious faith as the most important personal resource for rehabilitation activities. Differentiation of non-pathological religious experience from mental illnesses with a religious plot remains understudied in the literature. The analysis of the literature on the relationship between religion and psychiatry makes clear that psychiatrist's accurate understanding about the peculiarities of the religious life of patients is necessary for a successful therapeutic alliance.

General psychopathological features of psychotic states with religious delusions, according to the specificity of adolescent age, were identified. Common types of religious delusional episodes, forming by primal interpretive (delusion of sin, delusion of demonic possession) and sensual (messianic and antagonistic delusion, religious oneiroid) mechanisms were distinguished. A role of the previous religiosity, including overvalued religious ideas, was clarified. It was found out that the duration of the pre-manifest stage, hospitalization and the period of 'untreated psychosis', was longer in patients with religious delusions compared to patients with other types of delusions. Patients with interpretive mechanism of delusion formation demonstrated the subsequent intensification of religiosity that was not common for psychotic episodes with the sensual mechanism of delusion formation.

Introduction The study of the premanifest stages of the first psychotic episode with religious delusion is relevant due to the lack of clarity in differentiating normal religiosity from pathological and, as a consequence, a relatively longer period of an untreated psychotic state, which negatively affects both the course of the disease and its outcomes. Another important factor is the high risk of antisocial, autoaggressive and suicidal behavior at different stages of the disease. Objectives The aim of the study is to identify the conditions for the formation of religious delusion in adolescence and young adults, to analyze the correlations between religiosity at the pre-manifest stage and the subsequent manifest psychotic episode with religious delusions of different content. Methods The 57 male patients at a young age (16-25 years) with a manifest psychotic episode (F20, F25 according to ICD-10) with religious delusion (delusion of sin (21,6 %), delusion of demonic possession (29,4 %), antagonistic and messianic delusion (39,2 %), oneiroid with religious content (9,8 %)) were studied with the clinical-psychopathological, psychometric (PAS) methods. The religiosity of patients in premorbid was assessed with the Duke University Religion Index (DUREL) questionnaire. Results Of greatest importance in the formation of psychotic episode with religious content is hereditary burden, premorbid personality structure, high scores on the PAS scale. Conclusions The presence or absence of religiosity in premorbid doesn’t matter to formation of psychotic episode with religious delusion. Disclosure No significant relationships.

Background: Despite a large number of studies devoted to religiosity and religious coping of patients with mental illness, many issues remain uncertain or contradictory.The aim of the review: to present the analysis of domestic and foreign scientific publications on the problem of the religious life of patients, differentiation of normal and pathological religiosity, peculiarities of religiosity in patients with delusion with religious content, religious coping.Materials and methods: using keywords “normal religiosity”, “pathological religiosity”, “religious delusion”, “spiritual emergency”, “religious coping” papers were selected and explored in MEDLINE/PubMed, Scopus, eLIBRARY, Google scholar, Cyberleninka databases from 1990 to 2020.Conclusion: most researchers found out positive effect of religiosity on mental health. Religious coping is great resource for rehabilitation of patients with schizophrenia and schizophrenia spectrum disorders. At the same time, studies devoted to the problems of the influence of religiosity on the formation of delusion with religious content, its prognostic value, demonstrate contradictory results, partly due to the bias of psychiatrists towards the religiosity of patients. It seems important to minimize existing contradictions in order to improve the quality of life for patients, and increase compliance in the course of further research.

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