Religious delusions in older adults: Diagnoses, combinations, and delusional characteristics

Abstract

Objective Religious delusions (RDs) tend to occur relatively often in patients with affective or non‐affective psychosis. Few studies exist about RDs in later life. The current study explores (1) the distribution of RDs across diagnosis, (2) how RDs relate to other types of delusions, and (3) how RDs relate to several dimensions or characteristics of delusions. Methods Inpatients and outpatients in a Geriatric Psychiatry Department in the Netherlands (N = 155; mean age 76.5 years), and who were diagnosed with an affective or non‐affective psychotic disorder, participated in semi structured diagnostic interviews, using the Schedules for Clinical Assessement in Neuropsychiatry 2.1. Results Religious delusions were most common among patients with psychotic depression (47%) and schizophrenia (32%). The RDs frequently co‐occurred with other types of delusions. When combined with delusions of grandeur, RDs were more often classified as bizarre and were accompanied by higher levels of positive psychotic symptoms. When combined with delusions of guilt, RDs were associated with higher levels of distress and a shorter disease duration. The delusional characteristics bizarreness, frequency of psychotic symptoms, and degree of distress were more prevalent for RDs than for any other type of delusion. Conclusions The current study suggests that the prevalence of RDs in older adults is particularly high in late life psychotic depression. Also, in later life, RDs can be perceived of as independent marker of complex psychotic states, and as a denominator of severe arousal with respect to existential concerns.

“The Demons Made Me Do It”

“…The subjective terror and high level of psychological distress experienced by patients with active persecutory delusions during this acute moment of helplessness and hopelessness may be referred to as "persecutory panic" (Freeman et al, 2019). Although expressions of religious delusions may be adaptive or protective in some situations, they often lead to considerable distress, even in comparison to other delusional content (Noort et al, 2018). In this state, death by suicide may be perceived as the preferable outcome to demonic possession and body inhabitation (Goldblatt et al, 2016).…”

Religious delusions in Dutch older adults in treatment for psychosis: a follow-up study

“…A detailed description of the procedures has been described by Noort et al (2020). In summary, at the start of the study, all the patients who were already under treatment and fulfilled the inclusion criteria could be included (N = 77).…”

“…In a cross-sectional study based on the same sample as the present study, RDs were significantly more prevalent in (raised or current) strict Protestant's patients, especially in those with psychotic depression compared to nonaffiliated patients and mainline Protestant's patients. Therefore, it is likely that religion acts as a symptom-formation factor for psychotic symptoms in strict Protestant older adults (Noort et al, 2020).…”

Entity encounters and the therapeutic effect of the psychedelic mystical experience

“…William James' 'diabolical mysticism'; James, 2004James, [1902). Further, 'religious delusions' are reported to be prevalent in adult patients with schizophrenia (5%-44%) and psychotic depression (6%-14%) (Noort, Beekman, van Gool, & Braam, 2018) and encounters with anomalous entities that others cannot see are generally categorised as visual hallucinations (e.g. Blom, 2013).…”