High Religiosity, Polygenic Risk Score Influence Religious Delusions in Schizophrenia

Strong religious activity and high polygenic schizophrenia risk scores (SZ-PRS) are independent risk factors for religious delusions in schizophrenia and schizoaffective disorder, according to study data published in Schizophrenia Research.

The study cohort comprised 262 adults aged 18 to 80 years living in South, West, or Northern Germany with a lifetime diagnosis of paranoid schizophrenia or schizoaffective disorder. Patient sociodemographic and clinical information was captured at baseline, using a comprehensive phenotype inventory. SZ-PRS were determined for 239 patients. Using logistic regression, investigators tested for an association between religious delusions and the following predictors: self-reported degree of religious activity; diagnosis based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition; sex; age; education level; marital status; and the presence of acute delusion at the time of interview.

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The final study cohort comprised 217 Christian patients and 45 patients without religious affiliation. A total of 101 patients (39%) reported experiencing at least 1 religious delusion of some kind in their life; 89 were Christian and 12 had no religious affiliation. Very active religious patients were 3.6 times more likely to experience religious delusions compared with those without religious activity (P =.010). Low or moderate religious activity, however, had no significant effect. High religious activity remained a significant risk factor for religious delusions after adjustment for SZ-PRS (odds ratio [OR], 4.1; P =.008). In addition, the risk for religious delusions was higher with increasing SZ-PRS (OR, 1.4; P =.020). No other covariates were significantly associated with a lifetime occurrence of religious delusions, although the degree of self-reported religious activity was higher in those who had experienced religious delusions (P =.006) compared with those who had not.

Per these data, strong religious activity and high SZ-PRS emerge as independent risk factors for the occurrence of religious delusions. A high level of religiosity may therefore be an important factor for clinicians to consider in assessing patient risks and needs.


Anderson-Schmidt H, Gade K, Malzahn D, et al. The influence of religious activity and polygenic schizophrenia risk on religious delusions in schizophrenia [published online January 3, 2019]. Schizophr Res. doi: 10.1016/j.schres.2018.12.025