Practice of Religion as a Therapeutic Tool for Obtaining Neuropsychiatric Benefits

Nepal Interest Group of epilepsy and Neurology (NiGEN), Kathmandu, Nepal.

Sudan League of epilepsy and Neurology (SLeN), Khartoum, Sudan.

Iranian epilepsy Association, Teheran, Iran.

Corresponding Author: Devender Bhalla, Sudan League of epilepsy and Neurology (SLeN) Khartoum, Sudan.

Received Date: 03 Apr 2018   Accepted Date: 14 May 2018   Published Date: 18 May 2018 Copyright © 2018 Bhalla D

Citation: Bhalla D. (2018). Practice of Religion as a Therapeutic Tool For Obtaining Neuropsychiatric Benefits. Mathews J Neurol. 3(1): 011

KEYWORDS

Religion; Mental Health; Neuropsychiatry; Epidemiology.

INTRODUCTION

Since antiquity, the religion is attached with the mankind. It is defined as "the belief in, and worship of, a superhuman controlling power especially a personal God or gods". It is a particular system of faith and worship. In general, there are more number of subjects attached to one or the other religion (or its sects or denominations), in comparison to complete atheists. This situation however varies, table 1, for each individual country. Based on a survey, countries where most people feel religious were those from Asia, Africa, and middle-East and North Africa (MENA). In USA, based on a similar survey, only 3.0% were convinced that God does not exist at all [1]. About 20.0% of countries have an official state religion, most of these are in MENA. In many countries religion is seemingly unimportant, for instance in China 7.0% feel religious, in Israel 30.0% feel religious, table 1.

Table 1: The Most and least religious countries.

But which religion? What is the reliability? Broadly, there are three major religions, namely Islam, christianity, and Hinduism, to which atleast 70.0% of the world population is attached. Currently, the nature and reliability of religions is yet to be fully defined and understood; as seen in many examples below. Leaving aside Islam, there are about 200 different sects and denominations within Christianity; each having their own version of Bible and preaching. Moreover, the current Bible has atleast 30 known scientific mistakes which may explain in-part the reason that only 28.0% believe that Bible is the actual word of God [2]. This matches with general argument that Bible has a mix of text from God, interpreters, and religious institutions. Furthermore, The Holy Quran said that the God sent 124,000 messengers, most of whom were for a particular region and its people. Each time, the message of God got modified over time, thus requiring him to send the "last" messenger to correct this confusing polytheistic situation, but this time for the whole world, by repeating the same message that was given by 124,000 messengers.

Further substance on the comparative nature and reliability of religions can be derived from the title of individual holy scriptures. For instance, the word Bible has no intuitive meaning and just means a paper or a book, and the word Christianity indicates its central reliance on Jesus Christ as God (and the ultimate figure). In contrast, the meaning of word Islam is submission (to one God, not to messenger) and the word Quran means the recitation (of God's message to The Prophet). Similarly, Hinduism also contains varied systems of philosophy, beliefs, and rituals. It has no generally agreed one holy scripture at all. It is also incorrect to term Hinduism as the name of a religion as it is just an ethnogeographic term that was dervied from the word Sindhu (indus), a large body of water.

Are religion and spirituality same and whether both are beneficial? In sociology, the religion is clearly differentiated from spirituality but in medical field, being religious and being spiritual is seen as an identical concept [3]. This is important since health benefits disappear when a person becomes spiritual instead of religious [4]. This can also be clearly understood from their individual definitions and a comparison below, table 2. Religion as "the belief in and worship of a superhuman controlling power, especially a personal God or gods". Spirituality as "the quality of being concerned with the human spirit or soul as opposed to material or physical things".

Table 2: Difference between religion and spirituality

Why is the religion medically important? Since antiquity, the religion has a close and a strong relationship with the practice of medicine and provision of community medical services [5]. This can be seen from the fact that since French revolution, the practice of medicine was performed by clergies-cum-physicians and medical services were most often provided by (and through) religion-attached institutions [5]. Many such institutions currently exist even today such as the Red Cross. A better way to determine medical relevance of religion can be derived from the holy scriptures itself. For instance, in The Holy Quran, it is mentioned in Sura 4 verse 79, "everything good that happens to you (O Man) is from God, everything bad that happens to you is from your own actions". It is now well known that a disease occurs as physiology (natural state) gone wrong, almost always because of man-made factors [6, 7].

Past exploration of medical relevance of religion Despite clear association of religion, there is almost complete dearth of appropriate medical research on its possible impact and benefits (preventative and curative) for human health. This is because the research on this topic is deliberately avoided [5, 8]. One possible reason for this deliberate avoidance might be widespread misconceptions about religion, such as violence. Based on a UN survey, the most violent region in the World is Latin America, followed by sub-Saharan Africa, and then MENA [9], unlike widespread popular beliefs. Besides this, although The Holy Quran is exclusively attributed to violence connotations, the current Bible (and other holy scriptures) has more number of such verses (eg, Book of Samuels chapter 15, verse 3, Book of Kings chapter 2, verse 23-24, Book of Chronicles chapter 25, verse 12, etc.).

How much religion is neuropsychiatrically important? The religion has a valid clinical context [10]. For instance, it was historically established that about 1/4th of all mental illness cases can be clinically explained through religion [11]. This matches well with a very recent survey performed by the author in MENA which suggested that 29.0% variance in mental health and health-related lifestyle is attributed to the practice of religion (currently unpublished, D Bhalla, 2018). Despite such a considerable significance, religion aspects are never or rarely enquired about in a day-to-day clinical practice [10]. Besides this, hyper-religiousity [12] is negatively (but erroneously) attributed to a number of neuropsychiatric conditions such as epilepsy, schizophrenia, obsessive compulsion, etc, especially those in refractory states. This hyper-religiousity is rather more a consequence of underlying anomaly, instead of hyper-religiosity causing any of these ailments.

Extent of neuropsychiatric benefits of religion The benefits are either preventative, curative, or both [13-15]. The primary prevention is one of the most effective ways to reduce public health burden, as can be seen from a number of field data. For instance, fasting (eg. Ramadan in Islam, Navratra in Hindu religion, Paryushan in Jain religion, Vinaya rule in Buddhism) is an important event among various religions during which sexual abstinance is one of the essential duties. It was seen that a casual sexual abtinance lessens the risk of illict drug use, need for a health insurance, and reduces mental health scores for depression and anxiety [16].

Against suicide, The Islam prevents this risk by directly prohibiting it and indirectly by lowering the causes of suicide such as substance abuse or encouraging for maintenance of mental, social, and emotional well-being [17]. According to current Bible (Book of Samuels 17, verse 23), suicide is not an unforgivable sin although in Islam it is among the greatest sins. Based on a recent survey by the author, it was estimated in MENA that over a period of five long years, only 70 subjects attempted suicide and only two of them died (currently unpublished, D Bhalla, 2018).

In another example, meningococcal infection is an endemic tropical infection of which humans are the only reservoir. It is an important risk factor for a variety of neuropsychiatric ailments (eg. photophobia, sleep-related ailments, epilepsy, sensory deficits, depression, etc) and upto 20.0% of those affected have permanent neuropsychiatric sequalae. It was observed that a casual religion practice leads to >90.0% reduction in meningococcal infection and therefore of associated morbidities [18]. Another example comes of mortality and longevity, wherein those who practice religion live longer (upto 13.7 years) than their non-religious counterparts [19- 21].

With regards to curative benefits, the recitation of Quran provides curative benefits related to cognitive, behavioral, socioemotional, and mental health domains [13]. This matches with several curative effects of Islam on cognition, anxiety, depression, bereavement, schizophrenia [22, 23]. Few more curative examples are provided in subsequent sections.

Who does religion benefit? We may only provide few perspectives. Based on a recent survey, it was shown that the practice of religion benefit males 5.5x more than the females (p=0.0001) in terms of mental health prevention; even if both have an identical religion practice (currently unpublished, D Bhalla, 2018). This is seen in many other populations as well [10, 11, 24-27]; indicating that religion may benefit independent of its type. The males also obtain better mental health improvement than females, in terms of cognition, behavioral, and socio-emotional domains [13].

Similarly, in comparison to young, elders have different frequency of practicing religion [28], have different spiritual [29] and health [5, 11] needs, and are far more inclined to seek health and welfare benefits from religion [27]. It is shown that religious practices are associated with better physical health and greater longevity as well as better mental health and greater social support. It benefits elders through healthy aging, longevity [30, 31], as well as slower progression of dementia [32].

How does religion benefit? The religion exert both positive (i.e. inspirational) [33] and negative (i.e. punishment) influence on an individual [34]. It can therefore impact health behaviour and choices depending at the least upon the personality type, environment, and coping skills of an individual [35]. Limited information is available on how may religion provide good benefits. But it is shown that the practice of religion helps through abstinance, better discipline, lesser susceptibility to diseases, positive attitude and knowledge towards health maintenance, etc [36]. It is also shown to cause beneficial immune effects [37].

CONCLUSIONS

To conclude, the religion is an important health, medical, and neuropsychiatric topic, with clear possible benefits, both preventative and curative, with regards to a number of neuropsychiatric situations. How these benefits emerge from religion is not yet fully understood but initial concepts indicate modification of immune system, behavioral and lifestyle changes, change in how an individual thinks (i.e. perception) and interact (i.e. response to exposure to risk) with his environment, etc. The benefits are more likely for males and elderly. Among major religions, Islam seem to be better defined, preserved, and authentic religion; thus in better position to answer some of the greatest medical questions. There is also a need to differentiate spirituality from religion. Lastly, there is a need to better define, organise, and formalise neurotheology as an independent speciality; for which wider collaborations are invited from only values-driven individuals.

ACKNOWLEDGMENT

We acknowledge all, named or unnamed, that might be.

CONFLICT OF INTEREST

There is no conflicting interest

REFERENCES

1. (2006). Who believes in God and who doesn't? [Internet]. Gallup News Service. [cited 10 April 2018].
2. (2006). Twenty-eight percent believe Bible is actual word of God [Internet]. Gallup News Service. [cited 10 April 2018].
3. McEvoy M, Burton W and Milan F. (2014). Spiritual versus religious identity: a necessary distinction in understanding clinicians' behavior and attitudes toward clinical practice and medical student teaching in this realm. J Relig Health. 53(4): 1249-1256.
4. Kretchy I, Owusu-Daaku F and Danquah S. (2013). Spiritual and religious beliefs: do they matter in the medication adherence behaviour of hypertensive patients?. Biopsychosoc Med.7(1): 15.
5. Koenig HG, King DE and Carson VB. (2012). A history of religions, medicine and healthcare. Handbook of Religion and Health 2. New York, USA. Oxford University Press. 15- 34.
6. Adamu UF. (2012). Medicine in the Qur'an and Sunnah: An Intellectual Reappraisal of the Legacy and Future of Islamic Medicine and its Represent. Oxford, UK: African Books Collective CY.
7. Saadat SH, Chavoshi AA and Ahmadi K. (2014). A Brief Survey on Medical Ethics Regarding the Holy Quran and Isalmic Hadith. Int J Med Rev.1(1): 9-12.
8. Poole R and Cook CH. (2011). Praying with a patient constitutes a breach of professional boundaries in psychiatric practice. British J Psychiatr. 199(2): 94-98.
9. Bhalla D, Lotfalinezhad E, Amini F, Salmannejad M, et al. (2018). Incidence and risk profile of dementia in the regions of Middle-East and North Africa (MENA). Neuroepidemiol. 50: 144-152.
10. Curlin FA, lawrence RE, Odell S, Chin MH, et al. (2007). Religion, Spirituality, and Medicine: Psychiatrists' and Other Physicians' Differing Observations, Interpretations, and Clinical Approaches. Am J Psychiatr. 164(12): 1825-1831.
11. Larson DB, Thielman SB, Greenwood MA, Lyons JS, et al. (1993). Religious content in the DSM-III-R glossary of technical terms. Am J Psychiatr. 150(12): 1884-1885.
12. Wuerfel J, Krishnamoorthy ES, Brown RJ, Lemieux L, et al. (2004). Religiosity is associated with hippocampal but not amygdala volumes in patients with refractory epilepsy. J Neurol Neurosurg Psychiatry. 75(4): 640-642.
13. Darabinia M, Gorji AMH and Afzali MA. (2017). The effect of the Quran recitation on mental health of the Iranian medical staff. J Nurs Educ Pract. 7(11): 30-36.
14. Mahjoob M, Nejati J, Hosseini A and Bakhshani NM (2016). The Effect of Holy Quran Voice on Mental Health. J Relig Health. 55(1): 38-42.
15. Sabry WM and Vohra A. (2013). Role of Islam in the management of Psychiatric disorders. Ind J Psychiatr. 55(Suppl 2): S205-S214.
16. Nettleman M, Ingersoll KS and Ceperich SD. (2006). Characteristics of adult women who abstain from sexual intercourse. J Fam Plan Reprod Health Care. 32(1): 23-24.
17. Sarfraz A and Castle D. (2002). A Muslim suicide. Australasian Psychiatr. 10(1): 48-50.
18. Tully J, Viner RM, Coen PG and Robert Booy. (2006). Risk and protective factors for meningococcal disease in adolescents: matched cohort study. BMJ. 332(7539): 445- 450.
19. McCullough ME, Friedman HS, Enders CK and Martin LR. (2009). Does devoutness delay death? Psychological investment in religion and its association with longevity in the Terman sample. J Pers Soc Psychol. 97(5): 866-882.
20. Hummer RA, Rogers RG, Nam CB and Ellison CG. (1999). Religious involvement and U.S. adult mortality. Demography. 36(2): 273-385.
21. Marks LD, Nesteruk O, Swanson M, Betsy Garrison, et al. (2005). Religion and health among African Americans: A qualitative examination. Res Aging. 27(4): 447-474.
22. Wahass S and Kent G. (1997). Coping with auditory hallucinations: a cross-cultural comparison between western (British) and non-western (Saudi Arabian) patients. J Nerv Ment Dis. 185(11): 664-668.
23. Zhar MZ and Varma SL. (2000). Mental illness and its treatment in Malaysia. Mental illness in the Islamic world. New York, USA: International Universities Press. 163-85.
24. Divsalar K, Nejadnaderi S, Nakhaee N and Saed Rouhani. (2010). Religious Attitude Associated with General Health and Smoking in Iranian Students. Addiction & Health. 2(1- 2): 1-7.
25. Holt CL, Clark EM and Roth DL. (2014). Positive and Negative Religious Beliefs Explaining the Religion-Health Connection Among African Americans. Int J Psycho relig. 24(4): 311-331.
26. Maselko J and Kubzansky LD. (2006). Gender differences in religious practices, spiritual experiences and health: results from the US General Social Survey. Soc Sci Med. 62(11): 2848-2860.
27. Fabricatore AN, Handal PJ and Fenzel LM. (2000). Personal spirituality as a moderator of the relationship between stressors and subjective well-being. J Psychol Theol. 28(3): 221-228.
28. Montazeri A, Sajadian A, Ebrahimi M and Haghighat S, et al. (2007). Factors predicting the use of complementary and alternative therapies among cancer patients in Iran. Eur J Cancer Care (Engl). 16(2): 144-149.
29. Mowat H. (2007). Gerontological chaplaincy: The spiritual needs of older people and staff who work with them. Scottish J Healthcare Chaplain. 10(1) : 27-31.
30. Cherry KE, Marks LD, Benedetto T, Sullivan MC, et al. (2013). Perceptions of Longevity and Successful Aging in Very Old Adults. J Relig Spiritual Aging. 25(4).
31. Jaffe DH, Eisenbach Z, Neumark YD, and Orly Manor. (2005). Does Living in a Religiously Affiliated Neighborhood Lower Mortality? Ann Epidemiol. 15(10): 804-810.
32. Kaufman Y, Anaki D, Binns M and Freedman M. (2007). Cognitive decline in Alzheimer disease: Impact of spirituality, religiosity, and QOL. Neurology. 68(18): 1509-1514.
33. Walsh F. (1998). Strengthening family resiliance New York, USA: The Guildford Press. 55-60.
34. Ahmad WIU. (2000). Ethnicity, disability and chronic illness. Buckingham, UK. Open University Press. 154.
35. Rotter JB. (1966). Generalized expectancies for internal versus external control of reinforcement. Psychol Monogr. 80(1): 1-28.
36. Harold GK, McCullough ME and Larson DB. (2001). disease prevention, disease detection and treatment compliance. In: Koening HG, editor. Handbook of religion and health. Oxford, UK: Oxford University Press. 397-410.
37. Koenig HG, Cohen HJ, George LK, Hays JC, et al. (1997). Attendance at religious services, interleukin-6, and other biological parameters of immune function in older adults. Int J Psychiatry Med. 27(3): 233-250.