Objectives
To characterize the complex relationships between schizophrenia, spirituality and religion.
Background and aims
Spirituality influences the presentation, course and outcome of schizophrenia. The authors report an illustrative clinical case and conduct a literature review on this subject. 
Materials and methods
“Pubmed” database was searched from 2004 to 2019 using the terms “schizophrenia” and “religion”. Relevant data from the patient’s medical record was collected.
Results
A 42-year-old male with schizophrenia presented with extensive self-reference and religious delusions and attenuation of the boundaries of self, namely passivity phenomena: experiencing the movement of his members into a lotus position as a spiritual initiation in Rosicrucianism. He is part of this organization and he assures these passivity phenomena are private experiences, presenting poor treatment adherence.
The search returned 264 studies which met the inclusion criteria.
While anomalous self-experiences are episodic in mystical experiences, they are subjective, trait-like and interfere with experience in the mundane ontological context in schizophrenia. Theory of mind and attribution of agency are core cognitive concepts in the genesis of both religious experience and productive symptoms.
Religious themes in psychopathology are associated with more severe illness and poorer functioning. While a consistent belief system is associated with positive coping skills, the influence of religious experience on quality of life and disease outcomes have been mixed.
Conclusions
The translation of religious/mystical phenomenology into fundamentally different entities, and the relationship between religiosity and the natural history of schizophrenia are two essential and complementary approaches. Further research is needed, namely regarding treatment adherence.

SPIRITUALITY AND SCHIZOPHRENIA – CASE REPORT AND LITERATURE REVIEW