title: A randomized trial of spiritual assessment of outpatients with schizophrenia: patients' and clinicians' experience.
abstract: OBJECTIVE
  Recovery-oriented care for patients with schizophrenia involves consideration of cultural issues, such as religion and spirituality. However, there is evidence that psychiatrists rarely address such topics. This study examined acceptance of a spiritual assessment by patients and clinicians, suggestions for treatment that arose from the assessment, and patient outcomes--in terms of treatment compliance and satisfaction with care (as measured by treatment alliance).
  
  
  METHODS
  Outpatients with psychosis were randomly assigned to two groups: an intervention group that received traditional treatment and a religious and spiritual assessment (N=40) and a control group that received only traditional treatment (N=38). Eight psychiatrists were trained to administer the assessment to their established and stable patients. After each administration, the psychiatrist attended a supervision session with a psychiatrist and a psychologist of religion. Baseline and three-month data were collected.
  
  
  RESULTS
  The spiritual assessment was well accepted by patients. During supervision, psychiatrists reported potential clinical uses for the assessment information for 67% of patients. No between-group differences in medication adherence and satisfaction with care were found at three months, although patients in the intervention group had significantly better appointment attendance during the follow-up period. Their interest in discussing religion and spirituality with their psychiatrists remained high. The process was not as well accepted by psychiatrists.
  
  
  CONCLUSIONS
  Spiritual assessment can raise important clinical issues in the treatment of patients with chronic schizophrenia. Cultural factors, such as religion and spirituality, should be considered early in clinical training, because many clinicians are not at ease addressing such topics with patients.
authors.affiliation: Department of Psychiatry, University Hospitals of Geneva and University of Geneva, 36 Rue de 31 Décembre, Geneva 1207, Switzerland. philippe.huguelet@hcuge.ch
authors.forename: Philippe
authors.initials: P
authors.lastname: Huguelet
authors.forename: Sylvia
authors.initials: S
authors.lastname: Mohr
authors.forename: Carine
authors.initials: C
authors.lastname: Betrisey
authors.forename: Laurence
authors.initials: L
authors.lastname: Borras
authors.forename: Christiane
authors.initials: C
authors.lastname: Gillieron
authors.forename: Adham Mancini
authors.initials: AM
authors.lastname: Marie
authors.forename: Isabelle
authors.initials: I
authors.lastname: Rieben
authors.forename: Nader
authors.initials: N
authors.lastname: Perroud
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Brandt
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D016013:Likelihood Functions; D016014:Linear Models; D008297:Male; D055118:Medication Adherence; D010342:Patient Acceptance of Health Care; D010347:Patient Care Planning; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011581:Psychological Tests; D012559:Schizophrenia / Q000534:rehabilitation*; D029181:Spirituality; D013557:Switzerland