title: Influence of religion and supernatural beliefs on clinical manifestation and treatment practices in patients with bipolar disorder.
abstract: BACKGROUND
  Religious and supernatural beliefs influence help seeking and treatment practices in bipolar disorder, but these are rarely explored by clinicians. This study aimed to understand religiousness, magico-religious beliefs, prevalence of religious and supernatural psychopathology and treatment practices among patients with bipolar disorder in euthymic state.
  
  
  METHODS
  A total of 185 patients of bipolar disorder currently in remission were assessed cross-sectionally for their clinical profile, current clinical status on the Hamilton Depression Rating Sscale (HDRS), Young Mania Rating Scale (YMRS) and the Global Assessment of Functioning (GAF). A semi structured instrument for magico-religious beliefs, aetiological models, treatment seeking and treatment practices was administered.
  
  
  RESULTS
  More than a third of patients (37.8%) had psychopathology with either religious or supernatural content or both in their lifetime. Almost half (45.4%) the patients believed in a supernatural/religious aetiology for their illness. Among the specific causes, planetary influences (13.5%) and God's will (30.8%) were the most common supernatural and religious cause, respectively. Almost half (44.3%) of patients had first treatment contact with religious/supernatural treatment providers. More than 90% of patients reported belief in God, yet about 70% reported that their doctors did not ask them sufficient questions to understand their religiosity.
  
  
  CONCLUSIONS
  Magico-religious beliefs are common in bipolar disorder and a large number of patients attribute these as aetiological factors for their illness. Consequently they tend to seek treatment from traditional practitioners prior to approaching medical practitioners and may continue treatment with them alongside medical management.
authors.affiliation: a Department of Psychiatry , Postgraduate Institute of Medical Education and Research , Chandigarh , India.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Grover
authors.affiliation: a Department of Psychiatry , Postgraduate Institute of Medical Education and Research , Chandigarh , India.
authors.forename: Nandita
authors.initials: N
authors.lastname: Hazari
authors.affiliation: a Department of Psychiatry , Postgraduate Institute of Medical Education and Research , Chandigarh , India.
authors.forename: Jitender
authors.initials: J
authors.lastname: Aneja
authors.affiliation: a Department of Psychiatry , Postgraduate Institute of Medical Education and Research , Chandigarh , India.
authors.forename: Subho
authors.initials: S
authors.lastname: Chakrabarti
authors.affiliation: a Department of Psychiatry , Postgraduate Institute of Medical Education and Research , Chandigarh , India.
authors.forename: Ajit
authors.initials: A
authors.lastname: Avasthi
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D003469:Culture; D003863:Depression / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012069:Religion and Psychology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
keywords: India; Magico-religious beliefs; bipolar disorder; religiousness