THE CLINICAL IMPACT OF RELIGIOUS DELUSIONS IN SCHIZOPHRENIA: DIAGNOSTIC AND THERAPEUTIC IMPLICATIONS IN NIGERIAN PSYCHIATRIC PRACTICE

Schizophrenia patients in Nigeria’s urban areas, especially Lagos, face religious delusions which create significant clinical challenges because of their persistent nature. The range of delusions experienced by patients includes identities as divine beings and spiritual persecution alongside prophetic missions which extend beyond symptomatic variations and are intrinsically linked to sociocultural frameworks of belief systems and power structures that shape individual existential interpretations. The research examines how religious delusions affect diagnostic and treatment practices for schizophrenic patients in Lagos psychiatric hospitals through a convergent mixed-methods design that combines psychometric precision with narrative analysis. The study gathered quantitative data through the Psychotic Symptom Rating Scales–Delusions subscale (PSYRATS-D) and the Positive and Negative Syndrome Scale (PANSS) while qualitative insights emerged from DSM-5 Cultural Formulation Interview (CFI) alongside semi-structured interviews with both patients and clinicians. Early research shows religious delusions are widespread and socially sanctioned which results in unclear diagnosis and postponed treatment while damaging the doctor-patient relationship. Through thematic analysis researchers identified diverse religious idioms that defy standard nosological systems while demonstrating the constraints faced by Eurocentric medical categories when used in settings with intense religious influence. The research utilizes cultural psychiatry theory along with delusion phenomenology and DSM-5 cultural formulation principles to demonstrate the importance of diagnostic methods that align with cultural contexts and therapeutic approaches that integrate community engagement. The research advances a new clinical ethic: This clinical ethic refrains from both pathologizing belief and romanticizing it while ensuring contextual integrity for healing without erasure.