Differentiating spiritual experiences from mental disorders

It is not uncommon for patients with mental disorders to have symptoms with religious or spiritual (R/S) contents, and, on the other hand, spiritual experiences often involve psychotic-like phenomena. This frequently creates difficulties in differentiating between a non-pathological R/S experience and a mental disorder. Clinical differentiation between a non-pathological R/S experience and a mental disorder with R/S content brings risks in both extremes: to pathologize normal R/S experience (promoting iatrogenic suffering) or neglecting pathological symptoms (delaying proper treatment). In order to mitigate these risks, this chapter will gather the best current scientific evidence and propose clinical guidelines to help the distinction between R/S experiences and mental disorders with R/S content. Scientific studies in people who have spiritual experiences should be encouraged, especially investigations of the phenomenology, neurobiology, precipitants, and outcomes in order to enlarge the empirical base needed to advance the criteria for this differential diagnosis.