[Spirituality and cortisol in people living with schizophrenia: An exploratory study]

Objective Several factors can contribute to the recovery of people living with schizophrenia. According to service users living with schizophrenia, spirituality would be an important element in their recovery journey. Spirituality could serve as a coping mechanism to manage psychological stress. The objective of this exploratory study was to examine the relationship between spirituality and cortisol, a stress biomarker, among people living with schizophrenia compared to the general population. Method Participants were drawn from the Signature Project of the Institut universitaire en santé mentale de Montréal (IUSMM). The sample included 94 people living with schizophrenia and 95 control participants. Linear regressions were performed to examine the association between spirituality and cortisol. Results Individuals with schizophrenia accorded greater importance to spirituality than control participants, with a medium to large effect size. Spirituality was more important for women than men, regardless of the group. No significant differences were observed in cortisol concentrations. Lastly, spirituality had no effect on cortisol levels in either group. Bayesian analyses confirmed that the absence of effect was real and not due to a lack of statistical power. Conclusion This study highlights the clinical relevance and importance of integrating the perspective of those directly involved by confirming that people living with schizophrenia place great importance on spirituality. Furthermore, the findings suggest that the role played by spirituality in the recovery of people living with schizophrenia does not rely on a physiological mechanism. Therefore, it would be pertinent to explore the relationship between spirituality and other dimensions of recovery, such as psychological, social or cognitive aspects. A better understanding of the role of spirituality in the recovery of people living with schizophrenia would provide a better comprehension of how to mobilize it to support service users in their ongoing journey.