Preferences for Religious and Spiritual Discussion in Saudi Psychiatric Care

This study aimed to measure preferences of Saudi psychiatric outpatients regarding psychiatrist-initiated discussion of religion and spirituality (R/S) and to identify sociodemographic, clinical, and religiosity-related factors independently associated with these preferences.

In this cross-sectional study, 202 adult psychiatric outpatients at Al-Noor Specialist Hospital, Makkah, Saudi Arabia, completed a self-administered questionnaire assessing sociodemographic and clinical characteristics, religiosity, and preferences for R/S discussion. The primary outcome, receptiveness to R/S discussion, was modeled using Poisson regression with robust standard errors. A secondary continuous outcome was modeled using linear regression. False discovery rate correction was applied across baseline comparisons.

Of 259 patients approached, 202 (78.0%) participated in the study. A total of 38.6% of participants actively preferred psychiatrist-initiated discussion of R/S, and 43.6% were open to it if clinically relevant (combined: 82.2%, 95% CI: 76.3-86.8), while 9.9% preferred no discussion and 6.4% preferred to raise the topic themselves. The prevalence estimate was sensitive to outcome definition, ranging from 38.6% to 88.6% across four prespecified definitions, whereas the religiosity association was stable across all four. When the three Duke University Religion Index (DUREL) domains were entered simultaneously, intrinsic religiosity was the only domain independently associated with the outcome (adjusted prevalence ratio (aPR): 1.12 per point, 95% CI: 1.07-1.17, p < 0.001); organizational religiosity contributed modestly (aPR: 1.05, 95% CI: 1.01-1.10, p = 0.008) and non-organizational religiosity showed no independent association (aPR: 1.01, 95% CI: 0.96-1.08, p = 0.630). Older age was associated with greater acceptability in the primary model but was attenuated on further adjustment. Sex and education were not independently associated with the outcome.

Most Saudi psychiatric outpatients in this single-center sample considered psychiatrist-initiated discussion of R/S acceptable, particularly those with higher intrinsic religiosity, although a substantial minority preferred no discussion or preferred to raise the topic themselves. These findings describe stated preferences and do not establish the benefit of routine spiritual assessment; they support individualized, permission-based inquiry rather than routine implementation.