REVIEW ARTICLESFaith or Delusion? At the Crossroads of Religion and PsychosisPIERRE, JOSEPH M. MD Author Information PIERRE: UCLA School of Medicine and VA West Los Angeles Healthcare Center. Please send correspondence and reprint requests to: Joseph M. Pierre, MD, 11301 Wilshire Blvd., Building 210C [B-151H], Los Angeles, CA 90073. Journal of Psychiatric Practice 7(3):p 163-172, May 2001. Buy Abstract In clinical practice, no clear guidelines exist to distinguish between “normal” religious beliefs and “pathological” religious delusions. Historically, psychiatrists such as Freud have suggested that all religious beliefs are delusional, while the current DSM-IV definition of delusion exempts religious doctrine from pathology altogether. From an individual standpoint, a dimensional approach to delusional thinking (emphasizing conviction, preoccupation, and extension rather than content) may be useful in examining what is and is not pathological. When beliefs are shared by others, the idiosyncratic can become normalized. Therefore, recognition of social dynamics and the possibility of entire delusional subcultures is necessary in the assessment of group beliefs. Religious beliefs and delusions alike can arise from neurologic lesions and anomalous experiences, suggesting that at least some religious beliefs can be pathological. Religious beliefs exist outside of the scientific domain; therefore they can be easily labeled delusional from a rational perspective. However, a religious belief’s dimensional characteristics, its cultural influences, and its impact on functioning may be more important considerations in clinical practice. Copyright © 2001 Wolters Kluwer Health, Inc. All rights reserved.