Researchers at Wuhan Mental Health Center consecutively recruited adults aged 18 to 60 who had an International Classification of Diseases, 10th Revision diagnosis of schizophrenia and were considered clinically stable by their treating psychiatrists. Recruitment took place from March to May 2024 at the outpatient department of the hospital, which serves Wuhan and surrounding cities in south-central China. Patients were excluded if severe physical illness, marked cognitive or communication difficulties or acute psychotic symptoms prevented them from completing the questionnaire. The single-center sample therefore represents a selected group of non-geriatric outpatients rather than the full spectrum of people with schizophrenia.

Formal religious affiliation was reported by 36.5% of participants, with Buddhism the most common affiliation at 20.1%. Christianity accounted for 6.0% and folk religion for 4.7%; smaller groups identified with Catholicism, Islam, Daoism or other affiliations. Practice use did not closely follow formal membership, however. Among patients with a religious affiliation, 66.1% had used at least one religious, spiritual or folk healing practice, compared with 52.1% of those without such an affiliation, a statistically significant difference. Even among participants reporting no formal affiliation, Zen meditation was used by 38.9% and scripture chanting or religious rituals by 22.1%, illustrating the overlap between formal religion and culturally embedded spiritual practice in China.

The four practices assessed were Zen meditation, scripture chanting and religious rituals, religious prayer, and shamanic dance or exorcism rituals. Their prevalence differed according to affiliation: 65.0% of participants affiliated with Buddhism reported Zen meditation, while religious prayer was reported by 44.4% of those affiliated with Christianity. The authors noted that Chinese spiritual life can combine Buddhist, Daoist, Confucian, ancestral and folk traditions rather than fitting neatly into exclusive institutional identities. The questionnaire therefore measured both declared affiliation and specific beliefs and behaviors, including belief in reincarnation and karma, supernatural interpretations of illness, and whether family members held supernatural beliefs about illness.

Helpfulness ratings varied by practice. Among the 134 participants who used Zen meditation, 77.6% regarded it as helpful. The corresponding proportions were 61.1% for scripture chanting and religious rituals, 59.5% for religious prayer and 57.7% for shamanic dance or exorcism practices. These percentages describe subjective appraisals among each practice’s users, not changes in symptoms or evidence that any practice is clinically effective. The survey did not include standardized clinician-rated symptom measures such as the Positive and Negative Syndrome Scale, and it did not collect detailed antipsychotic use, medication adherence or psychotherapy information. A patient could therefore perceive benefit even if the underlying psychotic symptoms persisted.

Exploratory classification tree analysis identified belief in reincarnation and karma as the first factor separating patients by practice use. Among the 120 participants who endorsed these beliefs, 76.7% reported using a religious, spiritual or folk practice, compared with 44.1% of the 179 who did not, a difference with P<0.001. Further subdivisions involved education and age among those who endorsed reincarnation and karma. Among participants without those beliefs, the analysis instead highlighted non-conventional health beliefs, family members’ supernatural beliefs and occupation. The structure indicates combinations of factors rather than independent causes, and the researchers did not directly measure distress, stigma, motivations for using the practices or pathways into psychiatric care.

Within the subgroup of practice users, religious affiliation was the first split associated with perceived helpfulness. Among 53 patients affiliated with Buddhism, Daoism, Catholicism or Islam, 92.5% rated their practices helpful, compared with 59.3% among the other 118 users, a difference with P<0.001. Within that second group, family members’ supernatural beliefs were again associated with the rating: 70.8% of users whose relatives held such beliefs considered the practices helpful, versus 51.4% of those whose relatives did not. The authors interpreted the family findings cautiously, noting that relatives may reinforce particular ways of understanding illness, but the cross-sectional survey cannot establish that family beliefs cause practice use or perceived benefit.

Methodological constraints limit how broadly the findings can be applied. The practice checklist was developed for the study from relevant literature and preliminary interviews with 10 patients, while the exploratory four-item non-conventional health-belief scale had acceptable internal consistency in this sample, with Cronbach’s alpha of 0.75, but had not undergone formal factor or validity testing. Classification tree analysis was chosen as an exploratory way to detect potentially nonlinear subgroup patterns, not to build a validated predictive model. Its stability and generalizability remain untested in independent samples. The cross-sectional design also prevents causal conclusions, and recruitment from one tertiary hospital limits representation of inpatients, people with acute psychosis, older adults, untreated patients, rural communities and regions with different religious traditions.

Even with those limitations, the survey documents an important part of how patients in this Wuhan outpatient population experience and manage schizophrenia. The most common practice, meditation, was also the one most often regarded as helpful, while the analysis connected use and perceived benefit with personal beliefs, family context and selected demographic factors. The findings do not justify replacing evidence-based psychiatric treatment or interpreting spiritual rituals as treatments for core psychotic symptoms. They do indicate that clinicians assessing these patients may encounter religious and spiritual practices that are meaningful to them and influential within their families. Recognizing those practices without assuming that they caused symptom improvement could help make psychiatric communication more attentive to the cultural frameworks through which patients interpret illness.

Subject of Research: Prevalence and perceived helpfulness of religious and spiritual practices among clinically stable Chinese outpatients with schizophrenia

Article Title: Use of religious and spiritual complementary practices among Chinese patients with schizophrenia: prevalence, perceived helpfulness, and associated factors

Article References: Tang, M., Liu, H., & Zhong, B.-L. (2026). Use of religious and spiritual complementary practices among Chinese patients with schizophrenia: prevalence, perceived helpfulness, and associated factors. Frontiers in Psychiatry, 17, Article 1948994. https://doi.org/10.3389/fpsyt.2026.1948994

Image Credits: AI Generated

DOI: 10.3389/fpsyt.2026.1948994

Keywords: schizophrenia, religious practices, spiritual care, Chinese psychiatry, patient-reported outcomes, Zen meditation, folk healing, family beliefs, cultural psychiatry, cross-sectional survey, religious, spiritual

The study, conducted by Muhammad Asad Latif of the Islamia University of Bahawalpur, collected cross-sectional data between March and June 2023 using interviewer-administered surveys. This methodological choice was not incidental. In communities where literacy rates are low and digital access is limited, self-completed questionnaires risk excluding precisely the people whose experiences matter most. By having trained interviewers read questions aloud and record responses, the researcher was able to include participants who would otherwise have been invisible to the data, improving the representativeness of a sample drawn from 282 respondents in Lahore and 90 in Bahawalpur.

The central quantitative finding concerns the relationship between religious engagement and social connectedness. Participation in religious activities, the data show, is closely intertwined with patterns of social interaction: Christians who reported higher levels of religious engagement also reported stronger bonds with their community. In practical terms, churches and the networks that surround them function not merely as places of worship but as social infrastructure, anchoring friendships, mutual aid, and collective identity. For a minority that often experiences exclusion from mainstream civic life, the congregation becomes a parallel sphere of belonging.

Yet the qualitative insights embedded in the study complicate any rosy reading of that statistic. Respondents described persistent restrictions on the public expression of religious identity, a caution that shapes everything from how openly one wears symbols of faith to whether one discusses religious matters with neighbors. Many participants voiced concerns about safety during religious gatherings, a fear rooted in experience rather than abstraction. Pakistan has witnessed repeated attacks on Christian worshippers in recent decades, and the study found that the memory of violent incidents continues to shape perceptions of security, even in periods without active threats.

This gap between formal legal protection and lived experience is the study’s most consequential theme. Pakistan’s constitution guarantees religious freedom, and the country’s legal framework formally accords minorities a range of rights. But implementation, the research argues, remains uneven. Constitutional text does not automatically translate into police protection at a Sunday service, equal access to employment, or freedom from social pressure in a neighborhood. The result is a structural inequality that persists despite formal equality on paper, a pattern well documented in the broader scholarship on minority rights that the study situates itself within.

The methodological design deserves attention from social scientists working in comparable contexts. Cross-sectional surveys capture a snapshot rather than a trajectory, which limits causal inference; the study cannot say, for example, whether religious engagement causes stronger community bonds or whether tightly connected communities foster greater religious participation. What the design does allow is a systematic comparison of self-reported practices and perceptions across two urban settings of different size and character. Lahore, the provincial capital with a large and historically rooted Christian population, and Bahawalpur, a smaller city in southern Punjab, offer contrasting environments in which to observe how local conditions shape minority life.

The study’s ethical architecture is also notable. It was reviewed and approved by the Advanced Board of Studies and Research at The Islamia University of Bahawalpur, with written informed consent obtained from every participant before data collection. Respondents were told the purpose of the research, assured of their right to withdraw at any stage without consequence, and informed about confidentiality measures. No photographs, audio recordings, or other identifiable images were collected, and all data were anonymized at the point of collection. In a research setting where participants belong to a vulnerable minority, these safeguards are not bureaucratic formalities but essential conditions for honest testimony.

The findings arrive amid a wider body of scholarship documenting the pressures facing religious minorities in Pakistan. Recent census data from the Pakistan Bureau of Statistics confirm that Christians constitute a small fraction of the national population, concentrated disproportionately in Punjab. Prior studies have examined attitudes toward minorities, the political participation of non-Muslim citizens, and the socioeconomic disadvantages that cluster in minority neighborhoods, where many Christians work in sanitation and other low-status occupations. The new study adds a psychological and pastoral dimension to this literature, asking not only what structural conditions minorities face but how those conditions are experienced, internalized, and negotiated in everyday religious and social life.

For the author, the policy implications are concrete. Strengthening institutional enforcement of existing protections, enhancing security measures at places of worship, and addressing localized forms of exclusion are identified as essential steps toward improving the safety and social inclusion of religious minorities in Punjab. The emphasis on enforcement is significant: the problem, as the study frames it, is less a absence of law than a deficit of implementation. Police responsiveness, local administration, and community-level mediation all determine whether constitutional guarantees have any practical meaning for a family deciding whether to attend a church service or a young Christian deciding how openly to identify.

The study also speaks to a global conversation about religious freedom and minority protection. International frameworks, from United Nations standards on minority rights to the scholarship on multicultural citizenship, have long recognized that formal guarantees are necessary but insufficient without institutional machinery and social acceptance. Pakistan’s Christian community, with its long history in the region dating to the colonial era, illustrates how a minority can be legally recognized, economically marginalized, and socially cautious all at once. The finding that religious engagement and community connectedness rise together suggests that faith communities themselves are a resource for resilience, even as they remain sites of vulnerability. Understanding that dual role, the study suggests, is essential for anyone seeking to strengthen, rather than merely proclaim, the freedoms that Pakistan’s minorities are promised.

Subject of Research: Religious practices, social interactions, and perceived safety among Christian minorities in Punjab, Pakistan

Article Title: Christian minorities in Pakistan: An exploratory study of religious practices and social interactions in Punjab

Article References: Latif, M. A. (2026). Christian minorities in Pakistan: An exploratory study of religious practices and social interactions in Punjab. Pastoral Psychology. https://doi.org/10.1007/s11089-026-01367-y

Image Credits: AI Generated

DOI: 10.1007/s11089-026-01367-y

Keywords: Christian minorities, Pakistan, Punjab, religious freedom, social inclusion, religious practices, community connectedness, Lahore, Bahawalpur, minority rights, survey research, Pastoral Psychology