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Dissociative and Psychotic Experiences in Brazilian Spiritist Mediums

Spiritism is a French offshoot of the spiritualistic movement that developed in the 19th century. In Brazil it is the fourth largest religion and its practices are deeply connected to mediumistic activity. This is not reimbursed but considered charitable voluntary work [8] . We examined the socio-demographic profile, social adjustment and mental health in Spiritist mediums as well as the clinical and socio-demographic characteristics that help distinguish the dissociative and psychotic experiences of a pathological from a non-pathological character. One hundred and fifteen mediums were randomly selected from different Kardecist Spiritist centers in São Paulo, Brazil. In the early phase of the study, all participants signed a consent form and completed socio-demographic and mediumistic activity questionnaires, the Self-Report Psychiatric Screening Questionnaire (SRQ) [9] as well as the Social Adjustment Scale (SAS) [10] . Those mediums identified by the SRQ as probably having MD (n = 12) and a control group (12 subjects randomly selected among the remaining 103 mediums) were interviewed using the Dissociative Disorders Interview Schedule [11] and the Schedules for Clinical Assessment in Neuropsychiatry [12] . The types of mediumship were coded according to the Spiritist classification: embodiment/incorporation (the medium says that the spirit controls his/her whole body), psychophony (a feeling that the medium’s speech has an external origin, considered to be a disembodied spirit), hearing (hear the spirits), seeing (seeing the spirits) and psychography (the spirit writes through the medium’s hand) [13] . The t test for independent samples, 2 for categorical variables and the Pearson test for correlation coefficients were used. The main results are presented in table 1 . The sample had a high educational level, low unemployment rate and was predominantly female; a profile similar to other samples of mediums [14, 15] . The average SAS score was within the range of the general population and better than psychiatric patients [10] . SRQ results suggest a low prevalence of common mental disorders in the sample, lower than in other Brazilian studies using SRQ in non-clinical populations [16, 17] . Unlike patients with dissociative and psychotic disorders [2, 18] , these mediums had not experienced a high prevalence of childhood abuse. Incorporation was linked to better scores of social adjustment and fewer psychiatric symptoms; hearing and psychography were also associated with better social adjustment. Surveys performed over the last decade have shown that dissociative, hallucinatory and purported extrasensory experiences are common in the general population and often not associated with MD [2–4, 15] . The high level of mediumistic experiences was reflected in the high frequency of schneiderian first-rank symptoms for schizophrenia. However, these classic symptoms, in the present sample, had no statistical correlation with other markers of MD (social adjustment, SRQ scores and physical or sexual abuse).