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Studies have highlighted the impact of ego-consciousness, religiosity and spirituality on psychotic symptoms, although so far no study has investigated if and how these factors may be interrelated. In this exploratory cross-sectional study, involving 42 patients with a diagnosis of acute paranoid schizophrenia (DSM-IV), we assessed religiosity (Religious Orientation Test) spirituality (Spiritual Transcendence Scale) and ego-pathology (Ego Pathology Inventory) and analysed any relationship with these and psychopathological symptoms (Positive and Negative Symptom Scale). The subjects were divided into four ethnic groups (Caucasian, Afro-Caribbean, African, and Asian) and a structured, qualitative interview on religious needs and self-concepts was also conducted. Using a multivariate analysis, we found statistically significant negative associations between the scores on ego and common pathology and religiosity and spirituality as covariates. This was seen across all ethnic groups. The findings are discussed in respect of the potential clinical importance of ethnic, religious and spiritual factors for assessment and management of patients with schizophrenia. [ABSTRACT FROM AUTHOR]