Dissociative disorders, including trance and possession disorder, have long been shaped by cultural, social, and spiritual beliefs. Diagnosis now follows ICD-10, DSM-5, and ICD-11 criteria. In Indian society, trance and possession disorder poses particular challenges for psychiatrists. A case illustrates how social and cultural factors delay diagnosis and management; individuals often first consult a general physician rather than a psychiatrist. This underscores the need for consultation liaison psychiatry (CLP) in diagnosis and ongoing care. Greater awareness of the mind-body relationship and psychosocial support, respecting patients' and relatives' beliefs, remains necessary.
Trance and possession disorder involves a temporary altered state of consciousness, with trance marked by narrowed awareness or uncontrollable behaviors without identity change, and possession by replacement of personal identity with that of a spirit, deity, or animal. These episodes vary culturally and are linked to emotional stress, repressed emotions, domestic discord, or sociocultural issues. A case from Maharashtra, India, describes a patient diagnosed with trance and possession disorder alongside underlying dysthymia; treating the dysthymia stopped the trance episodes, illustrating the interplay between the two conditions.