Professeur de Psychiatrie, Chef de Service, Service de psychopathologie de l'enfant et de l'adolescent, psychiatrie générale et addictologie, Hôpital Avicenne (AP-HP), Université Paris 13, France
2 papers in the library · 84 citations · publishing 2011-2026
Dissociative trance disorder (DTD) is a recognized but understudied condition. A review of 28 articles covering 402 cases worldwide found that possession-type episodes (69%) are more common than trance alone (31%). Amnesia occurred in 20% of patients, while hallucinatory symptoms during possession were reported in 56%, suggesting this should be a key diagnostic criterion. Somatic complaints appeared in 34% of cases. The authors argue that DTD should be included in the DSM-5 with adjustments, as it is a widespread idiom of distress likely underdiagnosed in Western countries due to cultural biases. Accurate diagnosis requires evaluating both sociocultural and individual factors, including acculturation difficulties.
Possession states present a complex challenge in transcultural psychiatry. When a Somali patient experiencing possession was treated in a transcultural consultation group, young clinicians witnessed a trance and experienced cultural countertransference. Using the Cultural Formulation Interview, the clinicians' countertransference evolved, leading to a deeper understanding of the symptom and improvement in the patient's condition. This case demonstrates the importance of addressing cultural countertransference among young clinicians in transcultural consultations.