Trance and Possession Disorder With Dissociative-Psychotic Overlap: A Clinical Case Report

A young woman with no prior psychiatric history experienced a 12-hour episode of visual and auditory hallucinations, disorganized speech, and aggressive behavior requiring emergency restraint. Her symptoms began with unusual noises and a sense of external presence, which her partner also reported, leading to a religious consultation. She later described a trance-like state with loss of self and partial amnesia. Managed with antipsychotic and benzodiazepine treatment, she stabilized. The case illustrates the diagnostic complexity of trance and possession disorder, especially its overlap with acute psychosis, and underscores the need for a biopsychosocial approach that accounts for cultural context.

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Abstract

Trance and possession disorder (TPD) is a complex and culturally influenced condition characterized by alterations in consciousness, identity, and behavior, often posing diagnostic challenges in clinical psychiatry. We report the case of a young woman who presented with a 12-hour history of visual and auditory hallucinations, disorganized speech, and aggressive behavior toward her partner, requiring emergency intervention and physical restraint. Symptoms began with the perception of unusual noises and external presences in her home, reportedly shared by her partner, prompting religious consultation. Following this, the patient's condition worsened, progressing to marked psychomotor agitation, aggression, and loss of behavioral control. The patient later described a trance-like state with a sense of loss of self and partial amnesia of the episode. There was no prior psychiatric history, substance use, or family history of mental illness. The patient was managed with antipsychotic and benzodiazepine treatment, with subsequent clinical stabilization. This case highlights the diagnostic complexity of TPD, particularly its overlap with acute psychotic presentations and the influence of cultural context on symptom expression, emphasizing the need for a careful biopsychosocial approach in evaluation and management.