Possession Syndrome in Rural Nepal: A Case Study Examining Cultural, Clinical and Forensic Implications
Alok Atreya, Sabbu Maharjan, Samata Nepal, Ajay Risal, Sneha Chaudhary, Namuna Rasaely
Case Reports in Psychiatry January 1, 2025 DOI: 10.1155/crps/6680684 via OpenAlex
Summary
AI-generated from the abstractA 30-year-old woman in rural Nepal experienced acute episodes of altered consciousness, religious chanting, and deity-associated behavior, likely influenced by local beliefs in divine possession. Similar symptoms occurred in a family member, and she first sought help from traditional healers before psychiatric care. Medical tests were normal. The condition, understood as a possession state involving substitution of personality by a spirit or deity, responded well to combined medication and supportive psychotherapy during a brief hospital stay. The case underscores the need for cultural competence in forensic psychiatric evaluations in Nepal and highlights challenges in applying mental health legislation within traditional cultural settings.
Study at a glance
| Characteristics | Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | 30-year-old woman in rural Nepal |
| Interventions | pharmacotherapy supportive psychotherapy |
| Duration | Brief hospital stay |
| Keywords | Possession linguistics Mental health Competence human resources Context archaeology Legislation |
| Citations | 1 |
| Key finding | A possession state with religious manifestations in a Nepalese woman resolved with pharmacotherapy and psychotherapy, illustrating cultural influences on psychiatric presentation and the importance of culturally competent forensic evaluation. |
Abstract
Possession state is a disorder of consciousness with substitution of the personality, which is claimed to be a spirit, a deity, a dead person or some other power. In rural Nepal these experiences are normalised and Hindu communities often attribute psychological conditions to a supernatural cause. We report the case of a 30-year-old woman who presented with acute-onset symptoms characterised by episodes of altered consciousness, vocalisations suggestive of religious chants, and deity-associated behaviour, probably influenced by local suggestions of divine possession. Additional notable features included similar presentations among a family member and seeking help from traditional healers prior to psychiatric consultation. Medical examinations and investigations were normal. Specific cultural and religious manifestations posed challenges to clinical interpretation. The patient responded well to combined pharmacotherapy and supportive psychotherapy during her brief hospital stay, with cessation of possession episodes. This case report highlights the importance of cultural competence in Nepalese forensic psychiatric evaluations, particularly in the context of possession states, while examining the application of mental health legislation in traditional cultural settings.