Moral Injury, Trance and Possession State or a Schizophrenic Illness
Oluwatomiwa Ajayi, Arit Esangbedo, Abisola A. Lawal, Abimbola Oladapo Olanrewaju, Temitope Olumuyiwa Ojo, Olufemi Talabi
Nigerian Journal of Medicine January 1, 2025 DOI: 10.4103/njm.njm_4_24 via OpenAlex
Summary
AI-generated from the abstractMoral injury—intense distress after violating one's ethical beliefs—may contribute to the development of primary psychotic disorders, not just post-traumatic stress disorder. A 22-year-old Nigerian man with a conservative Christian background developed schizophrenia after experiencing moral injury: following prophecies that discouraged premarital intercourse, he had intrusive flashbacks, guilt, and disorganized thoughts a month after his first sexual experience, then psychotic symptoms including beliefs of possession, altered voice, and self-harm seven months later. Treatment with Olanzapine brought significant improvement within two weeks. Cultural and religious beliefs likely shaped his symptoms. More research is needed on moral injury's role in psychosis and sociocultural influences.
Study at a glance
| Characteristics | Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | 22-year-old Nigerian male with conservative Christian background |
| Intervention | Olanzapine |
| Duration | Two weeks |
| Keywords | Trance Possession linguistics Psychology Psychiatry Psychotherapist |
| Key finding | Moral injury may precipitate schizophrenia, with cultural and religious beliefs influencing psychotic symptoms. |
Abstract
Abstract Moral injury, characterised by intense cognitive and emotional distress following an event that violates one’s ethical beliefs, has been primarily associated with post-traumatic stress disorder. However, its role in the development of primary psychotic disorders remains underexplored. This case report presents a 22-year-old Nigerian male with a conservative Christian background who developed schizophrenia following an experience of moral injury. After receiving prophecies discouraging premarital intercourse, he began exhibiting symptoms of mental illness a month after coitarche, including intrusive flashbacks, excessive guilt, and disorganised thoughts. Seven months later, he presented with psychotic symptoms, including beliefs of possession, altered voice textures, and self-harm. A diagnosis of schizophrenia was considered, and treatment with Olanzapine led to significant improvement within two weeks. The case highlights the potential for moral injury to precipitate psychotic disorders, possibly influenced by cultural and religious beliefs. These findings suggest the need for further studies on the relationship between moral injury and primary psychosis, as well as the impact of sociocultural factors on psychiatric phenomenology.