Poster 11

[P-11-01] Case Report: Obsessive Compulsive Disorder Presenting as Spiritual Possession in a Southeast Asian Context

*Sabrina Goo¹, Tian Ling Low² (1.Institute of Mental Health(Singapore), 2.Singapore General Hospital(Singapore))

Keywords:

culture bound syndrome,obsessive compulsive disorder,cultural psychiatry

Culture affects how patients perceive and report discomfort, and the way in which clinicians interpret symptoms in terms of psychiatric diagnoses. Numerous culture-bound syndromes in Asia reflect the interaction of diverse cultural beliefs with mental illness, typified by the Eastern emphasis on the mind and body connection (in dhat), spiritual and ancestral worlds (in hsieh-ping), somatisation and emotional suppression (in shenjing shuairuo) and interdependence (in taijin-kyofusho). As religion is a way of explaining the unknown, of making meaning of experience and of healing, it is turned to as an avenue for mental health help in Asia. Some sects of Taoism, an East Asian religion, involve the idea of spirit possession where a medium's body is taken over by a deity, spirit, or ancestor, who then speaks through the medium. We report a case of a Singaporean male, who subscribed to Taoism, and who presented with various somatic complaints whom he attributed to ancestral spirits. His fixation on his bodily complaints, in the context of ‘spiritual possession’, engendered anxiety which then led to the manifestation of obsessive-compulsive symptoms with a compulsion to tap parts of his body to 'satisfy the [possessing] spirit'. This case highlights the need for the application of a culturally sensitive lens to the diagnosis of psychiatric illnesses given the ill-defined borders of cultural beliefs with psychotic beliefs.