Presentation Information
[P-11-04]“Between Demon and Espíritu: Transcultural Psychiatry in a Purépecha Woman with Severe Mood Disorder, Psychosis, and Catatonia”
*Diana Mireles Ortega, Claudia Alejandra Igual, Nicholas Soto Hernández, Christian Rosales-Michel, Aura Garcia-Aguilar, Sergio Armando Covarrubias-Castillo, Jose Manuel Hernandez Salas, Humberto Arizpe Mejía (Hospital Civil de Guadalajara "Fray Antonio Alcalde"(Mexico))
Keywords:
Transcultural psychiatry,Culturally sensitive care,Indigenous mental health,Purépecha culture,Spiritual beliefs
The Purépecha people of Michoacán, Mexico, conceptualize health as a balance between body, mind, and spirit. Illness arises when this harmony is disrupted by spiritual or emotional forces. Traditional healers (chiricahuas or uacúsechas) restore balance through rituals, prayers, and herbal interventions. We present the case of a 62-year-old Purépecha woman from a rural community in Michoacán with psychotic depression marked by severe self-harm, nihilistic delusions (“I am pure spirit”), command hallucinations, and catatonia. She attributed her symptoms to malevolent entities and spiritual disturbances, consistent with traditional beliefs. A culturally sensitive, multimodal approach integrated Western psychiatry and Purépecha healing practices. Language support through bilingual staff and interpreters was essential to build trust and improve adherence. Research shows that culturally competent, language-concordant care improves outcomes in Indigenous populations. Treatment combined pharmacotherapy with respect for the patient’s worldview, allowing the participation of traditional healers and rituals. Over several months, she demonstrated partial improvement: depressive symptoms and nihilistic delusions diminished, although distressing hallucinations and motivational deficits persisted. This case highlights how Purépecha cultural perspectives—emphasizing spiritual imbalance, community support, and rituals—are crucial to understanding and addressing mental illness. Persistent challenges included distrust in biomedical systems, treatment abandonment, and language barriers. Implementing culturally responsive care models, such as outreach teams staffed by Purépecha-speaking clinicians and inclusive healthcare spaces, can enhance engagement and continuity. A transcultural approach that acknowledges spiritual beliefs and incorporates ritual practices strengthens therapeutic alliances, improves treatment adherence, and may prevent relapse. Integrating biomedical and traditional care exemplifies the congress theme, “Where the Pacific Rim Meets the World,” by bridging ancestral traditions and modern psychiatry to promote holistic healing among Indigenous populations.