Dissociative Trance Disorder Triggered by Religious Switching – a Case Report

Abstract

Introduction The role of religious switching as an aetiological factor in dissociative trance disorder (DTD) is not well understood. We present a case of DTD diagnosed in a 57-year old Chinese lady who presented with a 3-week history of episodic passivity experiences and behavioural changes involving uncharacteristic hostility towards Christians after converting from Taoism to Christianity. Objectives • To briefly review existing literature on DTD. • To discuss a case in which religious switching in the context of unique cultural factors triggered a DTD. Aims To discuss the aetiological role of culturally-mediated psychological stress associated with religious switching in DTD. Methods We searched for existing literature on DTD on 'PubMed' using the keywords 'dissociative trance disorder'. Relevant information was synthesised into a brief review on DTD. The impact of religious and cultural nuances on the case formulation is discussed in the case presentation. Results The patient's dissociative trances were assessed to be triggered by ambivalence about an upcoming baptism ceremony after converting from Taoism to Christianity. She and her family were psychoeducated about the identified intra-psychic conflict stemming from her religious switching. Psychotherapy was initiated. A low dose of antipsychotic was used for symptomatic relief. A subsequent reduction in frequency of dissociative trances was observed. Conclusions Identifying psychological stress associated with religious switching is imperative in differentiating dissociative trance from other mental disorders. Addressing underlying intra-psychic conflict is the mainstay of treatment. Adjunctive use of medications aids symptomatic relief. Recognising cultural nuances also has broader relevance in formulating psychiatric presentations.