When Belief Meets Biology: Cultural Interpretations of Psychosis as Spirit Possession – A Narrative Study

Abstract The cultural context plays a critical role in shaping how psychiatric symptoms are perceived, interpreted, and managed. This article presents a clinically focused narrative on the misinterpretation of psychotic symptoms as spirit possession, based on a real-world case from a rural area in Himachal Pradesh, India. The case illustrates the interface between psychiatry and cultural beliefs and the diagnostic challenges posed in culturally diverse settings. The article critically analyzes existing literature on cultural syndromes and their overlap with psychotic disorders, discusses the biopsychosocial underpinnings of such misinterpretations, and proposes a culturally sensitive diagnostic approach that enhances therapeutic alliance, treatment adherence, and outcome. This article contributes to the growing body of transcultural psychiatry literature, emphasizing the need for integrated models that account for both biomedical and cultural dimensions of mental illness.