Moral Injury, Trance and Possession State or a Schizophrenic Illness

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 repo...

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Main Authors: Oluwatomiwa Charles Ajayi, Arit Esangbedo, Abisola A. Lawal, Abimbola Oladapo Olanrewaju, Temitope I. Ojo, Olufemi Talabi
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-01-01
Series:Nigerian Journal of Medicine
Subjects:
Online Access:https://journals.lww.com/10.4103/NJM.NJM_4_24
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author Oluwatomiwa Charles Ajayi
Arit Esangbedo
Abisola A. Lawal
Abimbola Oladapo Olanrewaju
Temitope I. Ojo
Olufemi Talabi
author_facet Oluwatomiwa Charles Ajayi
Arit Esangbedo
Abisola A. Lawal
Abimbola Oladapo Olanrewaju
Temitope I. Ojo
Olufemi Talabi
author_sort Oluwatomiwa Charles Ajayi
collection DOAJ
description 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.
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publishDate 2025-01-01
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series Nigerian Journal of Medicine
spelling doaj-art-df6666f5839148e3a5406159bb3b3ffc2025-08-20T03:24:32ZengWolters Kluwer Medknow PublicationsNigerian Journal of Medicine1115-26132667-05262025-01-01341767910.4103/NJM.NJM_4_24Moral Injury, Trance and Possession State or a Schizophrenic IllnessOluwatomiwa Charles AjayiArit EsangbedoAbisola A. LawalAbimbola Oladapo OlanrewajuTemitope I. OjoOlufemi TalabiMoral 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.https://journals.lww.com/10.4103/NJM.NJM_4_24case reportdissociationdissociative schizophreniadissociative trance disordermoral injurypossession trance disordertrance and possession disordertrance and possession state
spellingShingle Oluwatomiwa Charles Ajayi
Arit Esangbedo
Abisola A. Lawal
Abimbola Oladapo Olanrewaju
Temitope I. Ojo
Olufemi Talabi
Moral Injury, Trance and Possession State or a Schizophrenic Illness
Nigerian Journal of Medicine
case report
dissociation
dissociative schizophrenia
dissociative trance disorder
moral injury
possession trance disorder
trance and possession disorder
trance and possession state
title Moral Injury, Trance and Possession State or a Schizophrenic Illness
title_full Moral Injury, Trance and Possession State or a Schizophrenic Illness
title_fullStr Moral Injury, Trance and Possession State or a Schizophrenic Illness
title_full_unstemmed Moral Injury, Trance and Possession State or a Schizophrenic Illness
title_short Moral Injury, Trance and Possession State or a Schizophrenic Illness
title_sort moral injury trance and possession state or a schizophrenic illness
topic case report
dissociation
dissociative schizophrenia
dissociative trance disorder
moral injury
possession trance disorder
trance and possession disorder
trance and possession state
url https://journals.lww.com/10.4103/NJM.NJM_4_24
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