Cultural Aspects in the Hallucinations and Delusions of Schizoprenic Patients: An Autobiographical Approach

Authors

DOI:

https://doi.org/10.23917/indigenous.v10i2.10744

Keywords:

Culture, delusions, hallucinations, schizophrenia

Abstract

Cultural considerations play a pivotal role in the diagnostic process of mental disorders, underscoring the necessity for clinicians to incorporate a cultural formulation in their assessments, as recommended by the DSM-5. This aligns with the fundamental principle of cultural competence essential for clinicians. This study seeks to investigate and elucidate the content of hallucinations and delusions experienced by psychotic patients of Javanese cultural background. This research used an authobiographical approach in qualitative research. Data for the research were derived from authobiographical source, specifically personal narratives of former patients documented in the book 'Ratu Adil'. Thematic analysis was employed for data analysis. Findings revealed a prevalence of delusional experiences over hallucinations among participants. Delusions and hallucinations frequently contained cultural elements, with Islamic themes being the most prominent, followed by Javanese, Chinese, and global cultural elements. The identified themes in the content of delusions and hallucinations depict manifestations of these cultural influences. In conclusion, this study underscores that the content and themes of delusions and hallucinations represent the participants' internal perceptions, often reflecting the external cultural milieu or environment.

References

American Psychiatric Association. (1998). Diagnostic and statistical manual of mental disorders (4th

ed., text rev.). American Psychiatric Publishing, Inc.

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th

ed., text rev.). American Psychiatric Publishing, Inc.

Anderson-Schmidt, H., Gade, K., Malzahn, D., Papiol, S., Budde, M., Kalman, J., & Schulze,

T. G. (2017). T41 – Dissecting Religious Delusions In Schizophrenia: The Interplay Of

Religious Activity And Polygenic Burden. European Neuropsychopharmacology, 27, S457–

S458. https://doi.org/10.1016/j.euroneuro.2016.09.529

Atallah S.F, El-Dosoky A.R, Coker E.M, Nabil K.M, E.-I. M. (2001). A 22-year retrospective

analysis of the changing frequency and patterns of religious symptoms among inpatients

with psychotic illness in Egypt. Social Psychiatry and Psychiatric Epidemiology, 36, 407–415.

http://doi.org/10.1007/s001270170031

Bauer, S. M., Schanda, H., Karakula, H., Olajossy-Hilkesberger, L., Rudaleviciene, P., Okribelashvili,

N., Chaudhry, H. R., Idemudia, S. E., Gscheider, S., Ritter, K., & Stompe, T. (2011).

Culture and the prevalence of hallucinations in schizophrenia. Comprehensive Psychiatry,

52(3), 319–325. https://doi.org/10.1016/j.comppsych.2010.06.008

Bell, Grech, Maiden, Halligan, & E. (2005). Internet Delusions’: A Case Series and Theoretical

Integration. Psychopathology, 38, 144–150. https://doi.org/10.1159/000085845.

Bhavsar V, B. D. (2008). Religious delusions: finding meanings in psychosis. Psychopathology.,

41(3), 165–172. https://doi.org/10.1159/000115954

Bhikha, A., Farooq, S., Chaudhry, N., Naeem, F., & Husain, N. (2015). Explanatory models of

psychosis amongst British South Asians. Asian Journal of Psychiatry, 16, 48–54. https://doi.

org/10.1016/j.ajp.2015.05.042

Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in

Psychology, 3(2), 77–101. https://doi.org/10.1191/1478088706qp063oa

Burns, J. K., Jhazbhay, K., & Emsley, R. A. (2011). Causal attributions, pathway to care and clinical

features of first-episode psychosis: A South African perspective. International Journal of

Social Psychiatry, 57(5), 538–545.https://doi.org/10.1177/0020764010390199

Cook C. C. (2015). Religious psychopathology: The prevalence of religious content of delusions

and hallucinations in mental disorder. The International journal of social psychiatry, 61(4),

404-425. https://doi.org/10.1177/0020764015573089

Cannon BJ, K. L. (2012). Delusion content across the 20th century in an American psychiatric

hospital. inj J Soc Psychiatry., 58(3), 323–327. https://doi.org/10.1177/0020764010396413

Carter, L., Read, J., Pyle, M., & Morrison, A. P. (2017). The impact of causal explanations on

outcome in people experiencing psychosis: A systematic review. Clinical Psychology &

Psychotherapy, 24(2), 332–347. https://doi.org/10.1002/cpp.2002

Ceylan, A., & Alkar, zden. (2023). The Cross-Cultural Differences in Symptoms of Schizophrenia:

A Systematic Review. Journal of Cognitive-Behavioral Psychotherapy and Research, 0,1.

https://doi.org/10.5455/jcbpr.129188

Connell, A., Koen, L., Niehaus, D., Cloete, K. J., Jordaan, E., & Botha, U. (2015). Religious

Delusions in a Xhosa Schizophrenia Population. Journal of religion and health, 54(5),

1555–1562. https://doi.org/10.1007/s10943-014-9860-0

Desjarlais, R., Eisenberg, L., Good, B., & Kleinman, A. (1995). World Mental Health: Problems and

Priorities in Low-income Countries. Oxford University Press.

Douglas, K., & Barnwell, A. (Eds.). (2019). Research methodologies for auto/biography studies.

Routledge. https://doi.org/10.4324/9780429288432

Dumpratiwi, A. N., Cahyadi, M. M., & Ardani, A. N. (2024). Javanese society’s eyes: Understanding

phenomenon of people with mental disorders in Java. Indigenous: Jurnal Ilmiah Psikologi,

8(2), 153-160. https://doi.org/10.23917/indigenous.v8i2.21010

Fekih-Romdhane, F., Obeid, S., & Hallit, S. (2023). Editorial: Psychotic experiences and symptoms

in adolescents and young adults from different countries and cultural backgrounds. Frontiers

in Psychiatry, 14(9). https://doi.org/10.3389/fpsyt.2023.1275061

Fitrikasari, A., & Kartikasari, L. (2022). Buku Ajar Skizofrenia. UNDIP Press Semarang.

Forsyth, R., Harland, R. and Edwards, T. (2001). Computer Game Delusions. Journal of the Royal

Society of Medicine, 94(4), 184–185. https://doi/10.1177/014107680109400409

Gawad, N. A., Desai, P., Ali, T., Lewis, K. K., Polo, R., Engstrom, A., & Pigott, T. (2018). Religious

activity, psychotic features, and suicidality in 688 acute psychiatric inpatients. Journal of

Psychiatric Practice, 24(4), 253–260. https://doi.org/10.1097/pra.0000000000000311

Gearing, R. E., Alonzo, D., Smolak, A., McHugh, K., Harmon, S., & Baldwin, S. (2011).

Association of religion with delusions and hallucinations in the context of schizophrenia:

Implications for engagement and adherence. Schizophrenia Research, 126, 150–163. https://

doi.org/10.1016/j.schres.2010.11.005

Grover, S., Davuluri, T., & Chakrabarti, S. (2014). Religion, spirituality, and schizophrenia:

A review. Indian Journal of Psychological Medicine, 36(2), 119–124.https://doi.

org/10.4103/02537176.130962

Gureje, O. Lewis-Fernandez, R. Hall, B.J., Reed, G. M. (2020). Cultural considerations in the

classification of mental disorders: why and how in ICD-11. BMC Medicine, 18(25). https://

doi.org/https://doi.org/10.1186/s12916-020-1493-4

Heffernan, S., Neil, S., Thomas, Y., & Weatherhead, S. (2016). Religion in the recovery journey

of individuals with experience of psychosis. Psychosis, 8(4), 346–356. https://doi.org/10.1

080/17522439.2016.1172334

Huguelet, P., Mohr, S., Borras, L., Gillieron, C., & Brandt, P. Y. (2006). Spirituality and religious

practices among outpatients with schizophrenia and their clinicians. Psychiatric services,

57(3), 366–372. https://doi.org/10.1176/appi.ps.57.3.366

Jablensky, A., Sartorius, N., Ernberg, G., Anker, M., Korten, A., Cooper, J. E., Day, R., & Bertelsen,

A. (1992). Schizophrenia: Manifestations, incidence and course in different cultures A

World Health Organization Ten-Country Study. Psychological Medicine. Monograph

Supplement, 20, 1–97. https://doi.org/10.1017/S0264180100000904

Kiran, C., & Chaudhury, S. (2009). Understanding delusions. Industrial psychiatry journal, 18(1),

3–18. https://doi.org/10.4103/0972-6748.57851

Kim, K. I., Hwu, H., Zhang, L. D., Lu, M. K., Park, K. K., Hwang, T. J., Kim, D., & Park,

Y. C. (2001). Schizophrenic delusions in Seoul, Shanghai and Taipei: A transcultural

study. In Journal of Korean Medical Science, 16(1), 88–94. https://doi.org/10.3346/

jkms.2001.16.1.88

Krzystanek, M., Krysta, K., Klasik, A., & Krupka-Matuszczyk, I. (2012). Religious content of

delusions and hallucinations in chronically hospitalized patients with schizophrenia over

the last 80 years. Psychiatria Polska, 46(6), 1017–1026.

Lerner, V., Libov, I., & Witztum, E. (2006). "Internet delusions": the impact of technological

developments on the content of psychiatric symptoms. The Israel journal of psychiatry and

related sciences, 43(1), 47–51. Retrived from https://pubmed.ncbi.nlm.nih.gov/16910385/

Lin, K., & Kleinman, A. (1988). Psychopathology and clinical course of schizophrenia: A

cross-cultural perspective. Schizophrenia Bulletin, 14(4), 555-567. https://doi.org/10.1093/

schbul/14.4.555

Maslim, R. (2020). Pedoman penggolongan dan diagnosis gangguan jiwa III (PPDGJ III). PT Nuh

Jaya.

Owen, M. J., Sawa, A., & Mortensen, P. B. (2016). Schizophrenia. The Lancet, 388(10039), 86–97.

https://doi.org/10.1016/S0140-6736(15)01121-6

Pietkiewicz, I. J., Kłosińska, U., & Tomalski, R. (2021). Delusions of Possession and Religious

Coping in Schizophrenia: A Qualitative Study of Four Cases. Frontiers in Psychology, 12.

https://doi.org/10.3389/fpsyg.2021.628925

Pols, H. (2006). The development of psychiatry in Indonesia: From colonial to modern times.

International Review of Psychiatry, 18(4), 363–370. https://doi.org/10.1080/0954026060

0775421

Romanenko, N., & Popovich, U. (2020). Juvenile Attack-Like Endogenous Psychosis with Religious

Delusion: Psychopathology and Clinical Features. Psikhiatriya, 17(4), 49–56. https://doi.

org/10.30629/2618-6667-2019-17-4-49-56

Sartorius, N., Gulbinet, W., Harrison, G., Laska, E., & Siegel, C. (1996). Long-term follow up of

schizophrenia in 16 countries. Social Psychiatry and Psychiatric Epidemiology, 31, 249-258.

https://doi.org/10.1007/s001270200005

Siddle, R., Haddock, G., Tarrier, N., & Faragher, E. B. (2002). Religious delusions in patients

admitted to hospital with schizophrenia. Social Psychiatry and Psychiatric Epidemiology,

37, 130138. https://doi.org/10.1007/s001270200005

Stompe T, Bauer S, Ortwein-Swoboda G, Schanda H, Karakula H, Rudalevicienne P, et al. (2006).

Delusions of guilt: The attitude of Christian and Muslim schizophrenic patients toward

good and evil and the responsibility of men. Journal of Muslim Mental Health, 1(1),

43–56. http://doi/ abs/10.1080/15564900600654294

Subandi. (2007). Kaget , bingung , dan teror : Dimensi psikokultural dalam pengalaman psikotik.

Jurnal Fakultas Psikologi Universitas Gadjah Mada, 34(1), 40–54 https://doi.org/10.22146/

jpsi.7088

Suci, E.S.T. (2025). Psikologi Kolonial: Jejak pemikiran sebelum lahirnya ilmu psikologi modern

di Indonesia. Buletin KPIN, 11(37)

Suhail, K. and Cochrane, R. (2002). Effect of culture and environment on the phenomenology

of delusions and hallucinations. International Journal of Social Psychiatry, 48(2), 126–138.

https://doi.org/10.1177/002076402128783181

Uludag, K., & Zhao, M. (2024). How Religious Delusions Impact Patients with Schizophrenia.

International Journal of Religion 5(1), 294–300. https://doi.org/10.61707/cnj9b481

World Health Organization. (1992). The ICD-10 classification of mental and behavioural disorders:

clinical descriptions and diagnostic guidelines. World Health Organization.

Yip, K. S. (2003). Taoism and its impact on mental health of the Chinese people. International

Journal of Social Psychiatry, 49(2), 103–114. https://doi.org/10.1177/0020764003049

002003

Yuniarti, K. W., Hanafi, S., & Laheba, T. H. (Eds.). (2019). Psikopatologi lintas budaya. UGM

Press–University Publisher

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Submitted

2025-06-01

Published

2025-07-31

How to Cite

M.A., S., Swasti, I., Nihayah, M., & Sukamto, P. (2025). Cultural Aspects in the Hallucinations and Delusions of Schizoprenic Patients: An Autobiographical Approach . Indigenous: Jurnal Ilmiah Psikologi, 10(2), 127–145. https://doi.org/10.23917/indigenous.v10i2.10744

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