Cultural Perspectives on First-Episode Psychosis

First-Episode Psychosis (FEP) is not only a clinical event but also a profoundly cultural one, shaped by collective beliefs, values and social expectations. Cultural frameworks influence how symptoms are interpreted, the pathways by which individuals seek help and the interventions deemed acceptable. In many settings, psychotic experiences are understood through spiritual or moral lenses—attributions to witchcraft, ancestral spirits or possession are common in parts of Africa, Asia and Latin America. Such explanatory models guide help-seeking behaviour, often leading patients first to traditional healers or religious figures, which can delay or supplement biomedical treatment. Cultural expectations also modulate recovery trajectories: societal norms around independence, family roles and stigma determine functional outcomes in social, recreational and vocational domains. Early intervention services that respect local idioms of distress and engage community stakeholders show promise in promoting adherence and reducing duration of untreated psychosis. Integrating culturally sensitive assessment tools, negotiating explanatory models with patients and collaborating with faith leaders can enhance engagement, reduce stigma and tailor psychosocial support, underlining the global importance of culture-informed approaches to FEP care.

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Cultural Perspectives on First-Episode Psychosis publication trend

The graph below shows the total number of articles in cultural perspectives on first-episode psychosis across all publications each year (not limited to Nature Index journals).

Technical terms

First-Episode Psychosis (FEP): The initial onset of psychotic symptoms, including hallucinations, delusions or disorganised thinking, in an individual without prior treatment for psychosis.

Early Intervention Service: A specialised, often multidisciplinary, programme designed to detect and treat FEP rapidly, with the aim of improving long-term outcomes and reducing duration of untreated psychosis.

Prosocial Functioning: The capacity to engage in and maintain positive social interactions, including empathy, cooperation and adherence to social norms.

Delusion: A firmly held false belief that is resistant to reason or contradicting evidence and is not aligned with cultural norms.

Religious Coping: The use of spiritual beliefs and practices to make sense of and manage distressing experiences, which may include rituals, prayer or consultation with faith leaders.

References

1. Compulsory admission as access to early intervention service for patients with first episode psychosis: What relevance for clinical outcomes? Further findings from the Pr-EP program. Psychiatry Research (2025).
2. Context and Expectations Matter: Social, Recreational, and Independent Functioning among Youth with Psychosis in Chennai, India and Montreal, Canada. The Canadian Journal of Psychiatry (2023).
3. Delusions of Possession and Religious Coping in Schizophrenia: A Qualitative Study of Four Cases. Frontiers in Psychology (2021).
4. Concepts of madness in diverse settings: a qualitative study from the INTREPID project. BMC Psychiatry (2016).