Introduction : Early psychiatric intervention in psychotic disorders is a major determinant of clinical and functional outcome. However, in many cultural contexts, including Morocco, pathways to care are shaped by religious and supernatural explanatory models. Beliefs such as jinn possession, evil eye, or witchcraft may influence help-seeking behavior and contribute to prolonged duration of untreated psychosis (DUP). Understanding the role of cultural beliefs in delaying psychiatric consultation is essential for improving early intervention strategies.
Objectives : To assess the impact of cultural and religious beliefs on delay to first psychiatric consultation among patients with psychosis, and to describe help-seeking pathways prior to contact with mental health services.
Methods : This is a retrospective descriptive and analytic study carried out at Ibn Nafiss University Psychiatric Hospital in Marrakech, among patients diagnosed with psychotic disorders. Sociodemographic data, clinical characteristics, duration of untreated psychosis, first point of care, and causal beliefs regarding illness were collected using a structured questionnaire. Delay to psychiatric consultation was defined as the time between onset of psychotic symptoms and first contact with psychiatric services.
Results : The study population was predominantly composed of young adult men, most of whom were single, living in urban areas, and unemployed, with a minority having attained higher education. Schizophrenia was the most frequent diagnosis, followed by bipolar disorder with psychotic features, schizoaffective disorder, and brief psychotic disorder. A substantial delay between symptom onset and first psychiatric consultation was observed. The main factors contributing to this delay were poor awareness of mental illness, religious or supernatural explanatory beliefs, and denial of psychiatric pathology.
Discussion : Cultural and religious beliefs play a central role in shaping pathways to care for psychosis in Morocco and are associated with significant delays in accessing psychiatric services. While religious interpretations of illness may provide meaning and social support, exclusive reliance on supernatural explanatory models contributes to prolonged untreated psychosis and potentially poorer outcomes. Culturally sensitive mental health strategies, including collaboration with religious leaders and integration of cultural beliefs into psychoeducation, are crucial to reduce delays and improve early access to care for patients with psychosis.
Conclusion : Mental health and psychiatric care continue to be highly stigmatized in Morocco and in many other developing countries. This stigma represents a major barrier to access to care for individuals with mental illness, contributing to delayed consultation and poorer clinical and prognostic outcomes. Public health–oriented prevention campaigns promoting early psychiatric intervention are therefore essential to reduce stigma and improve the quality and timeliness of mental health care.
References
1. Zarouf, H., Chtibi, M., Belbachir, S., & Ouanass, A. (2023). The delay of psychiatric consultation in the Moroccan framework. European Psychiatry, 66(S1), S869–S870.
2. Burns, J. K., & Tomita, A. (2015). Traditional and religious healers in the pathway to care for people with mental disorders in Africa: A systematic review and meta-analysis. Social Psychiatry and Psychiatric Epidemiology, 50(867–877). https://doi.org/10.1007/s00127-014-0989-7
3. Ghanem, M., Evangeli-Dawson, C., & Georgiades, A. (2023). The role of culture on the phenomenology of hallucinations and delusions, explanatory models, and help-seeking attitudes: A narrative review. Early Intervention in Psychiatry, 17(9), 843–863. https://doi.org/10.1111/eip.13449
BOULAID Brahim
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