Cultural conceptions of self and their impact on the clinical expression and management of identity disturbances in schizophrenia: a philosophical and psychiatric inquiry in Arab-Muslim populations
F. Zaouali, I. AnesIntroduction
The experience and expression of identity disturbances in schizophrenia are profoundly influenced by cultural conceptions of the self. In Arab-Muslim societies, traditional philosophical and religious views shape patients’understanding of selfhood, potentially modifying symptom presentation and treatment engagement.
Objectives
This study aims to investigate how cultural and philosophical constructs of the self within Arab-Muslim contexts affect the clinical manifestation and management of identity disturbances in schizophrenia.
Methods
A mixed-methods approach was employed. First, a systematic literature review (2000–2025) was conducted across PubMed, PsycINFO, Scopus, and Google Scholar using keywords: “schizophrenia,” “identity disturbances,” “self-concept,” “Arab-Muslim,” “culture,” and “philosophy.” Inclusion criteria encompassed studies addressing cultural or philosophical aspects of self in schizophrenia. Secondly, qualitative interviews were conducted with 20 Arab-Muslim patients diagnosed with schizophrenia at a regional psychiatric clinic, exploring their subjective experiences of self and illness. Data were analyzed using thematic analysis to identify culturally specific patterns influencing symptom expression and treatment adherence.
Results
The systematic review identified 18 relevant studies, with 65% reporting that cultural and spiritual beliefs significantly shape symptom expression in schizophrenia among Arab-Muslim populations. Qualitative interviews with 20 patients revealed that 70% interpreted their identity disturbances through spiritual frameworks, such as possession or divine punishment. Additionally, 60% reported initial reliance on religious or traditional healers before seeking psychiatric care. Treatment adherence was affected, with 45% of patients expressing skepticism towards biomedical interventions when cultural beliefs were not acknowledged. Family influence was prominent, with 80% of participants noting that familial attitudes guided help-seeking behavior and symptom The literature and patient narratives revealed that Arab-Muslim cultural frameworks emphasize a relational and spiritual conception of self, contrasting with Western individualistic models. This influences the presentation of identity disturbances, often manifested through spiritual interpretations.
Conclusions
Cultural conceptions of self significantly shape identity disturbances in schizophrenia among Arab-Muslim populations. Incorporating philosophical and cultural insights into psychiatric practice enhances diagnostic accuracy and fosters culturally congruent, patient-centered care. Future research should focus on developing culturally adapted clinical tools and therapeutic interventions to improve outcomes in this population.
Disclosure of Interest
None Declared