The case of the missing key: Cultural underpinnings of the ingestion of a foreign body in a psychotic patient

Abstract

We present the case of a 21‐year old woman who developed a delusional system of beliefs within the context of her religious and cultural experiences as well as substance use. This ultimately led her to carry out bizarre behaviors which culminated in her decision to swallow the key to a door while undergoing clinical investigations in hospital. The act of, and motivation for, swallowing the key as well as the patient’s other unusual behaviors and beliefs are explored. We demonstrate how seemingly inexplicable psychotic behaviors can be better understood through a consideration of pertinent sociocultural issues. Clinical interventions and the patient’s response to treatment are also described.

Keywords:

• religion
• culture
• foreign bodies
• psychotic disorders