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Rootwork is a belief system practiced among some African-Americans in the Southern United States that appears to be a North American variation of voodoo, which involves folk magic and hexing. Many psychiatrists regard the psychosomatic effects that occur when a patient believes he/she is hexed to be indicative of a mental disorder.

Prevalence
Rootwork is most prevalent among African-Americans in the rural South and in some poor urban areas. It should be noted, however, that Southern whites have been known to engage in the practice. Rootwork is known in the areas it is practiced by many different names, including "hoodoo," "conjure," and simply "witchcraft."

Beliefs and traditions
According to tradition, roots are spells or hexes that are placed on someone by a root worker or root doctor. This is often accomplished by using magic cloth, dust, or potions. Another method of placing a hex is known as foot track magic, which "ascribes magical essence to a person's footprint." . In this case, a special powder is laid down strategically so that the victim may walk over it; this causes a "magical poisoning" that may bring about illness or a string of bad luck.

There are a number of ways to remove a hex. Some "good" root doctors attempt to help their hexed patients with "innate spiritual abilities" that allow the doctor to remove the spell. A sort of spiritual cleansing may also be attained through the use of hoodoo oils, sachet powders, bath oils, and candles.

Symptoms
People who believe they have been hexed often report a diverse array of symptoms, such as:
 * Generalized anxiety
 * Gastrointestinal complaints
 * Dizziness
 * Weakness
 * Delusions; paranoid thoughts about hexes
 * Fear of being poisoned

There are also reports of more isolated cases of eccentric behavior, including one case in which a patient would periodically crawl on all fours and howl like a dog.

Challenges to professional treatment
Many people who believe they have been put under a spell will often attempt to alleviate their symptoms with folk remedies, such as those listed above. Some patients who show these symptoms may seek professional treatment, but rarely admit to their physicians that they feel they have been hexed. Those who do admit their beliefs may not be fully understood by their physicians, especially in modern urban areas that are not permeated by hoodoo culture. For this reason, it is important that caregivers are informed about this culture-bound phenomenon so that these patients may receive proper care. Some psychologists are beginning to suggest that physicians ask patients whether they believe in rootwork or witchcraft if they display "unusual symptoms and the appropriate cultural background."