Psychotic symptoms of sexual nature as core psychopathology in schizophrenia - Case series

Sep 29, 2026

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Psychotic symptoms involving sexual content remain underreported in schizophrenia, particularly in Indian settings. This case series reviewed six patients with schizophrenia presenting with sexually themed delusions or hallucinations as core psychopathology. Data were extracted via chart review with informed consent and de-identification. Diagnostic formulation used ICD-11 criteria and insight was assessed on a 5-point clinical scale. The mean age was 32 years and five patients were female; three were treatment-resistant and responded to clozapine.

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CategoryHealthcare

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Abstract

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CASE SERIES Psychotic symptoms of sexual nature as core psychopathology in schizophrenia: Case series Anjali Sharma, Manish R. Thakur, Bhavuk Garg, Shiv Prasad Department of Psychiatry, Lady Hardinge Medical College, New Delhi, India ABSTRACT Background: Psychotic symptoms involving sexual content remain underreported in schizophrenia, particularly in Indian settings. Cases: Six patients with schizophrenia presenting with sexually themed delusions or hallucinations as core psychopathology were reviewed. Data were extracted through chart review with informed consent and de‑identification. Diagnostic formulation was based on ICD-11 criteria, and insight was assessed on a 5-point clinical scale. The mean age was 32 years; five patients were female. Presentations included somatic passivity, delusional perception, and delusion of control. Three patients met criteria for treatment-resistant schizophrenia and responded to clozapine. Conclusion: Sexually themed psychotic experiences may occur as prominent features of schizophrenia, particularly in chronic or treatment-resistant cases. Awareness of such presentations can facilitate culturally sensitive diagnosis and management. Key words: Psychopathology, psychosis, schizophrenia, sexual symptoms INTRODUCTION Schizophrenia is a multifaceted, complex, and severe mental disorder characterized by a wide array of symptom domains. [1] Reported estimates have suggested a lifetime prevalence of schizophrenia varying between 0.28% and 0.7%, notwithstanding a vast dissimilitude between countries and ethnicities. [2] The key symptom domains are positive symptoms, negative symptoms, depressive and manic mood symptoms, psychomotor symptoms, and cognitive symptoms. The positive Address for correspondence: Dr. Anjali Sharma, 209, House surgeon block, Lady Hardinge Medical College, New Delhi, India. E‑mail: [dranjalis28@gmail.com](dranjalis28@gmail.com) Submitted: 19‑Apr‑2025, Revised: 26‑Nov‑2025, Accepted: 30‑Nov‑2025, Published: 18‑Dec‑2025 | Access this article online | | | --- | --- | | Website:
[https://journals.lww.com/indianjpsychiatry](https://journals.lww.com/indianjpsychiatry) | Quick Response Code | | | | | DOI:
10.4103/indianjpsychiatry_378_25 | | symptom domain includes psychotic symptoms, which include delusions, hallucinations, disorganized thinking, disorganized behavior, and experiences of passivity and control. [3] While researchers have made progress in comprehending delusions and hallucinations in schizophrenia-spectrum psychotic disorders using both phenomenological and analytical approaches, psychotic symptoms involving sexual content remain underreported, especially within Indian psychiatric literature. [4-6] Although there have been publications documenting the occurrence of psychotic symptoms involving sexual content, including among individuals with schizophrenia,[7-15] only fewer studies have explored their possible associations with This is an open access article distributed under the terms of the Creative Commons Attribution‑NonCommercial‑NoDerivatives 4.0 License (CC BY‑NC‑ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. For reprints [contact:](contact: WKHLRPMedknow_reprints@wolterskluwer.com)[ WKHLRPMedknow_reprints@wolterskluwer.com](contact: WKHLRPMedknow_reprints@wolterskluwer.com) How to cite this article: Sharma A, Thakur MR, Garg B, Prasad S. Psychotic symptoms of sexual nature as core psychopathology in schizophrenia: Case series. Indian J Psychiatry 2025;67:1191‑4. Sharma, et al.: Sexual psychotic symptoms in schizophrenia psychopathological factors. [16,17] However, among all modalities of hallucinations (i.e. , auditory, visual, olfactory, gustatory, and tactile), sexual types have been the least analyzed so far.[17] In Indian literature, there is a dearth of literatur

FAQs

What was the main focus of this case series?

The study focused on psychotic symptoms involving sexual content presented as core psychopathology in schizophrenia.

How were patients selected and data collected?

Six inpatient cases meeting ICD-11 criteria for schizophrenia were identified through retrospective chart review, and clinical information was verified through patient and caregiver interviews with consent.

What measures were used to assess clinical features and insight?

Insight was assessed using a five-point clinical scale, and symptom severity was measured with the Positive and Negative Syndrome Scale (PANSS).

What treatment response was reported in some patients?

Three patients met criteria for treatment-resistant schizophrenia and responded to clozapine.

Sep 29, 2026

Uploaded by dabgoudw