Primary delusion revisited -a case report

BACKGROUND: Primary delusions are out of the blue experiences which cannot be understood on the basis of previous patient experiences. Studies are consistent with neurobiological hypothesis that aberrant salience attribution to stimuli is the pathology behind primary delusion. Its significance in course and prognosis needs further systematic evaluation. AIM-: To report a case of 16 year old female who had presented with primary delusion. METHOD: -Patient was evaluated as in patient. She had a bad dream following which she started believing that she is victim of sexual assault which had happened at age 8. Inspite of her parents disproving her, she continued to believe so. She was brought for admission following deliberate self harm. On examination, Primary - delusional memory was elicited along with second person auditory hallucination & visual hallucination. Imaging and blood investigations were within normal limits. Patient was diagnosed with Unspecified non-organic psychosis and treated with Olanzapine . Later diagnosis was revised to Paranoid Schizophrenia continuous course upon onset of passivity delusions. DISCUSSION: Primary delusions are very rarely elicited in patients with schizophrenia often due to the long course, causing difficulty in recall. This case throws light in to psychodynamic aspects of delusion.