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.