Author ORCID Identifier
https://orcid.org/0009-0000-8750-6570
Abstract
Background:
Pseudohallucinations are vivid, hallucination-like experiences that are internal, recognized as unreal. Distinguishing from true hallucinations remains a diagnostic challenge.
Case-report
33-year-old female with family history of psychosis presented with 10-year duration of delusion of infidelity and auditory experiences, with normal Biopsychosocial functioning. She had multiple psychiatric consultations, diagnosed as paranoid schizophrenia, treated with various antipsychotics, ECT, current prescription of clozapine(350mg) with clozapine induced seizure. Reported that her husband was emotionally unavailable. She described the voices in her head which were non-threatening, praising her for having qualities of an ideal-wife. They were constant companions giving her solace and hence refrained from controlling them even if she could (Pseudo hallucinations). Psychological-assessment corroborated. Inadequate coping was noted. Diagnosis revised to Delusional Disorder. Psych educated, Clozapine tapered and stopped, Olanzapine(10mg), CBT and Marital therapy administered- improvement noted.
Conclusion: Globally few cases are reported with initial diagnosis of psychosis with auditory-hallucinations, later revised as non-psychotic illness with pseudohallucinations. Pseudohallucinations are subjective, with insight and links to psychological stress or coping rather than progressive psychotic deterioration as is our case. Careful phenomenological interview, attention to psychosocial stressors and coping can prevent unwarranted psychotropic exposure and improve long-term outcomes.
Publication Date
3-2026
Publisher
JSS Academy of Higher Education & Research
Conflict of Interest
None
The authors declare that there is no conflict of interest
Keywords
Psueudohallucination, delusional disorder, Diagnostic conundrum
Word Count
925
Recommended Citation
Nayak D, Aswath M, Gowda VS.
Pseudo-Hallucinations: A Diagnostic Conundrum.
Digital Journal of Clinical Medicine.
2026;
8(2):
-.
doi:
https://doi.org/10.55691/2582-3868.1315
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
Cover Page Footnote
Article Type: Case Report Manuscript Title: Pseudo-Hallucinations: A Diagnostic Conundrum Running Title: Pseudo-Hallucinations in Delusional Disorder Authors: Dr Sankram Nayak, MBBS, Postgraduate (MD Psychiatry) Department of Psychiatry, KIMS Hospital, Bangalore, Karnataka, India Email: [email protected] ORCID number- 0009-0000-8750-6570 Dr Manju Aswath, MBBS, MD Psychiatry Professor and Head, Department of Psychiatry, KIMS Hospital, Bangalore ORCID number- 0000-0001-5855-1364 Dr Vathsalya S Gowda, MBBS, MD Psychiatry Assistant Professor, Department of Psychiatry, KIMS Hospital, Bangalore ORCID number- 0000-0002-4669-4314 Corresponding Author: Dr Sankram Nayak Department of Psychiatry, KIMS Hospital, Bangalore, Karnataka, India Email: [email protected] Author Contributions: Dr Sankram Nayak: Conceptualization, design, definition of intellectual content, literature search, data acquisition, data analysis, manuscript preparation, guarantor. Dr Manju Aswath: Manuscript editing, manuscript review, supervision. Dr Vathsalya S Gowda: Manuscript editing, manuscript review. Data Availability Statement: Data sharing does not apply to this article as no new data were created or analysed. Disclosure of Use of Generative AI: No generative artificial intelligence tools were used in the preparation of this manuscript. Funding: None. Conflict of Interest: None. Presentation at a Meeting: None. Copyright Declaration: The authors confirm that this manuscript is original, unpublished, and not under consideration elsewhere.
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