Delusions or obsessions: the same only different? A case report

The phenomenological distinction between delusions and obsessions has been the subject of much debate in psychiatry. Some authors feel these symptoms are distinct nosological entities, while others argue that they reflect manifestations of the same symptom and are distinguishable on the basis of the level of insight a patient displays. In this report we describe the case history of a lady who presented with an obsessional disorder. The symptom was resistant to standard treatments and subsequently became more delusional in nature. We review the literature in terms of the classification of obsessions and delusions and offer assistance to clinicians in terms of the diagnosis and treatment of cases where the distinction between these phenomena is not clear and offer alternative means of classifying these symptoms based on insight.