Monosymptomatic Hypochondriacal Psychosis: Atypical Presentation and Response to Olanzapine

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Sir: Monosymptomatic hypochondriacal psychosis (MHP)is an illness characterized by a single delusion of somatic typethat can present at any age from late adolescence onward,equally affecting both sexes and having a poor prognosis withouttreatment.¹ Infestation with parasites, body dysmorphophobia,and halitosis are the most commonly reported somaticdelusions.¹ Pimozide has been frequently used and reported tobe effective in the treatment of MHP, but has the potential for undesirable side effects including tardive dyskinesia and cardiacconduction defects.¹‘ ‹’ ‹