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In addition to the symptoms listed, he elaborated about someone having sexual intercourse with him, against his will.

On mental status examination, the patient appeared to be very much distressed with his psychopathology.

He described the phenomenon of auditory hallucination commanding and discussing type and thought broadcast.

In addition, the patient explained that at night, when he would go to his bed, he could feel the sensation of being touched by a female, whom he would describe as a good-looking woman.

He would be able to feel his private parts being touched, leading to erection and ejaculation. As per patient, he did not want this experience, this would happen against his will, would feel guilty about having such an experience and having sexual contact with an unknown female, and he was fully convinced about having such an experience.

Very occasionally, he would get up from the sleep, after this experience and remain distressed and fearful. There was no history suggestive of narcolepsy, insomnia, hypersomnia, sleep terrors, nightmares, sleep-related movement disorders, and sleep paralysis; symptoms suggestive of Dhat syndrome, panic attacks, posttraumatic stress disorder, cognitive deficits, and recent change in medications.

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Based on the available information, a diagnosis of schizophrenia was considered. His investigations in the form of haemogram, renal function test, liver function test, serum electrolytes, thyroid function test, electroencephalogram, and magnetic resonance imaging of brain did not reveal any abnormality. He would now report lack of any such experience but was not sure about the previous experience being real or part of the illness.

Case 2 A year-old male, who has been using cannabis in dependent pattern presented with an insidious onset and continuous illness of 2 years' duration, characterized by the delusion of reference, delusional percept, delusion of love, auditory commenting, commanding, and discussing , and tactile hallucinations.

At presentation, on mental status examination, he was untidy and ill-kempt, had blunt affect; however, there was no formal thought disorder. When asked about his psychopathology, he ascribed the voices heard to one of his female teacher, who would express her love toward him in the conversations heard as part of the auditory hallucinations. He also ascribed the tactile hallucinations to the same teacher.

He described this as a sensation of vibration, which he would feel all over his body, more so in his thighs, and genital region. This would occur mainly at night, when he would be fully awake or asleep and alone, would feel aroused, and simultaneously hear the voice of his teacher claiming to be responsible for these sensations.

As per him, he would hear that she is in deep love with him and wanted to have sexual intercourse with him, would feel his penis to be touched, and in the process would have erection and occasional ejaculation. He would be unable to describe exactly how she would be doing this but was convinced that it was she who was doing so.

He also believed that his body is under the control of his teacher, who forces him to indulge in sexual activities, against his will.

He would deny drawing any pleasure out of these activities and would say that he was not able to avoid this experience. This experience was not associated with any active cannabis use or abstinence from cannabis.

At the time of mental status examination, his cognitive functions were preserved, and he had poor insight. Due to all these symptoms, he had to discontinue his education and became homebound. Based on the available information, a diagnosis of schizophrenia and cannabis dependence syndrome was considered, and he was sequentially treated with olanzapine, risperidone, Trifluoperazine, and the combination of olanzapine and fluphenazine decanoate, in adequate doses for adequate duration.

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