Vol. 7, Issue 2, Part B (2025)

Schizophrenia is a heterogeneous psychiatric disorder with diverse clinical presentations. Among its subtypes, senestopathic schizophrenia presents with prominent somatic delusions and abnormal bodily sensations (senestopathies), often leading to extensive medical evaluations before psychiatric care is initiated. We present a case of a 45-year-old male with chronic schizophrenia characterized by persistent somatic preoccupations, religious delusions, negative symptoms, and poor treatment adherence due to health-related anxieties. The patient had undergone multiple unsuccessful trials of antidepressants and antipsychotics. Following a switch to cariprazine monotherapy, he exhibited rapid improvement in both positive and negative symptoms, as well as resolution of somatic delusions. This case highlights the clinical utility of cariprazine in complex schizophrenia presentations and underscores the importance of comprehensive somatic evaluation in distinguishing psychiatric symptoms from genuine medical pathology.