Abstract
Chronic disabling psychotic disorders like schizophrenia are often considered to be relatively treatment-resistant. Drugs and psychosocial support is often prescribed for such patients. In this case study we present a patient for whom psychodynamic assessment of the symptoms suggested that the psychosis was partly developed and achieved a chronic status as a result of an inadequate comprehension of underlying sexual traumatization. Systematic reevaluation of the symptoms with a structured psychiatric interview and assessment of somatic comorbidity further supported the presence of a non-schizophrenic disorder with partly trauma-related etiology which had not been identified previously. The discussion underlines the need for comprehensive descriptive and psychodynamic assessments of chronic psychotic patients. Such assessments of seemingly chronic and hopeless patients may reveal therapeutic potentials not previously identified.
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