A case of marked improvement in pareidolia in untreated schizophrenia following antipsychotic treatment

Background: Pareidolia, the tendency to perceive meaningful images within ambiguous visual patterns, is commonly observed in neurodegenerative disorders and schizophrenia. Owing to the limited number of studies, the characteristics of pareidolia accompanying schizophrenia remain unclear. Case Presentation: We present the case of an 85-year-old woman with untreated schizophrenia for nearly 60 years, in whom pareidolia was observed. On evaluation using the Noise Pareidolia Test, the patient initially scored 16/40 correct responses, 24/40 pareidolic responses, and 0/8 misses. After antipsychotic treatment with 15 mg of olanzapine or 24 mg of aripiprazole, pareidolia completely disappeared. However, during the treatment course, pareidolia recurred when the antipsychotic dose was reduced owing to a medication switch. Conclusion: Even in schizophrenia with an insufficient response to pharmacotherapy, pareidolia may still demonstrate treatment responsiveness.