BackgroundA 52-year old lady presented for admission with severe depression characterised by suicidal ideation and delusional belief.Case presentationHer treatment regime was reviewed and modified. The dilemma was whether she suffered from a psychotic depression with delusion or an obsessional disorder. She responded well to change of antipsychotic medication.ConclusionsHer depression went in remission and her delusional belief decreased in intensity. She also gained reasonable insight into her problem. She is currently being followed up in the psychiatric outpatient clinic.