Cannabis-induced psychotic depression and evolving Bipolar 1 Disorder and Psychotic Disorder as a comorbidity: A case report

Abstract

Cannabis is a widely used substance among youth. It may cause affective and psychotic disorders or substance use disorders can be co-ocurred in affective and psychotic disorders. In this case report, we evaluated the 4.5-years psychiatric follow-up and treatment of a 23-year-old female patient who had been diagnosed with attention deficit hyperactivity disorder (ADHD) since the age of 10, started using cannabis occasionally since the age of 14, and consumed alcohol occasionally but mostly cannabis heavily for the last six years and who presented to the doctor with the clinical picture of major depression with psychotic features. Complete remission was achieved following first physician application. However, in the subsequent period, the episode of major depression with psychotic features recurred following alcohol and methylphenidate abuse and cannabis use. In the following periods, bipolar 1 disorder (BD-1) and paranoid psychosis symptoms emerged following the neglect of medication use and heavy cannabis use. During the final process, it was determined that the patient's last clinical picture showed partial remission. Consequently, based on this case, we aimed to draw attention to questions about whether bipolar disorder is a comorbidity with substance use disorder or whether there is a cause-effect relationship between them and to the relationship between substance use and psychotic disorder.