CHRONIC CANNABIS USE PRESENTING WITH NEUROCOGNITIVE IMPAIRMENT AND CANNABIS-INDUCED PSYCHOSIS: A CASE REPORT AND INTEGRATED TREATMENT APPROACH

Abstract

Cannabis-induced psychosis is a serious psychiatric condition and is associated with chronic and prolonged cannabis use. The chronic use of cannabis often results in significant cognitive, behavioural and psychosocial impairment. The present case study examined the case history of SM. He was a 45-year-old married male with a twenty-year history of cannabis dependence. He was presented with recurrent psychotic episodes characterized by aggression, irritability, grandiose delusions, self-talk, insomnia, mood instability and impaired social functioning. Clinical assessment was conducted through comprehensive interviews, behavioural observations, psychometric testing and laboratory investigations. Assessment tools included the Mini-Mental State Examination (MMSE), DSM-5-TR Checklist for Cannabis Use Disorder, House-Tree-Person Test (HTP), Rotter Incomplete Sentence Blank (RISB), Thematic Apperception Test (TAT) and drug screening tests. Findings indicated severe Cannabis Use Disorder accompanied by recurrent psychotic symptoms, emotional dysregulation, impaired insight and significant personality vulnerabilities. The patient demonstrated a pattern of symptom exacerbation following cannabis use and medication non-adherence. A substantial improvement was observed with consistent pharmacological treatment and psychosocial intervention. A structured treatment approach incorporating antipsychotic medication, psychoeducation, relapse prevention strategies, motivational enhancement and family involvement was implemented to address both substance dependence and psychotic symptoms. The findings further underscore the need for early identification and comprehensive management of cannabis-related psychiatric complications within the Pakistani clinical context.