Siembida Jagoda, Mohammed Saaduddin, Chishty Mariam, Leontieva Luba
Psychiatry, State University of New York Upstate Medical University, Syracuse, USA.
Cureus. 2022 Apr 1;14(4):e23744. doi: 10.7759/cureus.23744. eCollection 2022 Apr.
First break psychosis in young adults is sometimes presented as a dichotomous model of organic or substance-induced etiology or a primary psychiatric disorder on the schizophrenia spectrum and related disorders. In this case of a young adult with a typical age of onset for psychotic symptoms also presenting with cannabis use, excessive vaping, history of COVID-19 illness, pineal cyst, and extreme elevation of blood pressure, the diagnostic certainty decreases. Increased risk of progression to schizophrenia in individuals with cannabis use disorder and genetic loading has been extensively reported in the literature. Clinicians may face significant diagnostic and treatment challenges when managing a patient with severe psychotic symptoms. For the clinicians acutely managing such patients facing these exact questions of unknown certainty in progression to full-blown schizophrenia, we highlight a case of severe acute psychosis and complete recovery on a first-generation antipsychotic and mood stabilizer.
青年首次发作的精神病有时被呈现为一种二分模型，即器质性或物质所致病因，或精神分裂症谱系及相关障碍中的原发性精神障碍。在这个典型发病年龄的青年患者案例中，其出现精神病症状的同时还伴有大麻使用、过度吸电子烟、新冠疾病史、松果体囊肿以及血压极度升高，这降低了诊断的确定性。文献中已广泛报道了大麻使用障碍和基因负荷个体发展为精神分裂症的风险增加。临床医生在管理有严重精神病症状的患者时可能面临重大的诊断和治疗挑战。对于急性处理这类面临发展为全面精神分裂症确定性未知这些确切问题的患者的临床医生，我们重点介绍一例使用第一代抗精神病药物和心境稳定剂后严重急性精神病完全康复的病例。
