Cannabis use and first onset Schizophrenia-like psychosis after traumatic brain injury in a patient with intracranial bullet

Abstract

ABSTRACT Traumatic brain injury (TBI) is an important cause of mortality and morbidity worldwide. Cannabis use disorder and psychosis are rare but serious comorbidities seen after TBI. Recent studies indicate that the use of cannabis for self-medication may increase after TBI. Schizophrenia-like psychosis (SLP) is also seen, generally showing a late and gradual onset after TBI. Especially in case of cannabis use disorder, post-TBI psychosis may develop earlier than expected and cause difficulties in terms of diagnosis. In this report, a middle-aged female patient started using cannabis to relieve her anxiety symptoms, six months after a TBI secondary to gunshot wounding, and developed psychotic symptoms within two months. We document her admission, detoxification and recovery during an inpatient stay in the Alcohol and Drug Addiction Research, Treatment and Education Center (AMATEM) inpatient unit. We aim to emphasize the importance of follow-up of patients after TBI in terms of neuropsychiatric symptoms and initiation of symptomatic treatment.