Abstract
The current literature on khat and mental disorders focuses on khat-induced disorders neglecting at large the adverse consequences of co-morbid use on pre-existing disorders. The case of a 32 year old Somali with a delusional disorder and co-morbid khat abuse is presented who killed a man in the state of paranoid delusions. The psychotic exacerbation prior to this incident was accompanied by an increase of khat intake. Co-morbid khat abuse can lead to the deterioration of psychotic disorders, can facilitate aggressive acts and complicates treatment. The medical and legal system of the countries where khat use reaches highest levels are not fully prepared to deal with such cases. Further research and the development of adequate prevention and treatment measures is urgently needed. KEY WORDS: khat, psychosis, co-morbidity, aggression, Somalia
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