Delusions incorporating cannabis use in dually diagnosed patients with a primary psychotic disorder.
OBJECTIVE
To describe and discuss the implications for treatment of 3 cases of dually diagnosed patients with a primary psychotic disorder who have developed persisting, cannabis-oriented delusional systems.


METHODS
Psychiatric assessment and daily observation on an acute inpatient psychiatric unit.


RESULTS
Abstinence appears to be particularly difficult to attain for a patient with psychosis who hold delusional beliefs that cannabis is a conduit for supernormal experiences with positive affective content, grandiose themes and a sense of enhanced self-efficacy.


CONCLUSIONS
This phenomenon poses special challenges in the treatment of dual diagnosis patients. Modifications to existing CBT protocols for the treatment of substance abuse in psychosis might be useful in such patients.
Flanders
Sarah E
SE
Department of Psychiatry, James Fletcher Hospital, Newcastle, NSW, Australia. sarah.flanders@hnehealth.nsw.gov.au
D000328:Adult; D001714:Bipolar Disorder / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D002188:Cannabis / Q000009:adverse effects; D015928:Cognitive Behavioral Therapy; D015897:Comorbidity; D003702:Delusions / Q000139:chemically induced* / Q000175:diagnosis / Q000523:psychology*; D017831:Diagnosis, Dual (Psychiatry); D006760:Hospitalization; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D008960:Models, Psychological; D011567:Psychiatric Department, Hospital; D011605:Psychoses, Substance-Induced / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D011618:Psychotic Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D012559:Schizophrenia / Q000175:diagnosis / Q000453:epidemiology; D012565:Schizophrenic Psychology; D016896:Treatment Outcome