First break psychosis in a young military veteran with cannabis use disorder: an educational case report

Psychotropic management of a first psychotic break is challenging for many psychiatrists. The literature shows that the use of cannabis is widespread in psychotic individuals. The literature also points to young males being most at risk for substance abuse. Studies also show that obstructive sleep apnea and the stress of the military lifestyle contribute to the development of psychosis. Here, we present a case study of a young non-combat veteran with a medical history of obstructive sleep apnea who presented to the Emergency Department of a Veteran's Affairs hospital with symptoms consistent with a first psychotic break. On routine admission laboratory work, his urine toxicology screen was positive for cannabis. Given the widespread use of cannabis in individuals with psychosis, we suggest that it plays an important role in the regulation of psychosis and behavior.