Psychotic despair with suicidality within the context of web gaming dysfunction and continual hashish use

A person in his 20s was admitted after a critical suicide try (hypnotic overdose) following months of extreme despair and social withdrawal. In the previous 2 weeks, after a 2-day compelled break from gaming on account of a short, gentle, self-limited sickness throughout which COVID-19 testing was not carried out and lack of in-game standing, he developed derealisation and paranoid concepts that others had been ‘non-playable characters’. His historical past revealed compulsive on-line gaming (roughly 10 hours/day) and continual hashish use, and urine toxicology was constructive for hashish. He was handled with antipsychotics and antidepressants, a brief course of benzodiazepines, psychoeducation and household work, with plans for hashish abstinence and gaming restriction. Psychotic signs and suicidality remitted over 4 weeks. At follow-up, as much as 3 months, medical stability was maintained, urine toxicology was detrimental for hashish and symptom measures improved. This case illustrates a clinically necessary temporal and phenomenological affiliation between extreme despair, problematic gaming, hashish use and psychotic decompensation whereas emphasising that causality can’t be inferred from a single case.