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New research · Psychiatry
BMJ case reports · 1d
Case reportBMJ case reports · 2026

Psychotic depression with suicidality in the context of internet gaming disorder and chronic cannabis use.

Mirela Ćelić Ružić, Linda Rossini Gajšak, Darjan Svetinović, Marijana Knezović Florijan
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PsychiatryCase report

Psychotic symptoms and suicidality remitted in 4 weeks with treatment.

Psychotic depression with suicidality in the context of internet gaming disorder and chronic cannabis use.

Mirela Ćelić Ružić et al. · BMJ case reports · 2026
Background

A man in his 20s was admitted after a serious suicide attempt (hypnotic overdose) following months of severe depression and social withdrawal.

4
Results
weeks
delusions, paranoia, and thoughts of self-harm went away in this time
More results

In the preceding 2 weeks, after a 2-day forced break from gaming due to a brief, mild, self-limited illness during which COVID-19 testing was not performed and loss of in-game status, he developed derealisation and paranoid ideas that others were 'non-playable characters'.

More results

His history revealed compulsive online gaming (approximately 10 hours/day) and chronic cannabis use, and urine toxicology was positive for cannabis.

At follow-up, up to 3 months, clinical stability was maintained, urine toxicology was negative for cannabis and symptom measures improved.

“
Conclusion

This case illustrates a clinically important temporal and phenomenological association between severe depression, problematic gaming, cannabis use and psychotic decompensation while emphasising that causality cannot be inferred from a single case.

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