For young adults with early psychosis who receive coordinated specialty care, cannabis use often begins before psychosis onset and persists because of social normalization, coping with symptoms, and perceived benefits. Users describe cannabis as a way to manage stress, anxiety, and boredom, and they report that quitting is difficult due to withdrawal and lack of appealing alternatives. Non-users avoid cannabis because of paranoia, family disapproval, or health concerns. These findings suggest that treatment for cannabis use disorder in this population should address social contexts, symptom management, and withdrawal.
A patient with dementia with Lewy bodies (DLB) experienced long-lasting complex hallucinations before developing dementia. Over four years, detailed assessments at the predementia stage revealed hypnagogic and hypnopompic hallucinations, which helped distinguish DLB from Charles Bonnet syndrome. Neuropsychological testing showed a multiple-domain mild cognitive impairment without amnesia, including prefrontal executive, visuoperceptual, and visuospatial deficits, plus simultanagnosia—a finding not previously reported in MCI-DLB. These results extend the prognostic value of hallucinations to preclinical DLB, refine the MCI-DLB concept, identify simultanagnosia as a possible early cognitive marker, and support the idea that early hallucinations in DLB may reflect a narcolepsy-like REM-sleep disorder.