Cannabis-associated Emerging Psychosis Presenting with Prominent Somatic Delusions and Koro-like Symptoms: A Case Report
Nisha Balaji, Suvarna Jyothi Kantipudi
Journal of Clinical and Diagnostic Research July 1, 2026 DOI: 10.7860/jcdr/2026/87691.23922 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | A 24-year-old man with cannabis-associated psychosis |
| Interventions | Risperidone Cognitive behavioural therapy |
| Topics | Cannabis |
| Key findings | Reports a case of cannabis-associated psychosis presenting with Koro-like somatic delusions without hallucinations or persecutory delusions. Treatment with risperidone and cognitive behavioural therapy reduced symptoms and improved insight. The authors propose that such atypical phenomenology may complicate diagnosis and delay psychiatric care. |
Abstract
Cannabis use is a recognised risk factor for psychotic disorders, particularly among young adults. We report a case of cannabisassociated psychosis in a 24-year-old man presenting with persistent somatic delusions and Koro-like symptoms. Despite normal neurological, ophthalmological, and urological evaluations, the patient developed a fixed belief of bodily “power” shifting sides, resulting in perceived genital shrinkage and significant distress. Mental state examination revealed somatic delusions without hallucinations or formal thought disorder. Treatment with risperidone and cognitive behavioural therapy led to symptom reduction and emerging insight. The uniqueness of this case lies in the predominance of culturally influenced somatic delusions resembling Koro in the context of cannabis associated psychosis, without more commonly reported psychotic symptoms such as hallucinations or persecutory delusions. This atypical phenomenology may complicate diagnosis and delay appropriate psychiatric intervention. Awareness of such unusual presentations is important for clinicians to ensure early psychiatric intervention.
Comparable studies
Other case reports and case series on cannabis, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Psychotic Reactions Following Cannabis Use in East Indians Patients at an Indian drug addiction clinic who developed acute cannabis-related psychosis | 1974 | Descriptive report (case series of clinical observations) | n = 200 |
| Psychiatric effects of cannabis use Swedish cases of cannabis psychosis | 1985 | Case series | n = 70 |
| Forty-Six Cases of Psychosis in Cannabis Abusers Gunila Bernhardson Habitual cannabis users treated for psychosis at Swedish psychiatric clinics and mental... | 1972 | Case series (retrospective survey of psychiatric records) | n = 46 |
| Hallucinogen persisting perception disorder after psilocybin consumption: a case study 18-year-old man with HPPD after mixed psilocybin and cannabis intoxication | 2005 | Case study | n = 1 |
| Cannabis‐induced Koro in Americans American men aged 22-26 with years of cannabis experience who reported negative... | 2001 | Case series | n = 3 |