Abstract. The relationship between psychoactive substances (PAS) use and acute psychotic disorders has been a widely debated topic in psychiatry in recent decades. Research data show frequent associa- tion between psychoses triggered by PAS and non-psychotic disorders, including those from the obses- sive-compulsive disorder (OCD) spectrum. The issue of overlapping symptoms of OCD and psychoses remains unresolved if considered within the strict nosology as comorbid disorders. The variety of clinical features, the temporal occurrence of individual symptoms (obsessive and psychotic), their relationship to the use of PAS, and the influence of psychopharmacological therapy, present sometimes difficult clinical diagnostic and therapeutic situations. This paper presents a clinical case of a patient initially diagnosed with OCD, and subsequently with acute psychotic disorder induced by PAS, the dynamics of the clinical manifestations at long-term follow-up, a differential diagnostic discussion, and therapeutic strategies to optimize treatment.

Key words: obsessive-compulsive disorder, comorbidity, acute psychosis, psychoactive substances, anti- depressants, antipsychotics

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