Schizophrenization Process in a Hyperactive-Bipolar Patient with Substance Use: A Clinical Case with Neologistic Delusions

Author(s): Marcelo Caixeta.

Background: Psychotic symptoms with neologisms are rare and often associated with schizophrenic disorders. However, in some patients with bipolar disorder and attention deficit, a gradual process of “schizophrenization” may occur, especially when combined with chronic substance use. Case Presentation: We report the case of a 35-year-old male orthopedic physician with a history of childhood hyperactivity and adult-onset bipolar symptoms, progressively complicated by substance use. The patient developed persecutory delusions and neologistic psychotic constructs such as “ADHERAHI”, while remaining partially functional during periods of remission. Several therapeutic approaches were attempted over a three-year course, culminating in recent intramuscular antipsychotic treatment and new psychiatric hospitalization. Conclusion: This case illustrates a process of structural ego fragmentation and symbolic disruption, compatible with a borderline transition between affective psychosis and schizophreniform syndromes. The progressive breakdown of conceptual cohesion appears linked to neurobiological vulnerability, familial permissiveness, and lack of consistent psychiatric treatment.