Chemsex and psychosis: a dangerous cocktail

Abstract

We present the clinical case of a patient with a first psychotic episode (FPE) with paranoid delusional ideation associated with substance use, infectious comorbidity and risky sexual practices. The aim is to develop a comprehensive care plan for a person with an FPE induced by harmful substances, with infectious comorbidity and risky sexual relations (chemsex), admitted to the brief psychiatric hospitalization unit. The assessment was carried out following Marjory Gordon’s functional health patterns, identifying nursing diagnoses such as: [00128] Acute confusion, [00065] Ineffective sexuality pattern, [00146] Anxiety and [00037] Risk of poisoning. Care planning and implementation included interventions based on the NANDA (North American Nursing Diagnosis Association), NOC (Nursing Outcomes Classification) and NIC (Nursing Interventions Classification) taxonomies, focusing on cognitive orientation, education on safe sexual behaviour, anxiety management and the prevention of poisoning. This case underlines the importance of a comprehensive, multidisciplinary intervention in patients with substance-induced psychosis, infectious comorbidity and risky sexual relations, highlighting the need to implement health education programmes (harm reduction strategies to minimize the risks associated with substance use, as well as the development of early intervention and FPE prevention programmes) and coordination between mental health professionals and health services.