My 39 year old nephew is presently in a psychiatric facility outside of NYC after getting fired from his job of 5 years and experiencing paranoid psychotic symptoms. This is his 3rd psychotic break in 6 years. He has not been functioning up to his potential since leaving for college at age 18 where he failed courses and eventually dropped out. He remained there living like a college student working at entry level jobs, for a total of 8 years. He then came home to live with his parents for a couple of years, left for CA and did the same thing...underachieving with periods of unemployment until he called to say people were after him and he needed to come home in 2007. He saw a psychologist for months, and refused any medications. He managed to go to a 6 month tech school and intern at a radio show in NYC after that which lead to this job as the front desk receptionist at a music managing agency. His second psychotic break was April 12 where he again was totally paranoid but this time needed to be hospitalized for 2 weeks, and did go on an antipsychotic and antidepressant. He was able to return to work in July and moved into his own apt in NYC last December. He appeared to be doing well. He stopped the anti psychotic med in the Spring and his behavior has deteriorated since....manipulating, lying, stealing money until he lost the job and is now in a hospital. The one constant in all of this is pot.....he started in his second year of college and has continued to excessive use estimated at $500 a month before his second break. This time we are unaware of when he began smoking again but he has been asking his parents for more and more money each month since March. His presentation now in the hospital is that he is refusing meds, told me he isn t sick at all, won t allow his parents access to his treaters, has turned against family members and doesn t trust anyone. His parents are the target of his rage and a cousin in CA that he feels didn t have his back when he lived out there. He is smart, handsome young man who has not been able to make a life for himself anytime he leaves home. He had no friends in NYC, does nothing socially, and appears to stay in his apt when he wasn t working. Now he has no job and will be losing the apt at the end of the month. The hospital is going to go to court to force him to take meds. His last hospitalization they felt his diagnosis was not schizophrenia but rather psychosis brought on by excessive pot, his psychologist sees it as MDD with psychosis with an addiction to cannabis. It is hard to know if all of this stems from his pot smoking since age 20 or if he has a mental illness that he uses the pot to control symptoms. Does it even matter now....I think the whole family is just dumbfounded at his inability to live independently, to accept he needs medication and wonder how many times this is going to happen. His parents are getting older, want to retire and have no idea what his needs are going to be or whether he will accept help. It is a frustrating sad situation for all of us. My question is what is your assessment of him based on what I have told you...are we dealing with schizophrenia or an addiction to pot that brings on psychosis...