We present a clinical case of a psychotic drug abuser. The diagnostic hypothesis was paranoid schizophrenia. This case clearly demonstrates the diagnostic duel between schizophrenia and heroine addiction. Based on this case, we hypothesize that use of drugs in such a patient fulfils an appeasing function rather than pathological burial. It would be interesting to determine the specificity of how this type of patient uses drugs, beyond the apparent double incidence of two diagnoses, in the mode of decompensation and chronic progression of the disease, which would be particularly useful for developing a treatment strategy.
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