Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Psychiatry. May 19, 2026; 16(5): 114524
Published online May 19, 2026. doi: 10.5498/wjp.v16.i5.114524
Published online May 19, 2026. doi: 10.5498/wjp.v16.i5.114524
Adjustment disorder triggered by a unique and pervasive urban stressor, traffic cones: A case report
Emmanuel Stip, Department of Psychiatry and Addictology, University of Montreal, Montreal H1N 3V2, Quebec, Canada
Emmanuel Stip, Department of Psychiatry, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain 15551, Abu Dhabi, United Arab Emirates
Author contributions: Stip E observed the case, verified the consent, and wrote the manuscript versions.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Emmanuel Stip, MD, FRCP (C), Full Emeritus Professor, Senior Researcher, Department of Psychiatry and Addictology, University of Montreal, 7401 Hochelaga Montréal, Montreal H1N 3V2, Quebec, Canada. emmanuel.stip@umontreal.ca
Received: September 22, 2025
Revised: November 16, 2025
Accepted: February 13, 2026
Published online: May 19, 2026
Processing time: 219 Days and 16.8 Hours
Revised: November 16, 2025
Accepted: February 13, 2026
Published online: May 19, 2026
Processing time: 219 Days and 16.8 Hours
Core Tip
Core Tip: This report presents the first medically documented case of “Montreal syndrome” cone-induced urban rage (conophobia) in an otherwise healthy adult. A salient built-environment trigger (ubiquitous orange traffic cones) precipitated impulsive driving and acute affective distress; organic causes were excluded (benign scalp lipoma). The phenotype spans anxiety, avoidance, mood disturbance, and road-rage behavior, remaining distinct from recurrent intermittent explosive disorder. The case reframes urban infrastructure as a psychiatric stressor, situates it among city-named syndromes, and urges clinician awareness and urban-planning responses; cognitive behavior therapy/arts-based coping proved helpful.