Health

Narcissists have such a distorted and grandiose sense of self it appears psychotic, almost delusional.
But it is NOT a true psychosis.

Sociopaths are also chronic liars who manipulate and distort for personal gain.
For example it is quite possible that Trump knows full well he is telling lies.
We see the difference in his demeanor in public and while under oath testimony.
He lies without reservation in public, but under oath, he "cannot recall."

So what appears psychotic could just be a sociopath lying for personal gain.

Also a drug induced psychosis is not something that can be used as not guilty by reason of insanity.
It is a self induced temporary detachment from reality. Once the drug is withdrawn the person
is perfectly sane.

I seriously doubt that someone grossly impaired and disorganized by a serious psychotic disorder
could organize a presidential campaign and function to the extent Trump can function.
He is crazy like a fox.