Clinical differences between cocaine-induced psychotic disorder and psychotic symptoms in cocaine-dependent patients

Abstract

Page 2 of 24The aim of this study is to compare the clinical characteristics of three groups of patients in treatment for cocaine dependence: patients without any psychotic symptoms (NS), patients with transient psychotic symptoms (PS) and patients with cocaine-induced psychotic disorder (CIPD). An observational and retrospective study of 150 cocaine-dependent patients undergoing treatment in the Drug Unit of the Psychiatry Department of University Hospital Vall d'Hebron in Barcelona (Spain) using these three groups, NS, PS and CIPD, was performed. All patients were evaluated with the PRISM interview. ANOVA, Chi-square tests and multivariate multinomial regression analysis were used to perform statistical analyses. Seven patients with a primary psychotic disorder were discharged.Forty-six patients (32.1%) did not report any psychotic symptoms. Ninety-seven patients (67.9%) presented with a history of any cocaine-induced psychotic symptom and were considered as the cocaine-induced psychotic (CIP) group.Among them, 39 (27.3%) were included in the PS group, and 58 (40.6%) were included in the CIPD group. A history of imprisonment was found significantly more frequently in the PS than the NS group. The distribution of age at onset of dependence, lifetime cannabis abuse or dependence and imprisonment were significantly different between the NS and CIPD groups. We conclude that in cocaine-dependent patients, clinicians should be advised about the risk of development of psychotic symptoms. The presence of some psychotic symptoms could increase the potential risks of disturbing behaviours.

Neuroticism Associated with Cocaine-Induced Psychosis in Cocaine-Dependent Patients: A Cross-Sectional Observational Study

“…Also, in cocaine-dependent patients, aggression-hostility was associated with greater drug abuse and psychiatric severity [43]. Furthermore, CIP has been associated with agitated behavior and aggression [10], [12], [15], legal problems [20] and, in the same studies, with antisocial personality disorder [6], although this association is controversial [9], [23].…”

“…Although many risk factors of CIP in cocaine-dependent patients have been described, they have yet to be conclusively elaborated [18]. CIP has been associated with greater addiction severity [19], [20] agitated behavior, and aggression [12], [15]. Although assessment of personality during heavy drug use is complex, and there is some debate about its stability [16], [21], [22] antisocial personality disorder has been proposed as a risk factor for CIP [13].…”

Psychopathology in Substance Use Disorder Patients with and without Substance-Induced Psychosis

“…Moreover, Chen et al [ 8 ] reported that individuals with methamphetamine-induced psychosis exhibited significantly more major depression than those without SIPD. On the other hand, Tang et al [ 29 ] and Roncero et al [ 4 ] did not find a significant difference in major depression between cocaine-dependent patients with and without SIPD. While we found no association between anxiodepressive symptoms and SIPD in the current study, we did find an association between anxiodepressive symptoms and self-reported psychotic symptoms in SUD individuals without SIPD.…”

“…Furthermore, two previous studies reported no differences in alcohol or opioid dependence between SIPD patients and SUD patients without SIPD [ 11 , 29 ]. However, other studies examining cocaine-induced psychosis found that alcohol dependence was significantly elevated in SIPD patients, compared to individuals without SIPD [ 4 ]. The differences between studies in terms of alcohol dependence among patients with and without SIPD likely reflect baseline variations between cohorts.…”

“…Previous studies have observed associations between development of SIPD and negative life events, such as lifetime imprisonment [ 4 ] and rehospitalisation [ 5 ]. However, the issue of particular concern is the elevated rate of transition from SIPD to permanent psychiatric conditions, namely, schizophrenia spectrum [ 6 ] and affective disorders [ 7 ].…”