Risk factors for cocaine-induced psychosis in cocaine-dependent patients

• Published in: European psychiatry Vol. 28; no. 3; pp. 141 - 146
• Main Authors: Roncero, C, Daigre, C, Gonzalvo, B, Valero, S, Castells, X, Grau-López, L, Eiroa-Orosa, F.J, Casas, M
• Format: Journal Article
• Language: English
• Published: Paris Elsevier SAS 01.03.2013; Elsevier; Elsevier Masson SAS
• Subjects: Addictive behaviors; Adult; Adult and adolescent clinical studies; Antisocial personality disorder; Antisocial Personality Disorder - complications; Antisocial Personality Disorder - psychology; Antisocial personality disorders; Biological and medical sciences; Cannabis dependence; Cocaine; Cocaine induced psychosis risk factors; Cocaine-Related Disorders - complications; Cocaine-Related Disorders - psychology; Cocaïna; Cross-Sectional Studies; Drogoaddicció; Drug addiction; Female; Humans; Internal Medicine; Interview, Psychological; Logistic Models; Male; Marijuana Abuse - complications; Marijuana Abuse - psychology; Medical sciences; Multivariate Analysis; Personality disorders; Psicosi; Psychiatric Status Rating Scales; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychoses; Psychoses, Substance-Induced - etiology; Psychoses, Substance-Induced - psychology; Psychosis; Risk Factors; Trastorns de la personalitat antisocial; Psychosis; Cocaine; Cocaine induced psychosis risk factors; Antisocial personality disorder; Cannabis dependence; Human; Drug addiction; Antisocial personality; Cannabidaceae; Personality disorder; Ester; Cannabis; Dicotyledones; Angiospermae; Dependence; Risk factor; Spermatophyta; Drug of abuse; Recreational drug
• ISSN: 0924-9338; 1778-3585
• DOI: 10.1016/j.eurpsy.2011.06.012

Abstract Cocaine consumption can induce transient psychotic symptoms, expressed as paranoia or hallucinations. Cocaine induced psychosis (CIP) is common but not developed in all cases. This is the first European study on the relationship between CIP, consumption pattern variables and personality disorders. We evaluated 173 cocaine-dependent patients over 18 years; mostly males, whose average age was 33.6 years (SD = 7.8). Patients attending an outpatient addictions department were enrolled in the study and subsequently systematically evaluated using SCID I and SCID II interviews for comorbid disorders, a clinical interview for psychotic symptoms and EuropASI for severity of addiction. A high proportion of cocaine dependent patients reported psychotic symptoms under the influence of cocaine (53.8%), the most frequently reported being paranoid beliefs and suspiciousness (43.9%). A logistic regression analysis was performed, finding that a model consisting of amount of cocaine consumption, presence of an antisocial personality disorder and cannabis dependence history had 66.2% sensitivity 75.8% specificity predicting the presence of CIP. In our conclusions, we discuss the relevance of evaluating CIP in all cocaine dependent-patients, and particularly in those fulfilling the clinical profile derived from our results. These findings could be useful for a clinical approach to the risks of psychotic states in cocaine-dependent patients.