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

Published online by Cambridge University Press:  25 November 2011

C. Roncero ,
C. Daigre ,
B. Gonzalvo ,
S. Valero ,
X. Castells ,
L. Grau-López ,
F.J. Eiroa-Orosa  and
M. Casas
C. Roncero*
Affiliation:
Outpatient Drug Clinic Vall Hebron, Psychiatry Department, Hospital Vall d’Hebrón- Agència de Salut Pública de Barcelona, Universitat Autónoma de Barcelona, Barcelona, Spain Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
C. Daigre
Affiliation:
Outpatient Drug Clinic Vall Hebron, Psychiatry Department, Hospital Vall d’Hebrón- Agència de Salut Pública de Barcelona, Universitat Autónoma de Barcelona, Barcelona, Spain
B. Gonzalvo
Affiliation:
Outpatient Drug Clinic Vall Hebron, Psychiatry Department, Hospital Vall d’Hebrón- Agència de Salut Pública de Barcelona, Universitat Autónoma de Barcelona, Barcelona, Spain
S. Valero
Affiliation:
Psychiatry Department, Hospital Vall d’Hebrón, Universitat Autònoma de Barcelona, Barcelona, Spain
X. Castells
Affiliation:
Psychiatry Department, Hospital Vall d’Hebrón, Universitat Autònoma de Barcelona, Barcelona, Spain Clinical Pharmacology, Department of Medical Sciences, Universitat de Girona, Girona, Spain
L. Grau-López
Affiliation:
Outpatient Drug Clinic Vall Hebron, Psychiatry Department, Hospital Vall d’Hebrón- Agència de Salut Pública de Barcelona, Universitat Autónoma de Barcelona, Barcelona, Spain
F.J. Eiroa-Orosa
Affiliation:
Psychiatry Department, Hospital Vall d’Hebrón, Universitat Autònoma de Barcelona, Barcelona, Spain
M. Casas
Affiliation:
Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain Psychiatry Department, Hospital Vall d’Hebrón, Universitat Autònoma de Barcelona, Barcelona, Spain
*
⁎Corresponding author. Servei de Psiquiatría. Hospital Universitari Vall d’Hebron, Passeig de la Vall d’Hebron, 119-129, 08035 Barcelona, Spain. Tel.: +34 93 489 3880. E-mail address:croncero@vhebron.net (C. Roncero).
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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.

Keywords

CocainePsychosisCocaine induced psychosis risk factorsAntisocial personality disorderCannabis dependence
Type
Original article
Information
European Psychiatry , Volume 28 , Issue 3 , March 2013 , pp. 141 - 146
Copyright
Copyright © European Psychiatric Association 2011

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