Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-11-15T11:16:26.775Z Has data issue: false hasContentIssue false
  • English
  • Français

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:[email protected] (C. Roncero).
Get access

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

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aharonovich, E.Hasin, D.S.Brooks, A.C.Liu, X.Bisaga, A.Nunes, E.V.. Cognitive deficits predict low treatment retention in cocaine dependent patients. Drug Alcohol Depend 2006;81(3):313–322.CrossRefGoogle ScholarPubMed
Alia-Klein, N.Goldstein, R.Z.Kriplani, A.Logan, J.Tomasi, D.Williams, B., et al.Brain monoamine oxidase A activity predicts trait aggression. J Neurosci 2008;28(19):5099–5104.CrossRefGoogle ScholarPubMed
Bartlett, E.Hallin, A.Chapman, B.Angrist, B.. Selective sensitization to the psychosis-inducing effects of cocaine: a possible marker for addiction relapse vulnerability? Neuropsychopharmacology 1997;16(1):77–82.CrossRefGoogle ScholarPubMed
Bobes, J.Bascarán, M.Bobes, T.Carballo, J.Díaz, E.Flórez, G., et al.Valoración de la gravedad de la adicción: Aplicación a la gestión y monitorización de los tratamientos. Social MdSyP, editor. Madrid: 2007.Google Scholar
Brousse, G.Vorspan, F.Ksouda, K.Bloch, V.Peoc’h, K.Laplanche, J.L., et al.Could the inter-individual variability in cocaine-induced psychotic effects influence the development of cocaine addiction? Towards a new pharmacogenetic approach to addictions. Med Hypotheses 2010;75(6):600–604.CrossRefGoogle ScholarPubMed
Cubells, J.F.Kranzler, H.R.McCance-Katz, E.Anderson, G.M.Malison, R.T.Price, L.H., et al.A haplotype at the DBH locus, associated with low plasma dopamine beta-hydroxylase activity, also associates with cocaine-induced paranoia. Mol Psychiatry 2000;5(1):56–63.CrossRefGoogle ScholarPubMed
Cubells, J.F.Feinn, R.Pearson, D.Burda, J.Tang, Y.Farrer, L.A., et al.Rating the severity and character of transient cocaine-induced delusions and hallucinations with a new instrument, the Scale for Assessment of Positive Symptoms for Cocaine-Induced Psychosis (SAPS-CIP). Drug Alcohol Depend 2005;80(1):23–33.CrossRefGoogle Scholar
de Groot, M.H.Franken, I.H.A.van der Meer, C.W.Hendriks, V.M.Stability and change in dimensional ratings of personality disorders in drug abuse patients during treatment. J Subst Abuse Treat 2003;24(2):115–120.CrossRefGoogle ScholarPubMed
European Monitoring Centre for Drugs and Drug Addiction. 2009 Annual report on the state of the drugs problem in Europe. Lisbon 2009.Google Scholar
European Monitoring Centre for Drugs and Drug Addiction. 2010 Annual report on the state of the drugs problem in Europe. Lisbon 2010.Google Scholar
Fergusson, D.M.Horwood, L.J.Ridder, E.M.Tests of causal linkages between cannabis use and psychotic symptoms. Addiction 2005;100(3):354–366.CrossRefGoogle ScholarPubMed
First, M.B.Spitzer, R.L.Gibbon, M.Williams, J.B.Structured Clinical Interview for the DSM-IV Axis I Disorders, Research Version. Patient Edition. (SCID-I/P)New York: Biometrics Research. New York State Psychiatric Institute; 1996.Google Scholar
First, M.B.Gibbon, M.Spitzer, R.L.Williams, J.B.Benjamin, L.S.Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II). Washington, DC: American Psychiatric Press, Inc; 1997.Google Scholar
Floyd, A.G.Boutros, N.N.Struve, F.A.Wolf, E.Oliwa, G.M.Risk factors for experiencing psychosis during cocaine use: a preliminary report. J Psychiatr Res 2006;40(2):178–182.CrossRefGoogle ScholarPubMed
Frances, R.J.Miller, S.Mack, A.H., editors. Clinical textbook of addictive disorders. 3rd. ed., New York: The Guilford Press; 2005.Google Scholar
Hall, W.The mental health risks of adolescent cannabis use. PLoS Med 2006;3(2):e39.CrossRefGoogle ScholarPubMed
Jeffcoat, A.R.Perez-Reyes, M.Hill, J.M.Sadler, B.M.Cook, C.E.Cocaine disposition in humans after intravenous injection, nasal insufflation (snorting), or smoking. Drug Metab Dispos 1989;17(2):153–159.Google ScholarPubMed
Kalayasiri, R.Kranzler, H.R.Weiss, R.Brady, K.Gueorguieva, R.Panhuysen, C., et al.Risk factors for cocaine-induced paranoia in cocaine-dependent sibling pairs. Drug Alcohol Depend 2006;84(1):77–84.CrossRefGoogle ScholarPubMed
Kalayasiri, R.Sughondhabirom, A.Gueorguieva, R.Coric, V.Lynch, W.J.Morgan, P.T.et al.Self-reported paranoia during laboratory “binge” cocaine self-administration in humans. Pharmacol Biochem Behav 2006;83(2):249–256.CrossRefGoogle ScholarPubMed
Kalayasiri, R.Sughondhabirom, A.Gueorguieva, R.Coric, V.Lynch, W.J.Lappalainen, J.et al.Dopamine beta-hydroxylase gene (DbetaH) -1021C-->T influences self-reported paranoia during cocaine self-administration. Biol Psychiatry 2007;61(11):1310–1313.CrossRefGoogle ScholarPubMed
Kalayasiri, R.Gelernter, J.Farrer, L.Weiss, R.Brady, K.Gueorguieva, R.et al.Adolescent cannabis use increases risk for cocaine-induced paranoia. Drug Alcohol Depend 2010;107(2–3):196–201.CrossRefGoogle ScholarPubMed
Kessler, R.C.Nelson, C.B.McGonagle, K.A.Edlund, M.J.Frank, R.G.Leaf, P.J.The epidemiology of co-occurring addictive and mental disorders: implications for prevention and service utilization. Am J Orthopsychiatry 1996;66(1):17–31.CrossRefGoogle ScholarPubMed
Kessler, R.C.Chiu, W.T.Demler, O.Walters, E.E.Prevalence, severity, and comorbidity of 12-Month DSM-IV Disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 2005;62(6):617–627.CrossRefGoogle ScholarPubMed
Kokkevi, A.Stefanis, C.Drug abuse and psychiatric comorbidity. Compr Psychiatry 1995;36(5):329–337.CrossRefGoogle ScholarPubMed
Kranzler, H.R.Satel, S.Apter, A.Personality disorders and associated features in cocaine-dependent inpatients. Compr Psychiatry 1994;35(5):335–340.CrossRefGoogle ScholarPubMed
Kuepper, R.van Os, J.Lieb, R.Wittchen, H.-U.Höfler, M.Henquet, C.Continued cannabis use and risk of incidence and persistence of psychotic symptoms: 10 year follow-up cohort study. BMJ 2011;342.Google ScholarPubMed
Lapworth, K.Dawe, S.Davis, P.Kavanagh, D.Young, R.Saunders, J.Impulsivity and positive psychotic symptoms influence hostility in methamphetamine users. Addict Behav 2009;34(4):380–385.CrossRefGoogle ScholarPubMed
Mahoney, J.J. 3rd Kalechstein, A.D.De La Garza, R. 2nd Newton, T.F.Presence and persistence of psychotic symptoms in cocaine-versus methamphetamine-dependent participants. Am J Addict 2008;17(2):83–98.CrossRefGoogle ScholarPubMed
Mathias, S.Lubman, D.I.Hides, L.Substance-induced psychosis: a diagnostic conundrum. J Clin Psychiatry 2008;69(3):358–367.CrossRefGoogle ScholarPubMed
McLellan, A.T.Kushner, H.Metzger, D.Peters, R.Smith, I.Grissom, G.et al.The fifth edition of the addiction severity index. J Subst Abuse Treat 1992;9(3):199–213.CrossRefGoogle ScholarPubMed
Mendes, D.D.Mari Jde, J.Singer, M.Barros, G.M.Mello, A.F.Study review of biological, social and environmental factors associated with aggressive behavior. Rev Bras Psiquiatr 2009;31(Suppl. 2):77–85.CrossRefGoogle ScholarPubMed
Miller, N.S.Klahr, A.L.Gold, M.S.Sweeney, K.Cocores, J.A.The prevalence of marijuana (cannabis) use and dependence in cocaine dependence. N Y State J Med 1990;90(10):491–492.Google ScholarPubMed
Mooney, M.Sofuoglu, M.Dudish-Poulsen, S.Hatsukami, D.K.Preliminary observations of paranoia in a human laboratory study of cocaine. Addict Behav 2006;31(7):1245–1251.CrossRefGoogle Scholar
Moore, T.H.M.Zammit, S.Lingford-Hughes, A.Barnes, T.R.E.Jones, P.B.Burke, M.et al.Cannabis use and risk of psychotic or affective mental health outcomes: a systematic review. The Lancet 2007;370(9584):319–328.CrossRefGoogle ScholarPubMed
Östlund, A.Hensing, G.Sundh, V.Spak, F.Changes in some personality traits after recovery from alcohol dependence/abuse, anxiety and depression–results of a 5-year follow-up in a general population sample of women. Nord J Psychiatry 2007;61(4):279–287.CrossRefGoogle Scholar
Reid, M.S.Ciplet, D.O’Leary, S.Branchey, M.Buydens-Branchey, L.Angrist, B.Sensitization to the psychosis-inducing effects of cocaine compared with measures of cocaine craving and cue reactivity. Am J Addict 2004;13(3):305–315.CrossRefGoogle ScholarPubMed
Roncero, C.Ramos, J.A.Collazos, F.Casas, M.Psycotic complications in cocaine users. Adicciones 2001;13:179–189.Google Scholar
Roncero, C.Collazos, F.Valero, S.Casas, M.Cannabis consumption and development of psychosis: state of the art. Actas Esp Psiquiatr 2007;35(3):182–189.Google ScholarPubMed
Satel, S.L.Edell, W.S.Cocaine-induced paranoia and psychosis proneness. Am J Psychiatry 1991;148(12):1708–1711.Google ScholarPubMed
Smith, M.J.Thirthalli, J.Abdallah, A.B.Murray, R.M.Cottler, L.B.Prevalence of psychotic symptoms in substance users: a comparison across substances. Compr Psychiatry 2009;50(3):245–250.CrossRefGoogle ScholarPubMed
Swendsen, J.Ben-Zeev, D.Granholm, E.Real-time electronic ambulatory monitoring of substance use and symptom expression in schizophrenia. Am J Psychiatry 2011;168(2):202–209.CrossRefGoogle Scholar
Tang, Y.L.Kranzler, H.R.Gelernter, J.Farrer, L.A.Cubells, J.F.Comorbid psychiatric diagnoses and their association with cocaine-induced psychosis in cocaine-dependent subjects. Am J Addict 2007;16(5):343–351.CrossRefGoogle ScholarPubMed
Tang, Y.L.Kranzler, H.R.Gelernter, J.Farrer, L.A.Pearson, D.Cubells, J.F.Transient cocaine-associated behavioral symptoms rated with a new instrument, the scale for assessment of positive symptoms for cocaine-induced psychosis (SAPS-CIP). Am J Addict 2009;18(5):339–345.CrossRefGoogle Scholar
Villar Garcia, M.Perez Prieto, J.F.Hernandez Viadel, M.Renovell Farre, M.Preparation of a SCID-II-based diagnostic tool for personality disorders. Spanish version. Translation and adaption. Actas Lusoespanolas De Neurologia Psiquiatria Y Ciencias Afines 1995;23(4):178.Google Scholar
Volkow, N.D.The addicted brain: why such poor decisions? NIDA Notes 2003;18(4) [serial on the Internet].Google Scholar
Volkow, N.D.Wang, G.J.Fischman, M.W.Foltin, R.Fowler, J.S.Franceschi, D.et al.Effects of route of administration on cocaine induced dopamine transporter blockade in the human brain. Life Sci 2000;67(12):1507–1515.CrossRefGoogle ScholarPubMed
Williams, J.B.Gibbon, M.First, M.B.Spitzer, R.L.Davies, M.Borus, J.et al.The Structured Clinical Interview for DSM-III-R (SCID). II. Multisite test-retest reliability. Arch Gen Psychiatry 1992;49(8):630–636.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.