S03.02 - Cocaine addiction and psychotic disorders

Abstract

In order to create hypotheses about the relationship between the effects of cocaine and the development of psychotic symptoms we conducted a pilot study with 55 patients. All patients were personally investigated on their current psychopathology. The 55 patients (more than 80% were males) were distributed in 5 diagnostic subgroups:

1. 1) Addiction without a further AS I diagnosis (n=10)

2. 2) Addiction and psychotic disorder related to cocaine (n=8)

3. 3) Addiction, psychotic disorder related to cocaine and another AS I disorder (n=10)

4. 4) Addiction and a schizophrenic spectrum disorder (not schizophrenia) (n=10)

5. 5) Addiction and schizophrenia (n=17)

We investigated if psychotic symptoms occurred during cocaine use, if these symptoms depended on the dosage of cocaine and if similar symptoms also occurred without cocaine but during stress.

Hypotheses:

Schizophrenic patients receiving neuroleptics respond completely differently to cocaine use than all other groups including the schizophrenia spectrum group (without schizophrenia). When using cocaine the schizophrenic patients did not experience new psychotic symptoms, moreover, many of them reported being less bothered by delusions and hallucinations compared to times without cocaine. In all other groups positive psychotic symptoms occurred dependent on the dosage of cocaine, in some of them similar symptoms were triggered only by stress. The symptoms that are triggered by cocaine have a dosage dependent hierarchical structure: (1) mistrust, (2) plus delusions of reference with fear, (3) plus delusions of persecution with anxiety or panic and illusions, (4) plus hallucinations like threatening voices and noises, (5) plus disorganized behavior.