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Palma-Álvarez RF, Daigre C, Ballabriga- Córdoba T, Monterde-Ochoa E, Sierra-Fortuny M, Cantillo M, Pelaez M, Castrillo E, Camañes L, Roncero C, Ramos-Quiroga JA, Grau-López L. CLINICAL VIEW ON SUBSTANCE-INDUCED PSYCHOTIC SYMPTOMS IN A MEDICALLY SUPERVISED INJECTING ROOM: A DECADE OF EXPERIENCE. ACTAS ESPANOLAS DE PSIQUIATRIA 2023; 51:188-191. [PMID: 37817739 PMCID: PMC10803840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 07/01/2023] [Indexed: 10/12/2023]
Abstract
Medically supervised injecting rooms (MSIRs) are extremely important facilities for people who inject drugs (PWID) as MSIRs provide a safe place for the consumption of street-sourced drugs, impacting overdose rates and viral transmitted infections.
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Affiliation(s)
- Raul F. Palma-Álvarez
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
| | - Constanza Daigre
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
| | | | | | | | - Miguel Cantillo
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Manuel Pelaez
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Eduardo Castrillo
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Laura Camañes
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Carlos Roncero
- Psychiatry Service, University of Salamanca Health Care Complex, Insitute of Biomedicine, Salamanca, Spain
- Psychiatry Unit, School of Medicine, University of Salamanca, Salamanca, Spain
| | - Josep A. Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
| | - Lara Grau-López
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
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Muacevic A, Adler JR, Dakhode SU, Rannaware A, Gaidhane AM. Substance Abuse Amongst Adolescents: An Issue of Public Health Significance. Cureus 2022; 14:e31193. [PMID: 36505140 PMCID: PMC9728192 DOI: 10.7759/cureus.31193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 11/07/2022] [Indexed: 11/09/2022] Open
Abstract
Adolescence is a crucial time for biological, psychological, and social development. It is also a time when substance addiction and its adverse effects are more likely to occur. Adolescents are particularly susceptible to the negative long-term effects of substance use, including mental health illnesses, sub-par academic performance, substance use disorders, and higher chances of getting addicted to alcohol and marijuana. Over the past few decades, there have been substantial changes in the types of illegal narcotics people consume. The present article deals with the review of substance abuse as a public health problem, its determinants, and implications seen among adolescents. A systematic literature search using databases such as PubMed and Google Scholar was undertaken to search all relevant literature on teenage stimulant use. The findings have been organized into categories to cover essential aspects like epidemiology, neurobiology, prevention, and treatment. The review showed that substance addiction among adolescents between 12 to 19 years is widespread, though national initiatives exist to support young employment and their development. Research on psychological risk factors for teenage substance abuse is vast, wherein conduct disorders, including aggression, impulsivity, and attention deficit hyperactivity disorder, have been mentioned as risk factors for substance use. Parents' attitudes toward drugs, alcohol, academic and peer pressure, stress, and physical outlook are key determinants. Teenage drug usage has a significant negative impact on users, families, and society as a whole. It was found that a lot has been done to provide correct intervention to those in need with the constant development of programs and rehabilitative centers to safeguard the delicate minds of youths and prevent them from using intoxicants. Still, there is much need for stringent policy and program guidelines to curb this societal menace.
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Dos Santos ACM, Dos Santos BRC, Dos Santos BB, Bastos DM, de Moura EL, Neto ABL, E Silva ACP, de Farias KF, de Medeiros Alves V, Nardi AE, de Souza Figueiredo EVM. The Role of the IL-10 (-819C/T), TNFA (-308G/A) and ENOS (-786T/C) Polymorphisms of Impulsive and Aggressive Personality Traits in Cocaine/Crack Users. Neuroscience 2022; 498:280-288. [PMID: 35716966 DOI: 10.1016/j.neuroscience.2022.05.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 05/15/2022] [Accepted: 05/26/2022] [Indexed: 11/19/2022]
Abstract
Cytokines and nitric oxide have been associated with impulsive and aggressive personality traits. We conducted the first study that investigated the role of SNPs in cytokines and nitric oxide genes and the influence in the progression of aggressive and impulsive behavior in 107 of cocaine and crack users. In this case-control, IL-10 (-819C/T), TNFA (-308G/A) and ENOS (-786T/C) polymorphisms were determined by Real-Time PCR. In addition, the relationship between these polymorphisms and Impulsivity and Aggression was determined. We found that the physical aggressiveness sub score was negatively correlated with the C allele of -819C/T polymorphism of the IL-10 (b = -0.14; p = 0.04). The T allele of the SNP -786T/C of the ENOS gene positively predicts traits of physical aggressiveness (b = 0.14; p = 0.04). The GA genotype (b = 0.22; p = 0.01) and the A allele (b = 0.15; p = 0.02) of -308 G/A polymorphism of the TNFA were positively correlated with aggressiveness physical. The GA genotype (b = 0.20; p = 0.03) was positively correlated with aggressiveness verbal. IL-10 (-819C/T), TNFA (-308G/A) and ENOS (-786T/C) polymorphisms might be associated with high risk of aggressive and impulsive behavior.
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Affiliation(s)
- Ana Caroline Melo Dos Santos
- Federal University of Alagoas, Biomarkers and Health Monitoring Research Group (BMS), Molecular Biology and Gene Expression Laboratory, Brazil; Biomarkers and Health Monitoring Research Group (BMS), Post-Graduate Program in Health Sciences, Federal University of Alagoas, Molecular Biology and Gene Expression Laboratory, Brazil
| | - Barbara Rayssa Correia Dos Santos
- Federal University of Alagoas, Biomarkers and Health Monitoring Research Group (BMS), Molecular Biology and Gene Expression Laboratory, Brazil; Biomarkers and Health Monitoring Research Group (BMS), Post-Graduate Program in Health Sciences, Federal University of Alagoas, Molecular Biology and Gene Expression Laboratory, Brazil
| | - Bruna Brandão Dos Santos
- Federal University of Alagoas, Biomarkers and Health Monitoring Research Group (BMS), Molecular Biology and Gene Expression Laboratory, Brazil; Biomarkers and Health Monitoring Research Group (BMS), Post-Graduate Program in Health Sciences, Federal University of Alagoas, Molecular Biology and Gene Expression Laboratory, Brazil
| | - Dhayane Magalhães Bastos
- Federal University of Alagoas, Biomarkers and Health Monitoring Research Group (BMS), Molecular Biology and Gene Expression Laboratory, Brazil
| | - Edilson Leite de Moura
- Federal University of Alagoas, Biomarkers and Health Monitoring Research Group (BMS), Molecular Biology and Gene Expression Laboratory, Brazil; Biomarkers and Health Monitoring Research Group (BMS), Post-Graduate Program in Health Sciences, Federal University of Alagoas, Molecular Biology and Gene Expression Laboratory, Brazil
| | - Abel Barbosa Lira Neto
- Federal University of Alagoas, Biomarkers and Health Monitoring Research Group (BMS), Molecular Biology and Gene Expression Laboratory, Brazil
| | | | - Karol Fireman de Farias
- Federal University of Alagoas, Biomarkers and Health Monitoring Research Group (BMS), Molecular Biology and Gene Expression Laboratory, Brazil; Department of Nursing, Postgraduate Program in Nursing of the Federal University of Alagoas, Brazil
| | | | - Antônio Egídio Nardi
- Federal University of Rio de Janeiro, Brazilian Academy of Sciences and National Academy of Medicine, Brazil
| | - Elaine Virgínia Martins de Souza Figueiredo
- Federal University of Alagoas, Biomarkers and Health Monitoring Research Group (BMS), Molecular Biology and Gene Expression Laboratory, Brazil; Biomarkers and Health Monitoring Research Group (BMS), Post-Graduate Program in Health Sciences, Federal University of Alagoas, Molecular Biology and Gene Expression Laboratory, Brazil.
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dos Santos ACM, dos Santos BRC, dos Santos BB, de Moura EL, Neto ABL, Pereira e Silva AC, de Farias KF, de Medeiros Alves V, Nardi AE, de Souza Figueiredo EVM. IL-10 (-819C/T), TNFA (-30G/A) and ENOS (-786T/C) Polymorphisms Modulating the Outcome Related to Mental Disorders in Crack Addicted Users. Clin Pract Epidemiol Ment Health 2022; 18:e174501792201140. [PMID: 37274848 PMCID: PMC10156023 DOI: 10.2174/17450179-v18-e2201140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 11/23/2021] [Accepted: 12/20/2021] [Indexed: 06/07/2023]
Abstract
Background Cocaine/crack use affects immune system molecules and development of mental disorders has been identified. Objective To investigate the relationship of polymorphisms in the TNFA (-308G/A), IL-10 (-819C/T) and ENOS (-786T/C) genes with mental disorders in cocaine and crack users. Methods A case-control study was carried out, which included 107 cocaine and crack users and 115 controls who never used healthy cocaine and crack. The SNPs in the TNFA (-308G/A), IL-10 (-819C/T) and ENOS (-786T/C) genes were genotyped by real time PCR. Results As for the individuals included in this study, the average age of 31.4 years (± 8.59). We identified that the G/A genotype to TNFA (-308) (OR = 0.24; p = 0.03) and the A allele (OR = 0.30; p = 0.03) were associated with reduced risk for dysthymic disorder. The T allele of the IL-10 (-819) polymorphism was associated with decreased risk of developing panic disorder (OR = 0.44; p = 0.01), while the C allele was correlated with an increased risk for alcohol dependence (OR = 1.97; p = 0.04), alcohol abuse (OR = 1.81; p = 0.04) and psychotic syndrome (OR = 2.23; p = 0.01). C/C genotype was correlated with increased chances of developing current psychotic syndrome (OR = 4.23; p = 0.01). Conclusion Our results suggest that genetic polymorphisms promote susceptibility or promote protection for clinical phenotypes of psychiatric comorbidities in cocaine and crack users and be considered as good prognostic markers.
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Affiliation(s)
- Ana Caroline Melo dos Santos
- Program in Health Sciences, Molecular Biology and Gene Expression Laboratory, Federal University of Alagoas, Maceio, Brazil
| | | | - Bruna Brandão dos Santos
- Program in Health Sciences, Molecular Biology and Gene Expression Laboratory, Federal University of Alagoas, Maceio, Brazil
| | - Edilson Leite de Moura
- Program in Health Sciences, Molecular Biology and Gene Expression Laboratory, Federal University of Alagoas, Maceio, Brazil
| | - Abel Barbosa Lira Neto
- Program in Health Sciences, Molecular Biology and Gene Expression Laboratory, Federal University of Alagoas, Maceio, Brazil
| | | | - Karol Fireman de Farias
- Program in Nursing, Molecular Biology and Gene Expression Laboratory, Federal University of Alagoas, Maceio, Brazil
| | | | - Antônio Egídio Nardi
- Institute of Psychiatry, Federal University of Rio de Janeiro, Porto Alegre, Brazil
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Acute psychiatric illness and drug addiction during pregnancy and the puerperium. HANDBOOK OF CLINICAL NEUROLOGY 2021. [PMID: 32768084 DOI: 10.1016/b978-0-444-64240-0.00007-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Abstract
Pregnancy and the puerperium do not protect against acute psychiatric illness. During puerperium, the chance of acute psychiatric illness, such as a psychotic episode or relapse of bipolar disorder, is greatly increased. Suicide is a leading cause of maternal death. Both psychiatric disease and ongoing drug addiction impact not only the pregnant woman's somatic and mental health but also impact short-term and long-term health of the child. Indeed, prompt recognition and expeditious treatment of acute psychiatric illness during pregnancy and the puerperium optimize health outcomes for two patients. Pregnancy and puerperium represent a stage of life of great physiologic adaptations, as well as emotional and social changes. This conjunction of changes in somatic, emotional health and social health may mitigate the occurrence, clinical presentation, and clinical course of acute psychiatric illness and call for a multidisciplinary approach, taking into account both the medical and social domains. This chapter describes acute psychiatric illnesses during pregnancy and the puerperium and illicit substance abuse, from a clinical perspective, while also describing general principles of diagnosis and clinical management during this stage of life, which is an important window of opportunity for both the pregnant woman and the child.
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Cabé J, Brousse G, Pereira B, Cabé N, Karsinti E, Zerdazi EH, Icick R, Llorca PM, Bloch V, Vorspan F, De Chazeron I. Influence of Clinical Markers of Dopaminergic Behaviors on Depressive Symptoms During Withdrawal in Cocaine Users. Front Psychiatry 2021; 12:775670. [PMID: 34880796 PMCID: PMC8645893 DOI: 10.3389/fpsyt.2021.775670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 10/29/2021] [Indexed: 12/04/2022] Open
Abstract
Background: During cocaine withdrawal, transient depressive symptoms that do not meet the criteria for depression, but promote relapse, are frequently observed. Their temporality could evoke a role of dopamine, especially since the underlying mechanism of these depressive symptoms is not well understood. We hypothesized that variation in the dopaminergic activity profile, modeled from clinical markers, could be implicated in the development of depressive symptoms during cocaine withdrawal. Methods: We compared patients reporting depressive symptoms (RDS+) or not (RDS-) during cocaine withdrawal. We evaluated dopaminergic activity through indirect clinical markers based on the known dopaminergic behaviors. A combined criterion was constructed for hyper and hypo dopaminergic models according to the O'Brien method and illustrated by the Hedges' effect-size and forest-plot graph. A multidimensional factorial analysis was carried out to determine which parameters discriminate RDS+/RDS- patients. Results: 313 patients were included, and 77% reported depressive symptoms during cocaine withdrawal. Hyperdopaminergic variables used to discriminate the two groups had a large overall effect size (-0.669) and included psychotic symptoms (-0.524), hallucinations (-0.548), and delusions (-0.528). The overall effect of the hypodopaminergic component was considerable (-0.604) with a large effect size for the severity of dependence (-0.616), withdrawal symptoms (-0.578), and anhedonia (-0.528). The combined model including hyperdopaminergic and hypodopaminergic components had the largest effect size (-0.785). Conclusion: The dopaminergic activities profile, assessed by indirect clinical markers, seems to characterize patients with depressive symptoms very well during cocaine withdrawal. RDS+ patients reported moreover higher levels of psychotic symptoms and more severe cocaine use disorder than RDS-.
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Affiliation(s)
- Julien Cabé
- Service d'addictologie et pathologies duelles, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France.,Université Clermont Auvergne, CHU, CNRS, Clermont Auvergne INP, Institut Pascal, Clermont-Ferrand, France.,Faculté de Médecine, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Georges Brousse
- Service d'addictologie et pathologies duelles, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France.,Université Clermont Auvergne, CHU, CNRS, Clermont Auvergne INP, Institut Pascal, Clermont-Ferrand, France.,Faculté de Médecine, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Bruno Pereira
- Direction de la Recherche Clinique et des Innovations, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Nicolas Cabé
- Normandie University, UNICAEN, PSL Université de Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, France.,Service d'Addictologie, Centre Hospitalier Universitaire de Caen, Caen, France
| | - Emily Karsinti
- INSERM UMR-S 1144, Université de Paris, Optimisation Thérapeutique en Neuropsychopharmacologie, Paris, France.,Département de Psychiatrie et de Médecine Addictologique, Hôpital Fernand Widal, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - El-Hadi Zerdazi
- INSERM UMR-S 1144, Université de Paris, Optimisation Thérapeutique en Neuropsychopharmacologie, Paris, France.,Département de Psychiatrie et de Médecine Addictologique, Hôpital Fernand Widal, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Romain Icick
- INSERM UMR-S 1144, Université de Paris, Optimisation Thérapeutique en Neuropsychopharmacologie, Paris, France.,Département de Psychiatrie et de Médecine Addictologique, Hôpital Fernand Widal, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Pierre M Llorca
- Université Clermont Auvergne, CHU, CNRS, Clermont Auvergne INP, Institut Pascal, Clermont-Ferrand, France.,Faculté de Médecine, Université Clermont Auvergne, Clermont-Ferrand, France.,Service de Psychiatrie B, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Vanessa Bloch
- INSERM UMR-S 1144, Université de Paris, Optimisation Thérapeutique en Neuropsychopharmacologie, Paris, France.,Département de Psychiatrie et de Médecine Addictologique, Hôpital Fernand Widal, Assistance Publique-Hôpitaux de Paris, Paris, France.,Faculté de Médecine, Université de Paris, Paris, France
| | - Florence Vorspan
- INSERM UMR-S 1144, Université de Paris, Optimisation Thérapeutique en Neuropsychopharmacologie, Paris, France.,Département de Psychiatrie et de Médecine Addictologique, Hôpital Fernand Widal, Assistance Publique-Hôpitaux de Paris, Paris, France.,Faculté de Médecine, Université de Paris, Paris, France
| | - Ingrid De Chazeron
- Service d'addictologie et pathologies duelles, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France.,Université Clermont Auvergne, CHU, CNRS, Clermont Auvergne INP, Institut Pascal, Clermont-Ferrand, France.,Faculté de Médecine, Université Clermont Auvergne, Clermont-Ferrand, France
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Translational study of the whole transcriptome in rats and genetic polymorphisms in humans identifies LRP1B and VPS13A as key genes involved in tolerance to cocaine-induced motor disturbances. Transl Psychiatry 2020; 10:381. [PMID: 33159041 PMCID: PMC7648099 DOI: 10.1038/s41398-020-01050-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 09/18/2020] [Accepted: 10/05/2020] [Indexed: 12/04/2022] Open
Abstract
Motor disturbances strongly increase the burden of cocaine use disorder (CUDs). The objective of our translational study was to identify the genes and biological pathways underlying the tolerance to cocaine-induced motor effects. In a 5-day protocol measuring motor tolerance to cocaine in rats (N = 40), modeling the motor response to cocaine in patients, whole-genome RNA sequencing was conducted on the ventral and dorsal striatum to prioritize a genetic association study in 225 patients with severe CUD who underwent thorough phenotypic (cocaine-induced hyperlocomotion, CIH; and cocaine-induced stereotypies, CIS) and genotypic [571,000 polymorphisms (SNPs)] characterization. We provide a comprehensive description of the rat striatal transcriptomic response to cocaine in our paradigm. Repeated vs. acute cocaine binge administration elicited 27 differentially expressed genes in the ventral striatum and two in the dorsal striatum. One gene, Lrp1b, was differentially expressed in both regions. In patients, LRP1B was significantly associated with both CIS and CIH. CIH was also associated with VPS13A, a gene involved in a severe neurological disorder characterized by hyperkinetic movements. The LRP1B minor allele rs7568970 had a significant protective effect against CIS (558 SNPs, Bonferroni-corrected p = 0.02) that resisted adjustment for confounding factors, including the amount of cocaine use (adjusted beta = -0.965 and -2.35 for heterozygotes and homozygotes, respectively, p < 0.01). Using hypothesis-free prioritization of candidate genes along with thorough methodology in both the preclinical and human analysis pipelines, we provide reliable evidence that LRP1B and VPS13A are involved in the motor tolerance to cocaine in CUD patients, in line with their known pathophysiology.
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Roncero C, Grau-López L, Palma-Álvarez RF, Rodriguez-Cintas L, Ros-Cucurull E, Esojo A, Daigre C. Higher severity of cocaine addiction is associated with tactile and somatic hallucinations. Eur Psychiatry 2016; 42:63-69. [PMID: 28212507 DOI: 10.1016/j.eurpsy.2016.11.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 11/09/2016] [Accepted: 11/09/2016] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND The aim of this study is to describe the features of cocaine-dependent patients who have had cocaine-induced tactile/somatic hallucinations (CITSH), and to analyze the association with addiction-related variables and psychiatric comorbidity, comparing patients with CITSH, patients with cocaine psychotic symptoms (CIP) and no CITSH, and patients without any psychotic symptom. METHOD A cross-sectional study was conducted in 767 cocaine-dependent patients in an outpatient treatment center for addictions. The following data were obtained: sociodemographic characteristics, CIP information, addiction-related variables and psychiatric comorbidity. A bivariate and multivariate analysis was performed. RESULTS Of the whole sample, 6.6% reported CITSH at some point of their lives, 48.4% had suffered some CIP other than CITSH, and 45% had not experienced any psychotic symptom. According to multivariate analysis, risk of overdose increases by 12.1 (OR) times the probability of having had CITSH compared patients with CIP-no-CITSH. Other variables associated to patients with CITSH were: age of drug use onset, presence of episodes of overdose, prevalence of psychotic disorder induced by cocaine. In general, in all variables studied, patients with CITSH presented worse clinical features (addiction variables and psychiatric comorbidity) than patients with CIP without CITSH and non-CIP group. CONCLUSION CITSH are usually associated with other psychotic symptoms induced by cocaine. The patients who experienced CITSH are more severe cases compared both with patients with CIP without CITSH and patients without CIP. Increased risk of overdose is an important issue in this type of patients.
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Affiliation(s)
- C Roncero
- Addiction and Dual Diagnosis Unit, Psychiatry Department, University Hospital Vall Hebron - ASPB, CIBERSAM, Passieg Vall d'Hebron, 119-129, 08035 Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autónoma Barcelona, 08193 Bellaterra, Barcelona, Spain.
| | - L Grau-López
- Addiction and Dual Diagnosis Unit, Psychiatry Department, University Hospital Vall Hebron - ASPB, CIBERSAM, Passieg Vall d'Hebron, 119-129, 08035 Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autónoma Barcelona, 08193 Bellaterra, Barcelona, Spain
| | - R F Palma-Álvarez
- Addiction and Dual Diagnosis Unit, Psychiatry Department, University Hospital Vall Hebron - ASPB, CIBERSAM, Passieg Vall d'Hebron, 119-129, 08035 Barcelona, Spain
| | - L Rodriguez-Cintas
- Addiction and Dual Diagnosis Unit, Psychiatry Department, University Hospital Vall Hebron - ASPB, CIBERSAM, Passieg Vall d'Hebron, 119-129, 08035 Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autónoma Barcelona, 08193 Bellaterra, Barcelona, Spain
| | - E Ros-Cucurull
- Addiction and Dual Diagnosis Unit, Psychiatry Department, University Hospital Vall Hebron - ASPB, CIBERSAM, Passieg Vall d'Hebron, 119-129, 08035 Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autónoma Barcelona, 08193 Bellaterra, Barcelona, Spain
| | - A Esojo
- Addiction and Dual Diagnosis Unit, Psychiatry Department, University Hospital Vall Hebron - ASPB, CIBERSAM, Passieg Vall d'Hebron, 119-129, 08035 Barcelona, Spain
| | - C Daigre
- Addiction and Dual Diagnosis Unit, Psychiatry Department, University Hospital Vall Hebron - ASPB, CIBERSAM, Passieg Vall d'Hebron, 119-129, 08035 Barcelona, Spain
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Vergara-Moragues E, Mestre-Pintó JI, Gómez PA, Rodríguez-Fonseca F, Torrens M, González-Saiz F. Can symptoms help in differential diagnosis between substance-induced vs independent psychosis in adults with a lifetime diagnosis of cocaine use disorder? Psychiatry Res 2016; 242:94-100. [PMID: 27267440 DOI: 10.1016/j.psychres.2016.05.043] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 04/12/2016] [Accepted: 05/29/2016] [Indexed: 10/21/2022]
Abstract
The main goal of this study it is explore the psychopathological differences between IPD and SIPD in a sample of 125 adults with a lifetime diagnosis of cocaine disorder recruited from treatment setting and through street contacts. A secondary analysis of six cross-sectional studies was conducted between 2000 and 2010. SIPD and IPD were diagnosed using the Psychiatric Research Interview for Substance and Mental Disorders (PRISM). 38 subjects (30.4%) were diagnosed with lifetime IPD and 87 (69.6%) with lifetime SIPD. A binomial logistic regression analysis using SIPD as the reference group showed that only previous prison admissions (OR 2.59; 95% CI 1.05, 6.36) and visual hallucinations (OR 5.21; 95% CI 1.54, 17.65) remained significant variables in the group with lifetime SIPD. In the group with lifetime IPD, grandiose delusions (OR 0.19; 95% CI 0.06, 0.60) and disorganized speech (OR 0.16; 95% CI 0.04, 0.61) remained significant. Model predicts the diagnosis of lifetime SIPD with a sensitivity of 80.3% and a specificity of 78.2%. This clinical profile of lifetime SIPD could help distinguish between IPD and SIPD among adults with lifetime diagnosis of cocaine disorder.
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Affiliation(s)
- Esperanza Vergara-Moragues
- Department of Education and Psychobiology, Universidad Internacional de la Rioja (UNIR). Gran Vía Rey Juan Carlos I, 41, 26002 Logroño, La Rioja, Spain; Red de Trastornos Adictivos, Grupo de Investigación en Neurociencias Traslacional en Adicciones (GRINTA), Universidad de Granada, Spain
| | - Joan I Mestre-Pintó
- Institut Hospital del Mar d'Investigacions Mèdiques, Parc de Salut Mar, Passeig Maritim, 25-29, 08003, Barcelona, Spain; Institut de Neuropsiquiatria i Addictions, Parc de Salut Mar, Universitat Autònoma de Barcelona, Passeig Maritim, 25-29, 08003, Barcelona, Spain
| | - Pedro Araos Gómez
- FIMABIS, Mental Health Clinical Management Unit, Hospital Carlos Haya, Avda Carlos Haya 82, Pabellón de Gobierno Sótano, 29010 Málaga, Spain
| | - Fernando Rodríguez-Fonseca
- FIMABIS, Mental Health Clinical Management Unit, Hospital Carlos Haya, Avda Carlos Haya 82, Pabellón de Gobierno Sótano, 29010 Málaga, Spain
| | - Marta Torrens
- Institut Hospital del Mar d'Investigacions Mèdiques, Parc de Salut Mar, Passeig Maritim, 25-29, 08003, Barcelona, Spain; Institut de Neuropsiquiatria i Addictions, Parc de Salut Mar, Universitat Autònoma de Barcelona, Passeig Maritim, 25-29, 08003, Barcelona, Spain
| | - Francisco González-Saiz
- Red de Trastornos Adictivos, Grupo de Investigación en Neurociencias Traslacional en Adicciones (GRINTA), Universidad de Granada, Spain; Community Mental Health Unit of Villamartin, Jerez Hospital, Andalusian Health Service, Avda Feria 58 Villamartin, 11650 Cádiz, Spain.
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10
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Roncero C, Daigre C, Grau-López L, Barral C, Pérez-Pazos J, Martínez-Luna N, Casas M. An international perspective and review of cocaine-induced psychosis: a call to action. Subst Abus 2015; 35:321-7. [PMID: 24927026 DOI: 10.1080/08897077.2014.933726] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Cocaine use can induce transient psychotic symptoms that include suspiciousness, paranoia, hallucinations, and other cocaine-related behaviors. In this commentary, the authors provide an international perspective while reviewing the recent advances in epidemiology, clinical features, and risk factors related to cocaine-induced psychosis exhibited by patients with cocaine use disorders. In some settings, the occurrence of cocaine-induced psychosis has been shown to be as high as 86.5%. Many risk factors have been linked with cocaine-induced psychosis, including the quantity of cocaine consumed, lifetime amount of cocaine use, onset of cocaine dependence, years of use, routes of administration, other substance use disorder comorbidity, weight, gender, comorbidity with other medical and mental health disorders, genetics, and pharmacological interactions. Research has shown that the evaluation of cocaine-induced psychosis in patients with cocaine use is clinically relevant, especially in those patients who consume high amounts of cocaine, have a cannabis dependence history, have antisocial personality disorder, use administration routes other than intranasal, or exhibit attention-deficit/hyperactivity disorder (ADHD) comorbidity. Currently, the literature lacks information regarding the evolution of cocaine dependence or cocaine-dependent patients' risk for developing schizophrenia or other psychotic disorders. Furthermore, clinicians still do not have an evidence-based pharmacological approach to management of cocaine dependence available to them. Additional research is also needed regarding risk factors such as neurobiological markers and personality traits. Finally, we recommend the development of an integrative model including all of the risk factors and protective factors for cocaine-induced psychosis.
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Affiliation(s)
- Carlos Roncero
- a Outpatient Drug Clinic (CAS), Vall Hebron Psychiatry Department , University Hospital Vall d'Hebron-Barcelona Public Health Agency (ASPB) , Barcelona , Spain
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11
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Roncero C, Daigre C, Barral C, Ros-Cucurull E, Grau-López L, Rodríguez-Cintas L, Tarifa N, Casas M, Valero S. Neuroticism associated with cocaine-induced psychosis in cocaine-dependent patients: a cross-sectional observational study. PLoS One 2014; 9:e106111. [PMID: 25254365 PMCID: PMC4177812 DOI: 10.1371/journal.pone.0106111] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Accepted: 07/24/2014] [Indexed: 12/28/2022] Open
Abstract
Background Cocaine consumption can induce transient psychotic symptoms, which has been correlated with more severe addiction and aggressive behavior. However, little is known about the nature of the relationship between personality traits and psychotic symptoms in cocaine-dependent patients. This study examined the relationship between neuroticism and cocaine-induced psychosis. Methods A total of 231 cocaine-dependent patients seeking treatment were recruited to the study. Personality was evaluated by the Zuckerman-Kuhlman Personality Questionnaire. Cocaine-induced psychosis questionnaire, SCID-I, and SCID-II were used to evaluate comorbidity and clinical characteristics. Data analysis was performed in three steps: descriptive, bivariate, and multivariate analyses. Results Cocaine-induced psychosis was reported in 65.4% of the patients and some personality disorder in 46.8%. Two personality dimensions (Neuroticism-Anxiety and Aggression-Hostility) presented a significant effect on the risk of experiencing psychotic symptoms (t(229) = 2.69, p = 0.008; t(229) = 2.06, p = 0.004), and patients with psychotic symptoms showed higher scores in both variables. On the multivariate analysis, only Neuroticism remained as a significant personality factor independently associated with psychotic symptoms (Wald = 7.44, p<0.05, OR = 1.08, CI 95% 1.02–1.16) after controlling for age, gender and number of consumption substances. Conclusions An association between high neuroticism scores and presence of psychotic symptoms induced by cocaine has been found, independently of other consumption variables. Personality dimensions should be evaluated in cocaine-dependent patients in order to detect high scores of neuroticism and warn patients about the risk of developing cocaine-induced psychotic symptoms.
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Affiliation(s)
- Carlos Roncero
- Outpatient Drug Clinic, Department of Psychiatry, Vall d’Hebron University Hospital - Public Health Agency, Barcelona (ASPB), CIBERSAM, Barcelona, Spain
- Department of Psychiatry, Vall d’Hebron University Hospital, CIBERSAM, Barcelona, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- * E-mail:
| | - Constanza Daigre
- Outpatient Drug Clinic, Department of Psychiatry, Vall d’Hebron University Hospital - Public Health Agency, Barcelona (ASPB), CIBERSAM, Barcelona, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Carmen Barral
- Outpatient Drug Clinic, Department of Psychiatry, Vall d’Hebron University Hospital - Public Health Agency, Barcelona (ASPB), CIBERSAM, Barcelona, Spain
- Department of Psychiatry, Vall d’Hebron University Hospital, CIBERSAM, Barcelona, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Elena Ros-Cucurull
- Outpatient Drug Clinic, Department of Psychiatry, Vall d’Hebron University Hospital - Public Health Agency, Barcelona (ASPB), CIBERSAM, Barcelona, Spain
- Department of Psychiatry, Vall d’Hebron University Hospital, CIBERSAM, Barcelona, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Lara Grau-López
- Outpatient Drug Clinic, Department of Psychiatry, Vall d’Hebron University Hospital - Public Health Agency, Barcelona (ASPB), CIBERSAM, Barcelona, Spain
- Department of Psychiatry, Vall d’Hebron University Hospital, CIBERSAM, Barcelona, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Laia Rodríguez-Cintas
- Outpatient Drug Clinic, Department of Psychiatry, Vall d’Hebron University Hospital - Public Health Agency, Barcelona (ASPB), CIBERSAM, Barcelona, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Nuria Tarifa
- Outpatient Drug Clinic, Department of Psychiatry, Vall d’Hebron University Hospital - Public Health Agency, Barcelona (ASPB), CIBERSAM, Barcelona, Spain
| | - Miguel Casas
- Department of Psychiatry, Vall d’Hebron University Hospital, CIBERSAM, Barcelona, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Sergi Valero
- Department of Psychiatry, Vall d’Hebron University Hospital, CIBERSAM, Barcelona, Spain
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12
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Vergara-Moragues E, Araos Gómez P, González-Saiz F, Rodríguez-Fonseca F. Cocaine-induced psychotic symptoms in clinical setting. Psychiatry Res 2014; 217:115-20. [PMID: 24679995 DOI: 10.1016/j.psychres.2014.02.024] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Revised: 02/03/2014] [Accepted: 02/09/2014] [Indexed: 11/24/2022]
Abstract
Cocaine use is significantly associated with psychiatric co-morbidities of which psychotic symptoms are the most typical. The primary goal of this study is to estimate the life-time prevalence of cocaine-induced psychotic symptoms (CIPS) in a sample of patients without a history of primary psychosis, who attended specific out-patient drug-dependence treatment centres (ODDTCs). This is an observational, cross-sectional design and a consecutive sampling technique. The Scale for Assessment of Positive Symptoms-Cocaine Induced Psychosis (SAPS-CIP) was used to interview 114 patients who request treatment at specific ODDTCs for problems related to cocaine use. Most patients, 89.5% (95% CIs: 83.8-95.2%) had dependence of cocaine and 84.2% (95% CIs: 77.5-90.9%) showed at least one CIPS. Patients with CIPS had used cocaine more times throughout their lives and had a more frequency of use during the period of higher abuse severity in the last year, had higher severity of dependence score and had fewer abstinence periods greater than 30 days compared with those without CIPS. Cocaine dependency severity scale scores were significantly greater in patients with CIPS compared with those without CIPS.
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Affiliation(s)
- Esperanza Vergara-Moragues
- Department of Education, International University of La Rioja (UNIR), Spain; Neuropsychology Research Group and Clinical Psychoneuroimmunology (CTS-581), University of Granada, Granada, Spain.
| | - Pedro Araos Gómez
- FIMABIS, Mental Health Clinical Management Unit, Hospital Carlos Haya (Málaga), Spain
| | - Francisco González-Saiz
- Community Mental Health Unit, Villamartín, UGC-SM Hospital de Jerez, Andaluz Health Service (Cádiz), Spain
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13
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Roncero C, Martínez-Luna N, Daigre C, Grau-López L, Gonzalvo B, Pérez-Pazos J, Casas M. Psychotic symptoms of cocaine self-injectors in a harm reduction program. Subst Abus 2014; 34:118-21. [PMID: 23577904 DOI: 10.1080/08897077.2012.691446] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Psychotic symptoms are common among cocaine users. METHODS An observational naturalistic study on the effects and events of intravenous cocaine use in a drug consumption room was carried out; the patients were diagnosed of cocaine dependence (according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision). RESULTS Twenty-one patients, 81% men self-injected cocaine 375 times. Psychotic symptoms were observed in 62% of the patients and 21% of the self-injections; delusions were observed in 9.3%, psychotic self-reference with insight in 9.1%, illusions in 6.4%, and hallucinations in 5.3%. A higher presence of psychotic symptoms was noted with cannabis used in the previous month (76.9% versus 44.4%; P = .001) (no psychotic symptoms group); also, a greater use of benzodiazepines was observed: 75.6% versus 63.6% (P = .046). Lower use of methadone in the group with psychosis was observed: 75.6% versus 97.3% (P = .001). Motor alterations were tremor 58%, stereotyped movements 24%, and behaviour alteration 6%, significantly more frequent in the psychotic group. CONCLUSIONS Thus, there was a high frequency of psychotic symptoms after intravenous cocaine use; patients with psychotic symptoms reported higher use of cannabis and benzodiazepines in the previous month and lower use of methadone. More tremors and stereotyped movements were observed in the group with psychotic symptoms. It is necessary to give a special approach to cocaine intravenous users.
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Affiliation(s)
- Carlos Roncero
- Outpatient Drug Clinic Vall Hebron, Department of Psychiatry, University Hospital Vall Hebron-ASPB, Barcelona, Spain.
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14
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Morani AS, Panwar V, Grasing K. Tactile hallucinations with repetitive movements following low-dose cocaine: implications for cocaine reinforcement and sensitization: case report. Am J Addict 2013; 22:181-2. [PMID: 23414508 DOI: 10.1111/j.1521-0391.2013.00336.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Accepted: 08/24/2012] [Indexed: 11/28/2022] Open
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Broderick PA, Rosenbaum T. Sex-specific brain deficits in auditory processing in an animal model of cocaine-related schizophrenic disorders. Brain Sci 2013; 3:504-20. [PMID: 24961412 PMCID: PMC4061862 DOI: 10.3390/brainsci3020504] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Revised: 03/04/2013] [Accepted: 03/20/2013] [Indexed: 11/16/2022] Open
Abstract
Cocaine is a psychostimulant in the pharmacological class of drugs called Local Anesthetics. Interestingly, cocaine is the only drug in this class that has a chemical formula comprised of a tropane ring and is, moreover, addictive. The correlation between tropane and addiction is well-studied. Another well-studied correlation is that between psychosis induced by cocaine and that psychosis endogenously present in the schizophrenic patient. Indeed, both of these psychoses exhibit much the same behavioral as well as neurochemical properties across species. Therefore, in order to study the link between schizophrenia and cocaine addiction, we used a behavioral paradigm called Acoustic Startle. We used this acoustic startle paradigm in female versus male Sprague-Dawley animals to discriminate possible sex differences in responses to startle. The startle method operates through auditory pathways in brain via a network of sensorimotor gating processes within auditory cortex, cochlear nuclei, inferior and superior colliculi, pontine reticular nuclei, in addition to mesocorticolimbic brain reward and nigrostriatal motor circuitries. This paper is the first to report sex differences to acoustic stimuli in Sprague-Dawley animals (Rattus norvegicus) although such gender responses to acoustic startle have been reported in humans (Swerdlow et al. 1997 [1]). The startle method monitors pre-pulse inhibition (PPI) as a measure of the loss of sensorimotor gating in the brain's neuronal auditory network; auditory deficiencies can lead to sensory overload and subsequently cognitive dysfunction. Cocaine addicts and schizophrenic patients as well as cocaine treated animals are reported to exhibit symptoms of defective PPI (Geyer et al., 2001 [2]). Key findings are: (a) Cocaine significantly reduced PPI in both sexes. (b) Females were significantly more sensitive than males; reduced PPI was greater in females than in males. (c) Physiological saline had no effect on startle in either sex. Thus, the data elucidate gender-specificity to the startle response in animals. Finally, preliminary studies show the effect of cocaine on acoustic startle in tandem with effects on estrous cycle. The data further suggest that hormones may play a role in these sex differences to acoustic startle reported herein.
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Affiliation(s)
- Patricia A Broderick
- Department of Physiology, Pharmacology & Neuroscience, The Sophie Davis School of Biomedical Education, The City College of New York, The City University of New York, New York, NY 10031, USA.
| | - Taylor Rosenbaum
- School of Arts and Sciences, Emory University, Atlanta, GA 30322, USA.
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Vorspan F, Brousse G, Bloch V, Bellais L, Romo L, Guillem E, Coeuru P, Lépine JP. Cocaine-induced psychotic symptoms in French cocaine addicts. Psychiatry Res 2012; 200:1074-6. [PMID: 22551940 DOI: 10.1016/j.psychres.2012.04.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2010] [Revised: 03/14/2012] [Accepted: 04/02/2012] [Indexed: 11/16/2022]
Abstract
Cocaine use is known to induce transient psychotic symptoms. We evaluated retrospectively the lifetime prevalence of cocaine-induced psychotic symptoms in 105 cocaine addicts with the French version of the Scale for Assessment of Positive Symptoms-Cocaine Induced Psychosis (SAPS-CIP) in a clinical setting. Most patients (86.5%) described such symptoms.
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Affiliation(s)
- Florence Vorspan
- Service de Psychiatrie, et Neuropsychopharmacologie des Addictions, INSERM U705, UMR 8206, PRES-Sorbonne Paris-Cité, Hôpital Fernand Widal, AP-HP, 200 rue du Faubourg Saint Denis, F-75010 Paris, France.
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17
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Roncero C, Daigre C, Gonzalvo B, Valero S, Castells X, Grau-López L, Eiroa-Orosa F, Casas M. Risk factors for cocaine-induced psychosis in cocaine-dependent patients. Eur Psychiatry 2011; 28:141-6. [DOI: 10.1016/j.eurpsy.2011.06.012] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2010] [Revised: 06/07/2011] [Accepted: 06/20/2011] [Indexed: 11/29/2022] Open
Abstract
AbstractCocaine 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.
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