Am J Psychiatry 1995; 152:1464-1469
Copyright © 1995 by American Psychiatric Association
Clinical effects of recent cocaine use on patients with acute schizophrenia
MR Serper, M Alpert, NA Richardson, S Dickson, MH Allen and A Werner
New York University School of Medicine, NY, USA.
OBJECTIVE: Dopamine function has been hypothesized to be involved in both
producing schizophrenic symptoms and mediating cocaine's reinforcing
properties. As a result, cocaine abuse in schizophrenic patients may be
seen as a natural experiment that may alter the phenomenology and
neurobiology of schizophrenia. This report concerns the clinical effects of
cocaine abuse and cessation in schizophrenic patients at two times: when
patients presented to the psychiatric emergency service and again after 4
weeks of hospitalization. METHOD: The subjects were 15 cocaine-abusing and
22 cocaine-abstaining schizophrenic patients. Diagnostic assessments were
performed with the Structured Clinical Interview for DSM-III-R--Patient
Version, which uses DSM-III-R criteria. All of the patients were assessed
at both times with the Brief Psychiatric Rating Scale, the Scale for the
Assessment of Positive Symptoms, and the Scale for the Assessment of
Negative Symptoms. RESULTS: Cocaine-abusing schizophrenic patients showed
fewer negative signs and more anxiety/depression at the hospital- admission
assessment than their nonabusing counterparts. At retest, no group
differences were detected in patients' negative signs or mood symptoms.
Severity of positive symptoms was equal at both testing sessions.
CONCLUSIONS: The significant difference in negative signs and mood symptoms
at admission assessment was attributed to the neurobiological impact of
cocaine. The role of psychostimulants in schizophrenic patients is
discussed.
