Risk factors for experiencing psychosis during cocaine use: a preliminary report

Cocaine induced psychosis (CIP) is a common, but not universal side effect of cocaine abuse. Factors underlying the development and severity of CIP remain poorly understood. This study tests the hypothesis that earlier age of initiation of regular use may increase the likelihood of developing CIP, or the severity of CIP symptoms.

Cocaine use history and severity of CIP (if any) were assessed with the Cocaine Experience Questionnaire in 51 abstinent (3 weeks-1 year) cocaine dependent individuals. Subjects were divided into those with high and low CIP severity, and into those with early age of initiation of regular cocaine use, and later age of initiation. Various cutoffs between early and late age of initiation were used, ranging from 15 to 22 years.

From ages 17 through 20, controlling for cumulative duration of use, severity scores were significantly higher for the early initiation group than for the later initiation group (p values ranged from 0.031 to 0.036). Cumulative duration of use, but not age of initiation, significantly predicted initial development of CIP (p=0.044).

The data suggest that early age of initiation of regular cocaine use occurring during vulnerable periods of brain development, may lead to increased severity of CIP.