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Psychopathology in cocaine abusers. Changing trends.
R D Weiss1, S M Mirin, M L Griffin
1Alcohol and Drug Abuse Treatment Center, McLean Hospital, Belmont, Massachusetts 02178.
The Journal of Nervous and Mental Disease
|December 1, 1988
Summary
Affective disorders were more common in cocaine abusers than other drug users, but decreased significantly over time. This suggests premorbid psychopathology is a less important risk factor for chronic cocaine abuse as its use becomes more widespread.
Area of Science:
- Psychiatry
- Addiction Medicine
- Clinical Psychology
Background:
- Previous research in 1980-82 indicated a high prevalence of affective disorder among cocaine abusers.
- The epidemiology of cocaine abuse has evolved, potentially altering patient characteristics seeking treatment.
Purpose of the Study:
- To investigate changes in the clinical characteristics of hospitalized cocaine abusers compared to previous studies.
- To determine if observed changes in cocaine abusers are specific or reflect broader trends in substance abuse.
- To assess the prevalence of affective disorders in cocaine abusers and their first-degree relatives.
Main Methods:
- A follow-up study of 149 hospitalized cocaine abusers (1982-86) compared to an initial sample (1980-82).
- Comparison group of 293 hospitalized abusers of other substances (opioids, CNS depressants).
- Assessment of affective disorder prevalence in patients and their first-degree relatives.
Main Results:
- Cocaine abusers showed a higher rate of affective disorder (26.8%) and cyclothymic disorder (11.4%) compared to other drug abusers (20.1% and 2.7%, respectively).
- First-degree relatives of cocaine abusers had a significantly higher prevalence of affective illness (p < .05).
- A significant decrease in affective disorder rates was observed in cocaine abusers from the earlier to the later study period (50.0% to 21.0%, p < .01), unlike the comparison group.
Conclusions:
- While affective disorder remains prevalent in cocaine abusers, its significance as a premorbid risk factor has diminished with the wider spread of cocaine use.
- Changes in affective disorder rates over time were specific to cocaine abusers, not seen in other substance abuse populations.
- The evolving landscape of cocaine abuse is associated with shifts in the clinical profiles of individuals seeking treatment.