An analysis of cue reactivity among persons with and without schizophrenia who are addicted to cocaine.
OBJECTIVE
Persons with schizophrenia who are addicted to cocaine experience more psychiatric and substance abuse relapses and worse long-term outcomes than persons with only one of these conditions. This study examined whether individuals with cocaine dependence and schizophrenia experience more cue-elicited craving than those without schizophrenia.


METHODS
Ninety-one cocaine-dependent participants who had been abstinent from cocaine for at least 72 hours were recruited from substance abuse treatment programs in the Veterans Affairs New Jersey Health Care System. The study used a cue-exposure paradigm to stimulate cocaine craving. A self-report instrument was used to measure changes from baseline in four areas: craving intensity, happy or depressed mood, increased or decreased energy, and physical health or sickness.


RESULTS
The participants with schizophrenia (N=35) reported significantly more cocaine craving than those without schizophrenia (N=56). When data for participants who were cue reactive were analyzed without regard to diagnosis, 97 percent of the cocaine-dependent participants with schizophrenia were cue reactive, compared with 43 percent of those without schizophrenia.


CONCLUSIONS
Future research on cocaine dependence should focus on craving, particularly among patients with coexisting psychiatric disorders.
Smelson
David A
DA
Department of Veterans Affairs Mental Illness Research, Education, and Clinical Center, VISN3, Bronx, NY, USA. david.smelson@med.va.gov
Losonczy
Miklos F
MF
Kilker
Chris
C
Starosta
Aron
A
Kind
Jacob
J
Williams
John
J
Ziedonis
Douglas
D
D000328:Adult; D019970:Cocaine-Related Disorders / Q000150:complications* / Q000175:diagnosis; D003463:Cues; D003863:Depression / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000453:epidemiology*; D006304:Health Status; D006801:Humans; D008875:Middle Aged; D012008:Recurrence; D012559:Schizophrenia / Q000150:complications*