"Excessive tears": a diagnostic sign for cocaine-induced mood disorder?
OBJECTIVE
This study aims to investigate excessive tearfulness as a sign to help determine the etiology of depressive symptoms.


METHODS
Clinicians were instructed to document the occurrence of excessive tearfulness in all patients seen in the Psychiatric Emergency Service. Excessive tearfulness was defined as crying to the severity that at least 1 tear drops off the face. A comparison group was formed from the general population of the Psychiatric Emergency Service.


RESULTS
Excessive tearfulness was documented in 36 different patients. The prevalence of the sign in the general population was 1.9%. Patients with excessive tearfulness were more likely to have cocaine in their urine (P < .0001, chi(2) test), receive a substance-related primary diagnosis (P < .0001, chi(2) test), and be admitted for psychiatric hospitalization (P < .001 chi(2) test). Patients with excessive tearfulness had significantly shorter voluntary hospital stays (P < .05, t test).


CONCLUSIONS
Excessive tearfulness could be a useful clinical sign of cocaine-induced depression.
Zarkowski
Paul
P
Harborview Medical Center, University of Washington, Seattle, WA 98104-2499, USA. pzark@u.washington.edu
Pasic
Jagoda
J
Russo
Joan
J
Roy-Byrne
Peter
P
D000275:Adjustment Disorders / Q000175:diagnosis; D000328:Adult; D000701:Analgesics, Opioid / Q000652:urine; D001569:Benzodiazepines / Q000652:urine; D003042:Cocaine / Q000652:urine; D019970:Cocaine-Related Disorders / Q000150:complications / Q000175:diagnosis*; D003448:Crying / Q000523:psychology*; D018765:Dopamine Uptake Inhibitors / Q000652:urine; D004637:Emergency Services, Psychiatric; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000139:chemically induced* / Q000175:diagnosis; D044469:Racial Groups; D012737:Sex Factors; D015813:Substance Abuse Detection; D013405:Suicide / Q000523:psychology
D000701:Analgesics, Opioid; D018765:Dopamine Uptake Inhibitors; D001569:Benzodiazepines; D003042:Cocaine