title: Self-reported cue-induced physical symptoms of craving as an indicator of cocaine dependence.
abstract: BACKGROUND
  The presence of cocaine dependence is under-recognized by cocaine users and requires a careful standardized interview to be ascertained by clinicians.
  
  
  OBJECTIVE
  To test if past experiences of cue-induced physical symptoms of craving (nausea, vomiting, sweating, shaking, nervousness) before cocaine use could be a useful way to boost the diagnosis of cocaine dependence.
  
  
  METHODS
  A cross-sectional study of 221 cocaine users from several outpatient addiction treatment services in France, addressing the most severe period of cocaine use. DSM-IV cocaine dependence was determined with the MINI International Neuropsychiatric Interview (MINI). Physical symptoms before using cocaine were retrospectively assessed with a single item rated on a 0-5 scale.
  
  
  RESULTS
  The prevalence of DSM-IV cocaine dependence was 84.6%. The mean score on the physical symptoms item was 1.3 (SD 1.3). A cut-off score of ≥ 1 on this item alone resulted in a sensitivity of 62%, a specificity of 88.2%, a positive predictive value of 96.6% and a negative predictive value of 29.7% to detect DSM IV cocaine dependence in this sample. Adding this item to a model with the frequency of cocaine use significantly increased the predictive power: Nagelkerke's R(2) increased from .149 to .326 (p < .001).
  
  
  CONCLUSIONS
  Recalling past experiences of cue-induced physical signs of cocaine craving is associated with a clinical diagnosis of lifetime cocaine dependence and could be a simple way to improve its detection in clinical settings.
authors.affiliation: APHP, Hôpital Fernand Widal, Service de Médecine Addictologique, Paris, France.|Faculté de Médecine, Université Paris Diderot, Paris, France.|Inserm U1144, Variabilité de Réponse aux Psychotropes, Université Paris Descartes, Université Paris Diderot, PRES Sorbonne Paris Cité, France.|Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherland.
authors.forename: Florence
authors.initials: F
authors.lastname: Vorspan
authors.affiliation: APHP, Hôpital Fernand Widal, Service de Médecine Addictologique, Paris, France.|Faculté de Médecine, Université Paris Diderot, Paris, France.
authors.forename: Maeva
authors.initials: M
authors.lastname: Fortias
authors.affiliation: Inserm U1144, Variabilité de Réponse aux Psychotropes, Université Paris Descartes, Université Paris Diderot, PRES Sorbonne Paris Cité, France.
authors.forename: El-Hadi
authors.initials: el-H
authors.lastname: Zerdazi
authors.affiliation: Inserm U1144, Variabilité de Réponse aux Psychotropes, Université Paris Descartes, Université Paris Diderot, PRES Sorbonne Paris Cité, France.
authors.forename: Emily
authors.initials: E
authors.lastname: Karsinti
authors.affiliation: Inserm U1144, Variabilité de Réponse aux Psychotropes, Université Paris Descartes, Université Paris Diderot, PRES Sorbonne Paris Cité, France.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Bloch
authors.affiliation: APHP, Hôpital Fernand Widal, Service de Médecine Addictologique, Paris, France.|Faculté de Médecine, Université Paris Diderot, Paris, France.|Inserm U1144, Variabilité de Réponse aux Psychotropes, Université Paris Descartes, Université Paris Diderot, PRES Sorbonne Paris Cité, France.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Lépine
authors.affiliation: APHP, Hôpital Fernand Widal, Service de Médecine Addictologique, Paris, France.|Faculté de Médecine, Université Paris Diderot, Paris, France.|Inserm U1144, Variabilité de Réponse aux Psychotropes, Université Paris Descartes, Université Paris Diderot, PRES Sorbonne Paris Cité, France.
authors.forename: Frank
authors.initials: F
authors.lastname: Bellivier
authors.affiliation: Psychiatry B-Department of Addictology, Université Clermont 1, UFR Médecine, EA7280, Clermont-Ferrand, and CHU Clermont-Ferrand, Clermont-Ferrand, F-63003, France.
authors.forename: Georges
authors.initials: G
authors.lastname: Brousse
authors.affiliation: Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherland.
authors.forename: Wim
authors.initials: W
authors.lastname: van den Brink
authors.affiliation: Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherland.
authors.forename: Eske M
authors.initials: EM
authors.lastname: Derks
mesh_terms: D000328:Adult; D000368:Aged; D019970:Cocaine-Related Disorders / Q000175:diagnosis* / Q000523:psychology*; D066249:Craving; D003430:Cross-Sectional Studies; D003463:Cues; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D057566:Self Report; D012680:Sensitivity and Specificity; D055815:Young Adult