CLINICAL EFFECTS OF RECENT COCAINE USE ON PATIENTS WITH ACUTE SCHIZOPHRENIA

Objective: Dopamine function has been hypothesized to be involved in b oth producing schizophrenic symptoms and mediating cocaine's reinforci ng properties. As a result, cocaine abuse in schizophrenic patients ma y be seen as a natural experiment that may alter the phenomenology and neurobiology, of schizophrenia, This report concerns the clinical eff ects of cocaine abuse and cessation in schizophrenic patients at two t imes: when patients presented to the psychiatric emergency service and again after 4 weeks of hospitalization. Method: The subjects were 15 cocaine-abusing and 22 cocaine-abstaining schizophrenic patients. Diag nostic assessments were performed with the Structured Clinical Intervi ew for DSM-III-R-Patient Version, which uses DSM-III-R criteria. All o f the patients were assessed at both times with the Brief Psychiatric Rating Scale, the Scale for the Assessment of Positive Symptoms, and t he Scale for the Assessment of Negative Symptoms. Results: Cocaine-abu sing schizophrenic patients showed fewer negative signs and move anxie ty/depression at the hospital-admission assessment than their nonabusi ng counterparts. At retest, no group differences were detected in pati ents' negative signs or mood symptoms. Severity of positive symptoms w as equal at both testing sessions. Conclusions: The significant differ ence in negative signs and mood symptoms at admission assessment was a ttributed to the neurobiological impact of cocaine. The role of psycho stimulants in schizophrenic patients is discussed.