Clinical features of cocaine induced paranoia.
Clinical features of cocaine induced paranoia.
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可卡因引起的偏执狂的临床特征。
DOI：
10.1176/ajp.148.4.495
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发表时间：
1991
期刊：
影响因子：
--
通讯作者：
F. Gawin
中科院分区：
文献类型：
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作者：
S. Satel;S. Southwick;F. Gawin
目的：作者的目的是评估可卡因引起的偏执的频率和性质。方法：他们采访了50名连续接受28天康复计划的可卡因依赖男性。结果：34（68%）的50名男子报告高度痛苦的短暂偏执状态的背景下，可卡因的使用。经历过妄想症的男性在年龄、种族或可卡因使用量方面与那些没有经历妄想症的男性没有区别。报告有妄想症的男性在发展为妄想症之前使用可卡因的平均持续时间和数量与未报告有妄想症的男性使用可卡因的平均寿命和数量没有显著差异。随着可卡因的持续使用，妄想症变得更加严重，发展得更加迅速。结论：短暂的偏执状态似乎是可卡因依赖的一个共同特征，似乎不仅仅是超过使用阈值的结果。相反，受影响的个体可能具有这种药物诱导状态的易感性。妄想症变得更加严重，并随着持续的药物使用而发展得更快，这一事实与可卡因诱导的妄想症的致敏模型一致。在脆弱的个体中，边缘系统敏化可能是其表达的基础，但定位于特定的大脑区域是推测性的。使用量和给药途径似乎并不直接导致这种现象。未来的研究必须旨在揭示可卡因重度使用者易患短暂性妄想症的标志和意义。(Am J Psychiatry 1991; 148：495-498）
Objective: The authors’ objective was to assess the frequency and nature of cocaineinduced paranoia. Method: They interviewed 50 cocaine-dependent men consecutively admitted to a 28-day rehabilitation program. Results: Thirty-four (68%) of the 50 men reported highly distressing transient paranoid states in the context of cocaine use. The men who experienced paranoia did not differ from those who did not in age, race, or measures of cocaine use. The mean duration and amount ofcocaine use before development of paranoia of the men who reported paranoia were not significantly different from the mean lifetime duration and amount of cocaine used by the men who did not report paranoia. Paranoia became more severe and developed more rapidly with continued cocaine use. Conclusions: The transient paranoid state appears to be a common feature ofcocaine dependence and does not seem to be simply a result of exceeding a threshold of use. Rather, affected individuals might possess a predisposition to this drug-induced state. The fact that paranoia became more severe and developed more rapidly with continued drug use is consistent with a sensitization model of cocaine-induced paranoia. In vulnerable individuals, limbic sensitization may underlie its expression, but localization to a specific brain region is speculative. Quantity ofuse and route ofadministration do not appear directly to predispose to this phenomenon. Future investigations must be aimed at uncovering the markers and meaning of vulnerability to transient paranoia in heavy cocaine users. (Am J Psychiatry 1991; 148:495-498)