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Phenomenologic Comparison of the Idiopathic Psychosis of Schizophrenia and Drug‐Induced Cocaine and Phencyclidine PsychosesA Retrospective Study

 

作者: Richard Rosse,   Joseph Collins,   Maureen Fay-McCarthy,   Tanya Alim,   Richard Wyatt,   Stephen Deutsch,  

 

期刊: Clinical Neuropharmacology  (OVID Available online 1994)
卷期: Volume 17, issue 4  

页码: 359-369

 

ISSN:0362-5664

 

年代: 1994

 

出版商: OVID

 

关键词: Cocaine;Phencyclidine;Schizophrenia;Psychosis;Phenomenology

 

数据来源: OVID

 

摘要:

Summary:Both stimulant-induced and phencyclidine (PCP)-induced psychoses have been proposed as models of the idiopathic psychosis of schizophrenia. In this two-part study, the phenomenology of the psychosis associated with a period of cocaine intoxication was evaluated retrospectively in 34 male crack cocaine-dependent patients without concomitant psychiatric disorder and then was compared with the psychosis of 16 actively psychotic schizophrenic men (without a history of drug or alcohol abuse in the past year). Certain First Rank Schneiderian Symptoms (FRSS) were more commonly observed in the schizophrenic patients (e.g., thought broadcasting, thought withdrawal) than in the cocaine addicts. In the second part of this study, we retrospectively examined the cocaine and PCP experiences of an additional 22 cocaine addicts who had a past history of separate periods of cocaine and PCP use. Overall, the frequency of FRSS recalled during periods of cocaine and PCP intoxication was similar. However, the psychosis related to cocaine intoxication was more associated with an intense suspiciousness and paranoia related to a fear of being discovered or harmed while using cocaine. PCP-induced psychosis was less associated with suspiciousness and more associated with delusions of physical power, altered sensations, and unusual experiences [e.g., out of body experiences, periencing religious figures or events directly (e.g., being with Noah at the time of the Arc)]. As elements of both cocaine and PCP psychosis can be found in schizophrenia, a model integrating the mechanisms of several psychotogenic drugs may be more informative. Such an integrative model might better capture the heterogeneity of psychotic symptoms that can be seen in schizophrenia. Furthermore, different pharmacologic interventions (e.g., “anti-stimulant” versus “anti-PCP”) might address different aspects of the positive symptom picture in schizophrenia.

 

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