Examining the Association Between Psychiatric Disorders and Cocaine Binges: Results From the COSMO Study.

J Addict Med

Research Center, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, QC, Canada (L-CJ, JB, DJ-A); Department of Psychiatry and Department of Family Medicine, Université de Montréal, succursale Centre-ville, Montréal, QC, Canada (L-CJ); Department of Community Health Sciences, Université de Sherbrooke, Longueuil, QC, Canada (ÉR, DB, NA); Institut national de santé publique du Québec (INSPQ), Montréal, QC, Canada (ÉR); Department of Family Medicine, Université de Montréal, succursale Centre-ville, Montréal, QC, Canada (JB); Department of Psychiatry, Université de Montréal, succursale Centre-ville, Montreal, QC, Canada (DJ-A).

Published: August 2019

Objectives: Although cocaine binges and mental health problems have both been identified as significant risk factors for different health hazards, little is known about the relationship between mental health and cocaine binging. Hence, the aim of this study is to examine the association between psychiatric disorders and cocaine binge.

Methods: Participants were part of a prospective cohort study of individuals who either smoke or inject cocaine. The dependent variable, namely a cocaine binge within the past month, was defined as the repetitive use of large quantities of cocaine until the individual was unable to access more of the drug or was physically unable to keep using. Psychiatric disorders were assessed using the Composite International Diagnostic Interview and the Diagnostic Interview Schedule questionnaires. Logistic regression models were performed to examine the association between cocaine binging and psychiatric disorders, adjusting for potential confounders.

Results: Of the 492 participants, 24.4% reported at least 1 cocaine binging episode during the prior month. Among the study population, 48.0% met the criteria for antisocial personality disorder (ASPD), 45.5% for anxiety disorders, and 28.2% for mood disorders. Participants with ASPD were more likely to binge (adjusted odds ratio 1.73, 95% confidence interval 1.10-2.73), whereas those with a mood disorder were not. The association between anxiety disorders and cocaine binging was significant only in univariate analyses.

Conclusion: ASPD increased the odds of reporting cocaine binge in our study population. These results highlight the need for a better understanding of the specific dimensions of ASPD that contribute to the increased risk of unsafe drug use behaviors.

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http://dx.doi.org/10.1097/ADM.0000000000000378DOI Listing

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