Self‐reported cue‐induced physical symptoms of craving as an indicator of cocaine dependence. (6th November 2015)

• Record Type: Journal Article
• Authors: Vorspan, Florence; Fortias, Maeva; Zerdazi, El‐hadi; Karsinti, Emily; Bloch, Vanessa; Lépine, Jean‐Pierre; Bellivier, Frank; Brousse, Georges; van den Brink, Wim; Derks, Eske M.
• Is Part Of: American journal on addictions. Volume 24:Number 8(2015)
• Page Start: 740
• Page End: 743
• Publication Date: 2015-11-06
• Subjects: Substance abuse -- Periodicals; Substance abuse -- Treatment -- Periodicals; 616.86005
• DOI: 10.1111/ajad.12303
• Languages: English
• ISSNs: 1055-0496

Abstract

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). Discussion and Conclusion: 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. (Am J Addict 2015;XX:1–4)