The authors studied a group of 149 hospitalized
cocaine abusers as a follow-up to previous research performed in 1980-82, which had revealed a high prevalence of
affective disorder in
cocaine abusers. The authors hypothesized that the changing epidemiology of
cocaine abuse since that time may have been accompanied by changes in the characteristics of patients seeking treatment for dependence on the
drug. The
cocaine abusers were compared with 293 other drug abusers to see whether clinical changes over time were specific to individuals abusing
cocaine. The authors found slightly more
affective disorder in the
cocaine abusers when compared with the other patients (26.8% vs. 20.1%), with a significantly higher rate of
cyclothymic disorder (11.4% vs. 2.7%, p less than .001). Affective illness was significantly more prevalent in the first-degree relatives of the
cocaine abusers when compared with the sex-matched relatives of the other patients (p less than .05). Diagnostic trends changed a great deal, however, between the original 1980-82 study sample and the follow-up 1982-86 sample. The rate of
affective disorder decreased over time from 50.0% to 21.0% (p less than .01), and the rate of affective illness in the families also declined, from 31.0% to 11.5% in females (p less than .001) and from 14.3% to 2.2% in males (p less than .001). No such change occurred in the comparison group of
opioid and central nervous system depressant abusers. The authors conclude that although a substantial number of
cocaine abusers suffer from concurrent
affective disorder, this form of premorbid psychopathology has become a less important risk factor for the development of chronic
cocaine abuse as
cocaine use has become more widespread.