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Psychopathology in Cocaine-abusing Adolescents

Kilgus, Mark D. MD, PhD*; Pumariega, Andres J. MD

Addictive Disorders & Their Treatment: September 2009 - Volume 8 - Issue 3 - p 138-144
doi: 10.1097/ADT.0b013e3181825a0a
Original Articles

Objective Cocaine is a widely abused drug in the United States and a significant, but not well studied, problem in adolescent populations. Few studies have used structured diagnostic interviews and Diagnostic and Statistical Manual for Mental Disorders criteria to examine comorbidity in adolescents referred to inpatient treatment for substance use disorders (SUDs). Many psychiatric disorders have their onset and develop during adolescence, and a complex overlap can develop between substance abuse and adolescent behavioral or emotional disturbances. This study investigates cooccurring psychiatric disorders in cocaine-dependent adolescents.

Method Subjects were adolescents aged 14 to 17 years who had abused cocaine and were attending the 6-week adolescent inpatient drug and alcohol treatment program for the South Carolina Department of Mental Health. They completed the Diagnostic Interview Schedule for Children 2.3, PC version before viewing a 36-minute videotape with salient cocaine cues for craving.

Results Of the 31 subjects completing the study, 21 (68%) subjects were diagnosed with an axis I diagnosis other than conduct or other SUDs.

Conclusions The prevalence of affective disorders including sex differences is similar to other investigated adolescent SUD populations. However, cocaine-preferring adolescents may have higher comorbidity and more anxiety disorders. The presence of anxiety may be a major factor in adolescent cocaine addiction.

*Department of Psychiatry and Behavioral Medicine, Carilion Clinic, Roanoke, VA

Department of Psychiatry, The Reading Hospital and Medical Center, Reading, PA

Supported by a grant from the South Carolina Department of Mental Health (SCDMH) through the William S. Hall Psychiatric Institute, Columbia, SC. The Institutional Review Board of the SCDMH approved and provided oversight of this project.

Reprints: Mark D. Kilgus, MD, PhD, Department of Psychiatry and Behavioral Medicine, Carilion Clinic, 1st Floor Administrative Suite, 2017 Jefferson Avenue, Roanoke, VA 24014 (e-mail:

The authors have no financial relationships to disclose.

© 2009 Lippincott Williams & Wilkins, Inc.