Trastorno por uso de cocaína y depresión: Cuando el diagnóstico clínico no es suficiente

Background: Cocaine use is a growing global health problem and patients with cocaine use disorders (CUD) present several complications, including high rates of major depression. There are two types of major depressive disorder (MDD) in these subjects: Primary major depressive disorder (P-MDD) and cocaine-induced major depressive disorder (CI-MDD). To improve treatment, it is necessary to distinguish between both types. The aim of this study was to assess the differences in depressive symptomatology criteria (P-MDD vs CI-MDD) in CUD patients. Methods: Secondary data analysis was carried out with a cross-sectional sample of 160 patients presenting CUD and MDD. Clinical assessment was performed using the Psychiatric Research Interview for Substance and Mental Disorders (PRISM). A differential diagnosis was obtained between P-MDD and CI-MDD. Results: Men represented 80% of the sample, the mean age was 38.61 years, and 64.5% had elementary studies. CI-MDD diagnosis (61.3%) was more frequent than P-MDD (38.7%). There was a younger age of CUD onset in CI-MDD patients. In addition, 79.4% of the patients had another substance use disorder diagnosed. The criterion “Changes in weight or appetite” was more prevalent (57.1%) in P-MDD group. Conclusions: We found differences in the criterion “Changes in weight or appetite”. Further research is needed in this field in order to establish a differential diagnosis and thus provide better treatment for CUD individuals.