Studies on cocaine abusers in clinical settings report that more than half of such individuals experience paranoia and hallucinations. Even in community samples, the rates of psychotic experience are comparable. Among patients who attend psychiatric emergency services, nonschizophrenic cocaine abusers are reported to have as severe hallucinations as schizophrenic patients who do not abuse cocaine. Believing that their drug-using behaviour is being watched and they are being followed, hallucinations, in keeping with these delusions, are typical of cocaine-induced psychosis. This is so typical that it may be used as an important tool to differentiate it from schizophrenia. Presence or absence of Schneiderian first-rank symptoms can be another differentiating point between the two.
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