Delusions and hallucinations of cocaine abusers and paranoid schizophrenics: a comparative study

J Psychol. 1991 May;125(3):301-10. doi: 10.1080/00223980.1991.10543294.


We compared delusions and hallucinations of 100 cocaine abusers and 100 paranoid schizophrenic subjects admitted to an East Texas state psychiatric hospital. Subjects in both groups feared that individuals or organized groups might harm them in some way, but delusions of the paranoid schizophrenic subjects were more often bizarre than those of the cocaine abuse subjects. "Cocaine bugs" (parasitosis) were more often found in the cocaine abuse subjects. Command hallucinations were found in both groups, but the commands of the schizophrenic group more often related to harming or killing others. Cocaine abusers had a greater frequency of visual hallucinations (47 to 7), distinguished by shadows, flashing lights ("snow lights"), objects moving and bugs crawling on the arm. Finally, the most distinguishing characteristics were identity delusions, possession delusions, grandiose delusions (other than identities and possessions), and delusions that their families were imposters (Capgras Syndrome) reported by paranoid schizophrenics. No such delusions were reported by the cocaine abusers.

MeSH terms

  • Adolescent
  • Adult
  • Cocaine* / adverse effects
  • Delusions / chemically induced
  • Delusions / psychology*
  • Female
  • Hallucinations / chemically induced
  • Hallucinations / psychology*
  • Humans
  • Male
  • Middle Aged
  • Psychiatric Status Rating Scales
  • Psychoses, Substance-Induced / diagnosis
  • Psychoses, Substance-Induced / psychology*
  • Retrospective Studies
  • Schizophrenia, Paranoid / diagnosis
  • Schizophrenia, Paranoid / psychology*
  • Substance-Related Disorders / psychology*


  • Cocaine