Crack Cocaine and Schizophrenia as Risk Factors for PPD Reactivity in the Dually Diagnosed

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Abstract
We studied factors contributing to an increased risk of PPD positive status among 147 inpatients dually diagnosed for mental illness and substance abuse in a large urban hospital. Ninety-three percent (N = 137) were tested for PPD on admission. The rate of positive PPDs was 30.7%. Significant correlates of PPD positive status were the diagnosis of schizophrenia/psychosis NOS (p < .05), and crack cocaine use in the 30 days prior to admission (p < .01). A multiple logistic regression revealed a relative risk of 3.53 (p < .005) for PPD positive status for the crack using group and a relative risk of 2.16 (p < .06) for PPD positive status for the schizophrenic group. Reasons for why patients whose primary drug of abuse is crack cocaine and those whose diagnosis is schizophrenia/psychosis NOS may be at an increased risk for exposure to tuberculosis are discussed as are the implications for public health.