We present the case of a 33-year old man that suffer chronic cocaine and cannabis use since adolescence and at age of 25 develops depressive symptoms and later psychotic symptoms not congruent with mood state. He met criteria for schizoaffective disorder at that moment and was treated with antidepressants and antipsychotic drugs, improving symptomatology even without stopping completely substance use.

To study the relationship between schizoaffective disorder and cannabis and cocaine use, including the neurobiological disturbance secondary to these drugs that can lead to the development of this disorder and the relevance of diagnosing it in context of active substance use.

We carried out a literature review of scientific papers in Medline data base. We used the following terms: “Schizoaffective disorder” “cocaine use” and “cannabis use”. We considered English and Spanish papers for the last 5 years.

After 4 months of cocaine withdrawal and 1 month of cannabis withdrawal, the patient progressively improved depressive and positive psychotic symptoms. However, we reported the persistence of negative symptoms as psychomotor slowdown and cognitive and affective flattening.

The use of cocaine and cannabis is related to depressive and psychotic symptoms in intoxication and can also precipitate chronic psychotic and affective disorders. Induced schizoaffective disorder has not been widely described in literature. Our patient could be a case of schizoaffective induced disorder, but we should consider other pathogenic factors, differential diagnosis and clinical evolution in permanent withdrawal to confirm this diagnosis.

No significant relationships.

Little is known about outcomes of drug abuse related to attainment of stable housing. This study examined outcomes of cocaine use and service provision in an urban homeless sample.

Two-year longitudinal study of systematically selected homeless individuals (N = 255) in St. Louis, Missouri from 1999 to 2001. The sample was interviewed three times annually using a structured diagnostic interview. Urine drug testing was conducted at every interview, and service utilisation data were obtained from the structured interviews and the agency-provided service use data.

Cocaine use disorder and cocaine use proved to be distinct concepts because they predicted different outcomes across time. Cocaine use predicted subsequent poor housing outcomes, but stable housing had no apparent effect on subsequent use of cocaine. Service use predicted neither subsequent reduced cocaine use nor attainment of stable housing. Services used were appropriate to type of mental health need, but cocaine use may have reduced successful utilisation of appropriate psychiatric services.

These findings reinforce the concept that homelessness represents a complex phenomenon and consequently, service systems need to address multiple problems. Service approaches are needed that simultaneously address the complex needs of homeless individuals.