“Excessive tears”: a diagnostic sign for cocaine-induced mood disorder?

ObjectiveThis study aims to investigate excessive tearfulness as a sign to help determine the etiology of depressive symptoms.MethodsClinicians were instructed to document the occurrence of excessive tearfulness in all patients seen in the Psychiatric Emergency Service. Excessive tearfulness was defined as crying to the severity that at least 1 tear drops off the face. A comparison group was formed from the general population of the Psychiatric Emergency Service.ResultsExcessive tearfulness was documented in 36 different patients. The prevalence of the sign in the general population was 1.9%. Patients with excessive tearfulness were more likely to have cocaine in their urine (P < .0001, χ2 test), receive a substance-related primary diagnosis (P < .0001, χ2 test), and be admitted for psychiatric hospitalization (P < .001 χ2 test). Patients with excessive tearfulness had significantly shorter voluntary hospital stays (P < .05, t test).ConclusionExcessive tearfulness could be a useful clinical sign of cocaine-induced depression.