Cognition and Emotion Research Centre, School of Psychology, Australian Catholic University, Melbourne, Australia.
Cognition and Emotion Research Centre, School of Psychology, Australian Catholic University, Melbourne, Australia.
Neurosci Biobehav Rev. 2016 Dec;71:342-351. doi: 10.1016/j.neubiorev.2016.09.011. Epub 2016 Sep 17.
Opiate use is associated with deficits in decision-making. However, the impact of abstinence and co-morbid factors, like head injury and poly-substance abuse, on this ability, is currently unclear. This meta-analysis aimed to assess 1) the magnitude of decision-making deficits in opiate users; 2) whether co-morbid factors moderate the severity of these deficits; 3) whether ex-opiate users demonstrate smaller decision-making deficits than current users; and 4) whether the length of abstinence is related to the magnitude of decision-making deficits. We analysed 22 studies that compared the performance of current and ex-opiate users to healthy controls on decision-making measures such as the Iowa Gambling Task. Current users demonstrated a moderately strong impairment in decision-making relative to controls, which was not significantly moderated by co-morbid factors. The magnitude of the impairment did not significantly differ between studies assessing current or ex-users, and this impairment was not related to length of abstinence. Thus, it appears that opiate users have relatively severe decision-making deficits that persist at least 1.5 years after cessation of use.
阿片类药物的使用与决策能力缺陷有关。然而，目前尚不清楚戒断和共病因素（如头部损伤和多种物质滥用）对这种能力的影响。本荟萃分析旨在评估：1）阿片类药物使用者的决策能力缺陷程度；2）共病因素是否会影响这些缺陷的严重程度；3）前阿片类药物使用者是否比现用者表现出更小的决策能力缺陷；4）戒断时间的长短是否与决策能力缺陷的程度有关。我们分析了 22 项研究，这些研究比较了当前和前阿片类药物使用者与健康对照组在决策措施（如爱荷华赌博任务）上的表现。与对照组相比，当前使用者在决策方面表现出中度的严重缺陷，但共病因素并没有显著地调节这种缺陷。在评估当前或前使用者的研究中，这种损伤的程度没有显著差异，而且这种损伤与戒断时间的长短无关。因此，阿片类药物使用者似乎存在严重的决策能力缺陷，至少在停止使用后 1.5 年内仍然存在。
