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美沙酮维持治疗患者的认知功能基本保持完整。

Cognitive function is largely intact in methadone maintenance treatment patients.

机构信息

a Behavioral Sciences , Academic College of Tel Aviv-Yaffo , Tel Aviv , Israel.

b Dr. Miriam and Sheldon G. Adelson Clinic for Drug Abuse, Treatment and Research , Tel Aviv Sourasky Medical Center , Tel Aviv , Israel.

出版信息

World J Biol Psychiatry. 2019 Mar;20(3):219-229. doi: 10.1080/15622975.2017.1342047. Epub 2017 Jul 5.

Abstract

OBJECTIVES

To confirm our previous findings of less cognitive impairments (based on cognitive screening tools) among methadone maintenance treatment (MMT) patients who achieved take-home dose (THD) privileges.

METHODS

a random sample of 65 Israeli MMT patients were studied using computerised, age and education standardised, cognitive domains (attention, executive function, memory, motor skills), and non-computerised phonetic and semantic verbal fluency.

RESULTS

Cognitive scores were within ±1 standard deviation (SD) of average for most domains, including non-verbal IQ, attention and motor skills. Verbal fluency and memory were >1 SD below average (mean = 84; z = -1.1 for both). Females were younger than the males and had poorer motor skills (P = 0.005) but better verbal memory (P < 0.0005). Opiate usage duration correlated with reaction time (P = 0.05) and inversely with verbal memory (P = 0.01). Overall cognitive function was poorest among 25 (38.5%) current drug users, and 6 (9.2%) lifetime schizophrenia patients. Cognitive domains were comparable between THD privileges subgroups.

CONCLUSIONS

Despite heterogeneity in MMT duration, abuse duration, substance use and psychiatric comorbidity, all performed within ±1 SD of average for age and education in most cognitive domains. Our findings challenge the notion of MMT as being synonymous with compromised cognition and may lead to reduced bias regarding cognitive function of MMT patients.

摘要

目的

确认我们之前的发现,即在获得带药回家(THD)特权的美沙酮维持治疗(MMT)患者中,认知障碍(基于认知筛查工具)较少。

方法

使用计算机化、年龄和教育标准化的认知领域(注意力、执行功能、记忆、运动技能)以及非计算机化的语音和语义流畅性,对 65 名以色列 MMT 患者进行了随机抽样研究。

结果

大多数认知领域的评分都在±1 个标准差(SD)范围内,包括非言语智商、注意力和运动技能。流畅性和记忆力均低于平均水平 1 个标准差(均值=84;z 值分别为-1.1)。女性比男性年轻,运动技能较差(P=0.005),但言语记忆较好(P<0.0005)。阿片类药物使用时间与反应时间相关(P=0.05),与言语记忆呈负相关(P=0.01)。在 25 名(38.5%)当前吸毒者和 6 名(9.2%)终生精神分裂症患者中,整体认知功能最差。THD 特权亚组之间的认知领域无差异。

结论

尽管 MMT 持续时间、滥用持续时间、物质使用和精神共病存在异质性,但在大多数认知领域中,所有患者的年龄和教育程度均在±1 SD 范围内。我们的发现挑战了 MMT 与认知受损等同的观点,可能会减少对 MMT 患者认知功能的偏见。

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