a California School of Professional Psychology, Clinical Pyschology PhD Program , San Diego , CA , USA.
b Department of Psychiatry , University of California , San Diego , CA , USA.
Am J Drug Alcohol Abuse. 2019;45(1):11-25. doi: 10.1080/00952990.2018.1517262. Epub 2018 Oct 25.
Research has demonstrated that patients with opioid use disorders (OUD; including both opioid abuse and/or dependence) have poorer neuropsychological functioning compared to healthy controls; however, the pattern and robustness of the findings remain unknown.
This study meta-analyzed the results from previous research examining the neuropsychological deficits associated with opioids across 14 neurocognitive domains.
Articles comparing patients with OUD to healthy controls were selected based on detailed inclusion/exclusion criteria and variables of interest were coded. In total, 61 studies were selected for the analyses. These consisted of 2580 patients with OUD and 2102 healthy control participants (15.9% female). Drug-related variables were analyzed as potential moderators.
The largest effect size difference in neuropsychological performance was observed in complex psychomotor ability. With the exception of the motor and processing speed domains, which showed no group differences, small-to-medium effect sizes were associated with all neurocognitive domains examined. Meta-regression revealed that increases in the length of abstinence were associated with decreases in effect sizes of the complex psychomotor domain. Additionally, attentional ability predicted effect size differences in executive functioning as well as verbal memory ability. Although the majority of meta-analyzed studies demonstrated significant differences between patients with OUD and controls, the average raw scores for patients with OUD in these studies typically fell within the normal range.
The pattern of neuropsychological performance among patients with OUD appears to reflect mild generalized cognitive dysfunction, with a large effect in complex psychomotor abilities.
研究表明，与健康对照组相比，患有阿片类药物使用障碍（OUD；包括阿片类药物滥用和/或依赖）的患者神经心理功能较差；然而，研究结果的模式和稳健性仍不清楚。
本研究通过荟萃分析 14 个神经认知领域中与阿片类药物相关的神经认知缺陷的研究结果。
根据详细的纳入/排除标准选择比较 OUD 患者和健康对照组的文章，并对感兴趣的变量进行编码。共选择了 61 项研究进行分析。这些研究包括 2580 名 OUD 患者和 2102 名健康对照组参与者（15.9%为女性）。药物相关变量被分析为潜在的调节因素。
在复杂心理运动能力方面观察到神经心理表现的最大效应量差异。除了运动和处理速度领域没有组间差异外，所有检查的神经认知领域都与小到中等的效应量相关。元回归显示，戒断时间的延长与复杂心理运动领域效应量的降低有关。此外，注意力能力预测了执行功能和言语记忆能力的效应量差异。尽管大多数荟萃分析研究表明 OUD 患者与对照组之间存在显著差异，但这些研究中 OUD 患者的平均原始分数通常仍在正常范围内。
OUD 患者的神经心理表现模式似乎反映了轻度的广泛认知功能障碍，在复杂心理运动能力方面有较大的影响。
