Universidad Anáhuac México. Facultad de Psicología. México.
Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz. Unidad de Ensayos Clínicos en Adicciones y Salud Mental. México.
Psychiatry Res. 2020 Jun;288:112944. doi: 10.1016/j.psychres.2020.112944. Epub 2020 Apr 9.
The objective of this study was to explore the prevalence of substance-induced neurocognitive disorder (NCD) in a sample of polysubstance users, adding both objective- and subjective cognitive impairment.
We collected cross-sectional data from 33 community-based residential facilities in Mexico City. Montreal Cognitive Assessment was used for measurement of objective cognitive impairment, and a DSM-5-based interview for subjective impairment. Years and days of recent use of alcohol, marijuana, cocaine and inhalants were collected for regression analyses.
753 participants were analyzed; from these, 50.5% show objective impairment, 71% and 58.5% self-reported any cognitive deficit and cognitive decline, respectively. Between 21.8%-36.5% would qualify for NCD when integrating both objective- and subjective impairment (deficit or decline). Significant weak associations were found between objective impairment and subjective deficits in all cognitive domains except social cognition. Regression models adding both objective- and subjective measures explained more variation in the years of alcohol, inhalant and cocaine use, and in recent marijuana use, than the objective measure alone, but associations were inconsistent.
Though significant in proportion, the prevalence of NCD in this population can only be partially related to substance use. Further integrative approaches are needed to refine the epidemiology of this disorder.
本研究旨在探索物质所致神经认知障碍(NCD)在多物质使用者样本中的流行情况,同时纳入客观和主观认知障碍。
我们收集了来自墨西哥城 33 个社区住宅设施的横断面数据。使用蒙特利尔认知评估量表测量客观认知障碍,使用基于 DSM-5 的访谈评估主观认知障碍。收集最近使用酒精、大麻、可卡因和吸入剂的年数和天数进行回归分析。
对 753 名参与者进行了分析;其中 50.5%存在客观认知障碍,71%和 58.5%分别自我报告存在任何认知缺陷和认知下降。当整合客观和主观障碍(缺陷或下降)时,有 21.8%-36.5%符合 NCD 的诊断标准。在所有认知领域(除社会认知外),客观认知障碍与主观认知缺陷之间存在显著的弱关联。在纳入客观和主观测量的回归模型中,对酒精、吸入剂和可卡因使用年限以及最近大麻使用的解释比仅使用客观测量更为充分,但关联并不一致。
尽管在比例上有显著意义,但该人群中 NCD 的患病率仅部分与物质使用有关。需要进一步的综合方法来完善该障碍的流行病学。