Behavioral Sciences, Academic College of Tel Aviv, Yaffo, Israel.
Dr. Miriam and Sheldon G. Adelson Clinic for Drug Abuse, Treatment and Research, Tel Aviv Sourasky Medical Center, Israel.
Psychiatry Res. 2020 Dec;294:113526. doi: 10.1016/j.psychres.2020.113526. Epub 2020 Oct 22.
Individuals with substance use disorders are known to suffer from stress, poor sleep, and cognitive impairment. We investigated whether individuals with opioid use disorder would improve cognitive performance following a year of methadone maintenance treatment (MMT). Perceived Stress Scale (PSS), the Pittsburgh Sleep Quality Index (PSQI), and a standardized computerized cognitive battery were administered at admission (T0) to 29 patients, and repeatedly following one year of MMT (T1) by 19 patients. Admission measures did not differ between those who studied once or twice. Patients who perceived very high stress levels (PSS ≥24) at T0 (11, 37.9%) had lower computerized global cognitive scores (67.6±16.2 vs. 90.9±12.5 p≤0.0005). At T1, PSS and PSQI scores improved significantly among 11 patients with no substance abuse, but worsened among 8 with substance abuse (PSS p(interaction)=0.009, p(groups)=0.005, PSQI p(interaction)=0.01, p(groups)=0.04). Global cognitive score improved at T1 for the entire sample (81.8±20.1 to 89.2±13.8, p=0.05). Differentiation by high stress at T0 or by substance abuse at T1 subgroups showed that improvement was observed by those with very low cognitive scores at T0. Patients with poor cognition may improve following one year of MMT, due to stress and substance abuse reduction. Interventions for stress reduction are recommended.
已知患有物质使用障碍的个体患有压力、睡眠不佳和认知障碍。我们研究了接受美沙酮维持治疗(MMT)一年后,阿片类物质使用障碍患者的认知表现是否会改善。在入院时(T0),29 名患者接受了压力感知量表(PSS)、匹兹堡睡眠质量指数(PSQI)和标准化计算机认知测试,19 名患者在接受 MMT 一年后多次接受了测试(T1)。在 T0 时,那些感知到非常高压力水平(PSS≥24)的患者(11 名,37.9%),计算机化的整体认知评分较低(67.6±16.2 比 90.9±12.5,p≤0.0005)。在 T1,11 名无物质滥用的患者 PSS 和 PSQI 评分显著改善,但 8 名有物质滥用的患者评分恶化(PSS 交互作用 p=0.009,组间 p=0.005,PSQI 交互作用 p=0.01,组间 p=0.04)。整个样本的整体认知评分在 T1 有所提高(81.8±20.1 至 89.2±13.8,p=0.05)。根据 T0 的高压力或 T1 的物质滥用亚组进行区分表明,T0 认知评分非常低的患者观察到了改善。由于压力和物质滥用的减少,认知能力差的患者可能会在接受 MMT 一年后得到改善。建议采取干预措施以减轻压力。