Rezapour Tara, Hatami Javad, Farhoudian Ali, Noroozi Alireza, Daneshmand Reza, Sofuoglu Mehmet, Baldacchino Alex, Ekhtiari Hamed
Department of Cognitive Psychology, Institute for Cognitive Science Studies, Tehran, Iran.
Department of Psychology, Faculty of Psychology and Education, University of Tehran, Tehran, Iran.
J Subst Abuse Treat. 2021 Dec;131:108558. doi: 10.1016/j.jsat.2021.108558. Epub 2021 Jul 7.
Impaired cognitive functions, particularly executive function, predicts poor treatment success in people with substance use disorders. The current study investigated the effect of receiving adjunct cognitive rehabilitation and baseline executive function (EF) measures on treatment response among people with opioid use disorder (OUD).
The analysis sample consisted of 113 participants with OUD who were discharged from a compulsory court-mandated methadone maintenance treatment (MMT) and followed for 3 months. We used the Backward digit span/Auditory verbal learning, Stroop, and Trail making tests to assess the three measures of EF, including working memory, inhibition, and shifting, respectively. Treatment response was operationalized as (1) treatment retention and (2) the number of positive urine tests for morphine during 3-month follow-up periods. The study used Cox's proportional hazards model and linear mixed model to identify predictive factors.
Lower Stroop interference scores predicted increased length of stay in treatment (χ = 33.15, P < 0.001). The linear mixed model showed that scores on auditory verbal learning test and group intervention predicted the number of positive urine tests during a 3-month follow-up.
Working memory and inhibitory control, as well as receiving cognitive rehabilitation, could be potentially considered as predictors of treatment response for newly MMT admitted patients with OUD. Assessment of EF before treatment initiation may inform treatment providers about patient's cognitive deficits that may interfere with therapeutic interventions.
认知功能受损，尤其是执行功能受损，预示着物质使用障碍患者的治疗效果不佳。本研究调查了接受辅助认知康复和基线执行功能（EF）测量对阿片类物质使用障碍（OUD）患者治疗反应的影响。
分析样本包括113名OUD患者，他们从法院强制要求的美沙酮维持治疗（MMT）中出院，并随访3个月。我们使用倒背数字广度/听觉词语学习、斯特鲁普测试和连线测试来分别评估EF的三项指标，包括工作记忆、抑制和转换。治疗反应被定义为：（1）治疗保留率；（2）3个月随访期间吗啡尿检呈阳性的次数。本研究使用Cox比例风险模型和线性混合模型来确定预测因素。
较低的斯特鲁普干扰分数预示着治疗时间延长（χ = 33.15，P < 0.001）。线性混合模型显示，听觉词语学习测试得分和团体干预可预测3个月随访期间吗啡尿检呈阳性的次数。
工作记忆和抑制控制，以及接受认知康复，可能被视为新接受MMT治疗的OUD患者治疗反应的预测因素。在开始治疗前评估EF，可能会让治疗提供者了解到可能干扰治疗干预的患者认知缺陷。
