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一项为期6个月的随访研究:认知障碍可能预示着更频繁地使用甲基苯丙胺。

A 6-Month Follow-Up Study: Cognitive Impairment May Predict More Frequent Use of Methamphetamine.

作者信息

Karabulut Sercan

机构信息

Centre of Alcohol and Substance Addiction Treatment, Ataturk State Hospital, Antalya, Turkey.

出版信息

Subst Abuse. 2023 May 16;17:11782218231175811. doi: 10.1177/11782218231175811. eCollection 2023.

Abstract

OBJECTIVES

Methamphetamine (METH) use has been associated with impairments in a variety of cognitive functions. In this study, it was aimed to assess the relation between cognitive measures and frequency of METH use.

METHODS

Ninety-eight participants with methamphetamine use disorder were assessed with Wisconsin Card Sorting Test (WCST), Victoria-Stroop Word Color Test (SWCT), Trail Making Test (TMT) A and B. Participants were followed up during 6-month period with multiple urine toxicology tests (at baseline, month 1, month 2, month 3 and month 6).

RESULTS

Participants who had their prescriptions regularly were more likely to have higher rates of METH-negative urine results ( = .003). Participants who had more correct numbers, completed more categories and had more conceptual level responses on WCST were more likely to use lower frequency of METH (OR = 0.006,  < .01; OR = 0.171,  < .001; OR = 0.024,  < .001; respectively). The higher error numbers and perseverative error rates on WCST were associated with more frequent METH use (OR = 0.023,  < .001; OR = 0.076,  < .001). Interference factor on SWCT was related with lower frequency of METH use whereas color naming factor on SWCT was related with higher rates of urine results (OR = 0.012,  < .001; OR = 3.628,  < .001; respectively). Higher TMT B-A score was related with more frequent METH use, although the significance disappeared after adjustment (OR = 0.002,  < .001). Having psychotic symptoms predicted less frequent use, but after adjustment for other significant variables, there was no significance.

CONCLUSION

Lower frequency of METH use in the follow-up could be predicted by neurocognitive assessments. Deficits in executive functions, attention, set-shifting and mental flexibility seems to be the most effected domains and this effect may be independent from the severity of psychotic symptoms.

摘要

目的

使用甲基苯丙胺(METH)与多种认知功能受损有关。本研究旨在评估认知测量与METH使用频率之间的关系。

方法

对98名患有甲基苯丙胺使用障碍的参与者进行威斯康星卡片分类测试(WCST)、维多利亚-斯特鲁普文字颜色测试(SWCT)、连线测验(TMT)A和B评估。在6个月期间,通过多次尿液毒理学测试(基线时、第1个月、第2个月、第3个月和第6个月)对参与者进行随访。

结果

定期接受处方治疗的参与者更有可能获得更高比例的METH阴性尿液检测结果(P = 0.003)。在WCST中,正确数字更多、完成类别更多且概念水平反应更多的参与者使用METH的频率更低(OR = 0.006,P < 0.01;OR = 0.171,P < 0.001;OR = 0.024,P < 0.001)。WCST中的错误数字和持续性错误率越高,与METH使用频率越高相关(OR = 0.023,P < 0.001;OR = 0.076,P < 0.001)。SWCT的干扰因素与METH使用频率较低有关,而SWCT的颜色命名因素与尿液检测结果比例较高有关(OR = 0.012,P < 0.001;OR = 3.628,P < 0.001)。较高的TMT B - A分数与METH使用频率较高有关,尽管调整后该显著性消失(OR = 0.002,P < 0.001)。有精神病症状预示着使用频率较低,但在对其他显著变量进行调整后不再显著。

结论

神经认知评估可以预测随访期间较低的METH使用频率。执行功能、注意力、转换能力和心理灵活性的缺陷似乎是受影响最大的领域,且这种影响可能独立于精神病症状的严重程度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/77f1/10192674/c33c17fd35c2/10.1177_11782218231175811-fig1.jpg

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