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酒精依赖综合征患者戒毒后持续存在的认知缺陷。

Cognitive deficits persisting in patients with alcohol dependence syndrome after detoxification.

作者信息

Sachdeva Ankur, Chandra Mina, Khullar Shilpa, Abbas Syed Zafar

机构信息

Department of Psychiatry, ESIC Medical College and Hospital, NIT, Faridabad, Haryana, India.

Department of Psychiatry and Drug De-addiction, Post Graduate Institute of Medical Education and Research (PGIMER) and Dr Ram Manohar Lohia Hospital, New Delhi, India.

出版信息

Ind Psychiatry J. 2024 Jul-Dec;33(2):292-298. doi: 10.4103/ipj.ipj_236_24. Epub 2024 Dec 17.

Abstract

BACKGROUND

Alcohol-related cognitive deficits (ARCDs) have received little clinical recognition due to doubts regarding the etiopathogenesis and lack of consensus in the diagnostic guidelines.

AIM

The present study aimed at evaluating the pattern of cognitive deficits in patients of alcohol dependence without dementia, and assessing the relationship between these subtle cognitive deficits and alcohol use parameters.

MATERIALS AND METHODS

The study included randomly selected, consenting, non-delirious patients of alcohol dependence syndrome (ADS) without dementia, admitted in the de-addiction ward. Cognition was assessed by Mini Mental State Examination (MMSE) of the Diagnostic Interview for Genetic Studies at admission and after 7 days of detoxification. "T-test" was used to assess cognitive improvement and residual deficits, while correlation analysis was used to compare the relationship between alcohol use parameters and MMSE scores.

RESULTS

We recruited 63 male patients with mean age of 38.62 (±9.61) years. Significant improvement was noted in cognition post-detoxification. However, most of the subjects had subtle cognitive deficits which may fall within the realm of ARCD, mainly in domains of attention/concentration, recall, language, and visuo-constructional skills ( < 0.05). The cognitive deficits correlated with duration and severity of alcohol dependence ( < 0.05), however, were independent of daily alcohol quantity.

CONCLUSION

Subtle cognitive deficits may persist in patients of ADS without dementia, even after successful detoxification. They may be easily missed despite contact with mental health professionals, as these deficits may only be evident on neuro-psychological testing.

摘要

背景

由于对酒精相关认知缺陷(ARCDs)的病因发病机制存在疑问,且诊断指南缺乏共识,其在临床上很少得到认可。

目的

本研究旨在评估无痴呆的酒精依赖患者的认知缺陷模式,并评估这些细微认知缺陷与酒精使用参数之间的关系。

材料与方法

该研究纳入了在戒毒病房随机选取的、自愿参与且无谵妄的无痴呆酒精依赖综合征(ADS)患者。在入院时和戒毒7天后,通过遗传研究诊断访谈的简易精神状态检查表(MMSE)评估认知情况。使用“t检验”评估认知改善和残留缺陷,同时采用相关分析比较酒精使用参数与MMSE评分之间的关系。

结果

我们招募了63名男性患者,平均年龄为38.62(±9.61)岁。戒毒后认知有显著改善。然而,大多数受试者存在细微认知缺陷,可能属于ARCD范畴,主要集中在注意力/集中力、回忆、语言和视觉构建技能领域(<0.05)。认知缺陷与酒精依赖的持续时间和严重程度相关(<0.05),但与每日饮酒量无关。

结论

即使成功戒毒,无痴呆的ADS患者可能仍存在细微认知缺陷。尽管与心理健康专业人员接触,但这些缺陷可能很容易被忽视,因为这些缺陷可能仅在神经心理学测试中才明显。

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本文引用的文献

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Alcohol and Dementia - What is the Link? A Systematic Review.酒精与痴呆症——有何关联?一项系统综述。
Neuropsychiatr Dis Treat. 2020 Jan 9;16:87-99. doi: 10.2147/NDT.S198772. eCollection 2020.
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Alcohol-related dementia: an update of the evidence.酒精相关痴呆:证据的更新。
Alzheimers Res Ther. 2013 Jan 25;5(1):3. doi: 10.1186/alzrt157. eCollection 2013.
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The Korsakoff syndrome: clinical aspects, psychology and treatment.科萨科夫综合征:临床症状、心理学及治疗
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