Predicting alcohol relapse post-detoxification: The role of cognitive impairments in alcohol use disorder patients

被引:2
作者
Teixeira, Joana [1 ,2 ,12 ]
Pinheiro, Maria [3 ]
Pereira, Gabriela alvares [4 ,5 ]
Nogueira, Paulo [6 ,7 ,8 ,9 ]
Guerreiro, Manuela [2 ]
Castanho, Miguel [10 ]
do Couto, Frederico Simoes [11 ]
机构
[1] Ctr Hosp Psiquiatr Lisboa, Unidade Alcool & Novas Dependencias, Lisbon, Portugal
[2] Univ Lisbon, Fac Med, Lisbon, Portugal
[3] CNS, Torres Vedras, Portugal
[4] Ctr Hosp Psiquiatr Lisboa, Unidade Neuropsicol, Lisbon, Portugal
[5] Univ Catol Portuguesa, Fac Human Sci, Catolica Res Ctr Psychol Family & Social Wellbeing, Lisbon, Portugal
[6] NOVA Univ Lisbon, Publ Hlth Res Ctr, Comprehens Hlth Res Ctr, NOVA Natl Sch Publ Hlth,CHRC, Lisbon, Portugal
[7] Univ Lisbon, Fac Med, Inst Saude Ambiental, Lisbon, Portugal
[8] TERRA, Lab Sustentabilidade Uso Terra & Serv Ecossistemas, Lisbon, Portugal
[9] Escola Super Enfermagem Lisboa, CIDNUR Ctr Invest Inovacao & Desenvolvimento Enfer, Lisbon, Portugal
[10] Univ Lisbon, Fac Med, Inst Med Mol, Lisbon, Portugal
[11] Catolica Med Sch, Sintra, Portugal
[12] Ctr Hosp Psiquiatr Lisboa, Ave Brasil 53, P-1749002 Lisbon, Portugal
来源
ALCOHOL-CLINICAL AND EXPERIMENTAL RESEARCH | 2024年 / 48卷 / 05期
关键词
alcohol use disorder; cognitive impairment; executive function; memory; relapse; REGRESSION-BASED NORMS; EXECUTIVE FUNCTIONS; EPISODIC MEMORY; DEFICITS; DRINKING; IMPULSIVITY; DYSFUNCTION; OUTCOMES; IMPACT; MOCA;
D O I
10.1111/acer.15302
中图分类号
R194 [卫生标准、卫生检查、医药管理];
学科分类号
摘要
BackgroundStudies on early abstinence suggest that cognitive function is significantly reduced in the first year of abstinence, which raises the question of whether it is relevant to early relapse in patients with substance use disorders. This study investigates the extent to which impairments in executive function and memory predict alcohol relapse in patients with alcohol use disorder (AUD). Understanding these relationships is crucial for improving therapeutic approaches to prevent relapse in patients with AUD.MethodsWe selected 116 adult patients (79 male and 37 female) diagnosed with AUD based on DSM-5 criteria, all of whom were undergoing alcohol detoxification treatment. A comprehensive array of neuropsychological tests was administered to assess global cognition, memory, and executive functions. Patients' alcohol use was monitored monthly during a 6-month follow-up period. Logistic regression and Cox regression were used to explore the relationship between cognitive function and the likelihood of alcohol relapse.ResultsImpairments in global cognition, semantic and phonemic fluency, cognitive flexibility, and learning ability during detoxification were significant predictors of relapse in AUD patients, showing similar predictive values at both 3 and 6 months post-treatment. An abnormal Montreal Cognitive Assessment (MoCA) score increased the risk of relapse by 123% (HR: 2.227), and impairments in both semantic and phonemic fluency each increased the risk by 142% (HR: 2.423). Additionally, abnormal performance on the MoCA, Trail Making Test Part B (TMT-B), and California Verbal Learning Test (CVLT) was associated with a higher number of drinking days at 3 months (IRR: 3.764; IRR: 2.237; IRR: 2.738, respectively) and abnormal MoCA and TMT-B scores at 6 months (IRR: 2.451; IRR: 1.859, respectively).ConclusionsThe MoCA test is a valuable tool for predicting relapse risk in AUD patients undergoing detoxification treatment, with similar predictive value for relapse at 3 or 6 months. Learning ability needs to be assessed and their impairments considered in the treatment of AUD patients. Future research should explore strategies for managing patients with impairments in memory and learning ability to enhance treatment effectiveness and prevent relapse.
引用
收藏
页码:918 / 927
页数:10
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