Baseline executive functions and receiving cognitive rehabilitation can predict treatment response in people with opioid use disorder.

Cognitive rehabilitation Executive function Methadone maintenance treatment Opioid use disorders Relapse Retention Treatment response

Journal

Journal of substance abuse treatment
ISSN: 1873-6483
Titre abrégé: J Subst Abuse Treat
Pays: United States
ID NLM: 8500909

Informations de publication

Date de publication:
12 2021
Historique:
received: 10 01 2021
revised: 23 06 2021
accepted: 04 07 2021
pubmed: 10 8 2021
medline: 22 3 2022
entrez: 9 8 2021
Statut: ppublish

Résumé

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 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.

Sections du résumé

BACKGROUND
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).
METHOD
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.
RESULTS
Lower Stroop interference scores predicted increased length of stay in treatment (χ
CONCLUSION
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.

Identifiants

pubmed: 34366202
pii: S0740-5472(21)00284-1
doi: 10.1016/j.jsat.2021.108558
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

108558

Informations de copyright

Copyright © 2021 Elsevier Inc. All rights reserved.

Auteurs

Tara Rezapour (T)

Department of Cognitive Psychology, Institute for Cognitive Science Studies, Tehran, Iran.

Javad Hatami (J)

Department of Psychology, Faculty of Psychology and Education, University of Tehran, Tehran, Iran.

Ali Farhoudian (A)

Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran.

Alireza Noroozi (A)

Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences (TUMS), Tehran, Iran.

Reza Daneshmand (R)

Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.

Mehmet Sofuoglu (M)

Department of Psychiatry, School of Medicine, Yale University, CT, USA; VA Connecticut Healthcare System, West Haven, CT, USA.

Alex Baldacchino (A)

University of St Andrews, School of Medicine, Division of Population and Behavioral Sciences, St Andrews, Scotland, UK.

Hamed Ekhtiari (H)

Laureate Institute for Brain Research (LIBR), Tulsa, OK, USA. Electronic address: hekhtiari@laureateinstitute.org.

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