Cognitive deficits predict low treatment retention in cocaine dependent patients
Cognitive deficits predict low treatment retention in cocaine dependent patients
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DOI：
10.1016/j.drugalcdep.2005.08.003
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发表时间：
2006-02-28
影响因子：
4.2
通讯作者：
Nunes, EV
中科院分区：
文献类型：
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作者：
Aharonovich, E;Hasin, DS;Nunes, EV
以前，我们发现，在一个小样本的可卡因依赖患者中，认知受损预测了认知行为治疗（CBT）的治疗脱落。为了进一步解决认知受损在CBT中可卡因依赖患者的保留和治疗结果中的作用，我们将先前的调查扩展到更大的样本，增加了抑郁的可卡因患者，并增加了额外的认知评估。五十六例接受CBT门诊临床试验的可卡因依赖患者在治疗开始时采用计算机化MicroCog（MC）和威斯康星州卡片分类测验（WCST）评估认知表现。治疗完成定义为12周或以上。治疗退出者在注意力、记忆力、空间能力、速度、准确性、整体功能和认知能力方面的MC评分（认知功能较差）显著低于完成者，效应量在中度至重度范围内。这些发现不受抑郁症，人口统计学（年龄，性别，种族，性别，婚姻状况）或药物使用（可卡因使用年数或前30天平均每周可卡因支出）的影响。相比之下，患者在WCST上的表现处于平均或接近平均的范围内，并且WCST评分没有区分完成者和脱落者。与先前的研究一致，结果表明，轻度认知障碍（
Previously, we found that impaired cognition predicted treatment dropout from cognitive behavioral therapy (CBT) in a small sample of cocaine dependent patients. To further address the role of impaired cognition in retention and treatment outcome of cocaine-dependent patients in CBT, we expanded a previous investigation to a larger sample, added depressed cocaine patients, and added an additional cognitive assessment. Fifty-six cocaine dependent patients receiving CBT in outpatient clinical trials were assessed for cognitive performance at treatment entry with the computerized MicroCog (MC) and the Wisconsin Card Sort Test (WCST). Treatment completion was defined as 12 or more weeks. Treatment dropouts had significantly lower MC scores (poorer cognitive functioning) than completers on attention, memory, spatial ability, speed, accuracy, global functioning, and cognitive proficiency, with effect sizes in the moderate to large range. These findings were not affected by depression, demographics (age, gender, race, sex, marital status) or drug use (years of cocaine use or average weekly cocaine expenditure in the prior 30 days). In contrast, patients' performance on the WCST was in the average or near-average range, and WCST scores did not differentiate between completers and dropouts. Consistent with previous research, results suggest that mild cognitive impairments (