Abstract

Cognitive impairment is common in persons with opioid use disorder and associated with poor treatment outcomes, including elevated risk for relapse. Much less is known about the underlying structure of these deficits and the possible presence of cognitive phenotypes. A total of 177 adults (average 42.2 years of age, 52.0% male, 65.5% Caucasian) enrolled in a methadone maintenance treatment program completed the NIH Toolbox as part of a larger project. Cluster analyses revealed a 2-cluster solution–persons with intact cognitive function in all domains (n = 93; Intact) and those with impairments on tests of attention and executive function (n = 83; Impaired). Follow-up analyses revealed that the Impaired group was slightly older, more likely to self-identify as a racial/ethnic minority, and less likely to report consuming alcohol four or more times per week. These findings suggest the existence of distinct cognitive profiles in persons with opioid use disorder and encourage further examination, particularly studies to examine the possible benefits of routine screening for cognitive impairment as part of substance use treatment.

摘要

认知障碍在阿片类药物使用障碍患者中很常见，并且与不良治疗结果相关，包括复发风险升高。关于这些缺陷的根本结构以及认知表型可能存在的情况，人们知之甚少。作为更大项目的一部分，共有 177 名成年人（平均 42.2 岁，52.0% 男性，65.5% 白种人）参加了美沙酮维持治疗计划，完成了 NIH 工具箱。聚类分析揭示了一个 2 聚类解决方案——在所有领域认知功能完整的人（n  = 93；完整）和注意力和执行功能测试有缺陷的人（n = 83；受损）。后续分析显示，受损群体年龄稍大，更有可能自我认同为少数族裔/族裔，并且不太可能报告每周饮酒四次或以上。这些发现表明阿片类药物使用障碍患者存在不同的认知特征，并鼓励进一步检查，特别是研究作为物质使用治疗一部分的认知障碍常规筛查可能带来的益处。