The role of neurocognitive functioning, substance use variables and the DSM-5 severity scale in cocaine relapse: A prospective study

Author(s):Show less -

Lim, Danielle Ruiz ^{[1, 2]} ; Goncalves, Priscila Dib ^{[1, 2]} ; Ometto, Mariella ^{[1, 2]} ; Malbergier, Andre ^[2] ; Amaral, Ricardo Abrantes ^[2] ; dos Santos, Bernardo ^[3] ; Cavallet, Mikael ^[1] ; Chaim-Avancini, Tiffany ^[1] ; Serpa, Mauricio Henriques ^[1] ; Kobuti Ferreira, Luiz Roberto ^[1] ; de Souza Duran, Fabio Luis ^[1] ; Zanetti, Marcus Vinicius ^[1] ; Nicastr, Sergio ^{[1, 2]} ; Busatto, Geraldo Filho ^[1] ; Andrad, Arthur Guerra ^{[2, 4]} ; Cunh, Paulo Jannuzzi ^{[1, 2]}

Affiliation

^[1] Univ Sao Paulo, Fac Med, Hosp Clin HCFMUSP, Lab Neuroimagem Psiquiatria 21, Inst Psiquiatria I, R Dr Ovidio Pires Campos 785, BR-01060970 Sao Paulo, SP - Brazil

^[2] Univ Sao Paulo, Fac Med, Inst Psiquiatria IPq, Hosp Clin HCFMUSP, Grp Interdisciplinar Escudos Alcool & Drogas GREA, R Dr Ovidio Pires Campos 785, BR-01060970 Sao Paulo, SP - Brazil

^[3] Univ Sao Paulo, Fac Med, Hosp Clin HCFMUSP, Escola Enfermagem, Av Dr Eneas Carvalho Aguiar 419, BR-05403000 Sao Paulo, SP - Brazil

^[4] Escola Med ABC, Dept Neurociencias, Av Lauro Comes 2000, BR-09060870 Santo Andre, SP - Brazil

• Document type: Journal article
• Source: DRUG AND ALCOHOL DEPENDENCE; v. 197, p. 255-261, APR 1 2019.
• Web of Science Citations: 2

Abstract

Background: The severity of substance use disorder (SUD) is currently defined by the sum of DSM-5 criteria. However, little is known about the validity of this framework or the role of additional severity indicators in relapse prediction. This study aimed to investigate the relationship between DSM-5 criteria, neurocognitive functioning, substance use variables and cocaine relapse among inpatients with cocaine use disorder (CUD). Methods: 128 adults aged between 18 and 45 years were evaluated; 68 (59 males, 9 females) had CUD and 60 (52 males, 8 females) were healthy controls. For the group with CUD, the use of other substances was not an exclusion criterion. Participants were tested using a battery of neurocognitive tests. Cocaine relapse was evaluated 3 months after discharge. Results: Scores for attention span and working memory were worse in patients compared to controls. Earlier onset and duration of cocaine use were related to poorer inhibitory control and global executive functioning, respectively; recent use was related to worse performance in inhibitory control, attention span and working memory. More DSM-5 criteria at baseline were significantly associated with relapse. Conclusions: Recent cocaine use was the most predictive variable for neurocognitive impairments, while DSM-5 criteria predicted cocaine relapse at three months post treatment. The integration of neurocognitive measures, DSM-5 criteria and cocaine use variables in CUD diagnosis could improve severity differentiation. Longitudinal studies using additional biomarkers are needed to disentangle the different roles of severity indicators in relapse prediction and to achieve more individualized and effective treatment strategies for these patients. (AU)

• FAPESP's process: 10/15604-0 - White matter integrity of the corpus callosum and neuropsychological performance in maltreated children and adolescents: a brain morphometric and diffusion tensor imaging study
• Grantee: Paulo Jannuzzi Cunha
• Support type: Scholarships in Brazil - Post-Doctorate
• FAPESP's process: 10/01272-6 - Research about the impact of neuropsychological rehabilitation on cocaine/crack dependents
• Grantee: Priscila Dib Goncalves
• Support type: Scholarships in Brazil - Master
• FAPESP's process: 10/15786-1 - White matter integrity of the corpus callosum and neuropsychological performance in maltreated children and adolescents: a brain morphometric and diffusion tensor imaging study
• Grantee: Geraldo Busatto Filho
• Support type: Regular Research Grants