Cognitive Functioning in Formerly Opioid-Dependent Adults after At Least 1 Year of Abstinence: A Naturalistic Study.

This study is an evaluation of cognitive functioning in formerly opioid-dependent adults after at least 1 year of abstinence. Participants (45 formerly opioid-dependent patients, referred to as abstainers, and 45 matched healthy controls) completed a structured screening and subsequent cognitive test battery covering intelligence, learning and memory, attention, and executive functions. Many cognitive functions were comparable between long-term abstainers and healthy controls, and we found few relevant differences. Long-term abstainers seem to have subtle deficits in recognition performance. Based on our and earlier findings, opioid maintenance treatment may be seen as relatively safe with respect to cognitive dysfunction and cognitive functioning is of great relevance for the rehabilitation and daily functioning of substance-dependent people.

A comparison of cognitive function in patients under maintenance treatment with heroin, methadone, or buprenorphine and healthy controls: an open pilot study.

INTRODUCTION: Cognitive impairment has been reported in drug-dependent patients under opioid maintenance treatment. OBJECTIVES: To compare cognitive functioning in healthy controls and in opioid-dependent patients treated with Buprenorphine, Heroin, or methadone maintenance. METHODS: We used the standardized test battery ART-90 to study cognitive function in patients under long-term heroin treatment (n = 20), Bup (n = 22), or Met (n = 24) maintenance treatment and healthy controls (n = 25). RESULTS: Patients receiving heroin performed significantly worse than healthy controls in most domains. Heroin patients performed worse than patients in the other two treatment groups in subtests measuring psychomotor performance under stress conditions and monotony. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: Although a number of limitations must be taken into account, this study provides some preliminary evidence that cognitive function may be more impaired in patients under heroin maintenance treatment than in patients receiving Bup or Met and in healthy controls.

Characterization of patients discharged from inpatient treatment for burnout: use of psychological characteristics to identify aftercare needs.

With increasing severity, burnout corresponds to a state of significant suffering with impaired social functioning, decreased quality of life, and psychosomatic complaints. The present study investigates (a) how former patients of an inpatient clinic for burnout therapy can be grouped on the basis of their psychological characteristics and (b) whether these groups correspond to different levels of residual symptoms (depression and burnout) and general mental health. Cluster analysis of psychological characteristics was used to form groups. Four specific groups could be identified (functionals, dysfunctionals, straightforward pragmatists, unhappy altruists). This grouping, with subsequent characterization according to symptom levels, provides important information indicating possible needs for aftercare and suggests areas for improvement of previous care.

Criminal behavior in opioid-dependent patients before and during maintenance therapy: 6-year follow-up of a nationally representative cohort sample.

Lifetime prevalence of opioid dependence is about 0.4% in western countries. Opioid-dependent patients have high morbidity and mortality and a high risk of criminal behavior. Few studies have addressed the long-term impact of opioid maintenance therapy on convictions and criminal behavior. The PREMOS study is a prospective, longitudinal, naturalistic clinical study of a nationally representative sample of 2694 opioid-dependent patients to investigate convictions and criminal behavior at baseline and after 6 years of maintenance treatment. At follow-up, 2284 patients still were eligible (84.7%). A comprehensive assessment including a patient and doctor questionnaire, and the EuropASI was completed at baseline and follow-up. Data on criminality at follow-up had been received for 1147 (70.6%) patients. A large number (84.5%) of them had been charged or convicted at any time before baseline assessment, most frequently with drug-related offenses (66.8%), acquisitive crime (49.1%), or acts of violence (22.0%). Reported charges and convictions had declined to 17.9% for the last 12 months before follow-up, which was also reflected by a significant decrease in the EuropASI subscore "legal problems" from 1.52 at baseline to 0.98 after 6 years. These data indicate a significant and clinically relevant reduction in criminal behavior in opioid-dependent patients in long-term maintenance treatment. Maintenance therapy is effective in the reduction in both narcotics-related and acquisition crime.