Comparative study assessing Neurocognitive Impairment associated With Alcohol Dependence Syndrome and Opioid Dependence Syndrome

AIM: The aim of the study was to compare the Neurocognitive impairment in patients with Alcohol Dependence Syndrome patient and Opioid Dependence Syndrome. OBJECTIVES: To compare the difference in the domains of neurocognitive assessment in Alcohol Dependence Syndrome with Opioid Dependence Syndrome. METHODS: Fifty patients each diagnosed either as alcohol dependence syndrome or opioid dependence syndrome were evaluated. The baseline demographic of both the groups were quite comparable according to their age, sex, background education, propensity of having an addiction. Clinical Institute withdrawal assessment for alcohol scale (CIWA-Ar) and clinical opiate withdrawal score (COWS), alcohol use disorders identification test, alcohol severity index was the evaluated at baseline in these patients accordingly. These patients were followed up for a period of one month in the outpatient department and re-evaluated on the same scales after the treatment. RESULTS: PGI-Memory Scale was evaluated for the memory components, there was a significant increase in all the domains from baseline to follow up in both the groups except remote memory which although improved a little but was statistically and clinically insignificant in both the groups. The patients had statistically significant and clinically meaningful improvements in the domains of mental balance, improvements in attention and concentration across both the groups. The retention capacity in the patients also improved after one month of treatment. There was not much reduction in remote memory domain at baseline and thus not much improvement in the same at follow-up. This shows that remote memory is not significantly affected in both alcohol and opioid dependencies. Although improvements were seen from baseline to follow-up individually in both the study groups, there was no statistically significant difference in the follow up scores between the groups. At follow up the memory rating improved and none of the patients in either group had a dysfunctional rating score of three. CONCLUSION: The study has shown that there is an overall neurocognitive impairment associated with both alcohol addiction as well as opioid dependence at baseline when compared to the general population, but the magnitude of neurocognitive improvement is more in opioid dependence syndrome in this current study at follow up when compared to alcohol dependence patients. Thus, the results support our main hypothesis of higher chances of improvement in cognitive performance with therapy in patients of opioids dependency, evident as early as week four or one month of therapy. A cross-sectional survey was conducted among adult psychiatric outpatients with depressive disorders at a teaching hospital in Kuala Lumpur for 10 months. Sociodemographic and illness-related data were gathered. Two questionnaires, Mood Disorder Insight Scale (MDIS) and Internalized Stigma of Mental Illness Scale (ISMI), were administered.