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This is noteworthy because cognitive impairments negatively affect several treatment processes and therapeutic change mechanisms as well as treatment outcomes such as rates of drop-out and relapse. Moreover, elevated psychological distress has also been linked with cognitive impairments in patients with SUD. Conversely, substance use may cause neuropsychological impairments originating from factors such as neuroadaptations, cerebrovascular changes and hypoxia. Psychological distress and executive deficits are also considered integral transdiagnostic components of SUD and map to the withdrawal/negative affect and preoccupation/anticipation stages in the addiction cycle. The manifestation of cognitive impairment in apparently recovered patient cohorts implies that some cognitive impairments associated with mental illness may possess trait-like qualities. Indeed, psychological distress and several psychiatric disorders are associated with both specific deficits in executive function and general neurocognitive impairments, including impaired intellectual functioning.
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Executive dysfunction, and cognitive impairments in general, are suggested to be a transdiagnostic dimension in psychopathology. Epidemiological and clinical studies link SUD to a host of mental illnesses, such as mood and anxiety disorders, attention-deficit hyperactivity disorder, psychosis, personality disorders, suicidality and general psychological distress. The relationship between SUDs, mental health and cognitive functioning is intricately intertwined. Therefore, it is imperative to identify risk factors influencing long-term mental health to optimize the efficiency of SUD treatment. Elevated psychological distress impedes individuals’ capacity to engage in long-term objectives of psychosocial improvement and moderation of substance use but also results in a perception of unmet treatment needs, particularly among male patients with SUDs. Cognitive impairment at treatment initiation may hold predictive value on later psychological distress, yet its clinical utility is uncertain.Īddressing mental health is pivotal to the treatment of substance use disorders (SUDs) due to its effect on quality of life, treatment retention and risk of relapse. Results from MoCA ® and WASI was found to be less sensitive to the effect of psychological distress than BRIEF-A. WASI predicted psychological distress at year one, but not at year five. The main results was that MoCA ® and BRIEF-A predicted psychological distress at years one and five, but BRIEF-A lost predictive power when accounting for psychological distress at treatment initiation. We ran hierarchical logistic regressions to assess the predictive ability of the respective cognitive instruments administered at treatment initiation on psychological distress measured one and five years later including psychological distress at treatment initiation and substance intake at the time-points of the measurements as covariates. We examined associations between cognitive impairment according to Montreal Cognitive Assessment ® (MoCA ®), Wechsler Abbreviated Scale of Intelligence (WASI), and Behaviour Rating Inventory of Executive Function - Adult version (BRIEF-A) administered at treatment initiation and psychological distress defined by the Symptom Check List-90-Revised (SCL-90-R) at treatment initiation, one and five years later. N = 164 treatment seeking patients with pSUD were sampled at treatment initiation. This study aimed to investigate the associations and predictive ability of cognitive impairment on psychological distress one and 5 years after treatment initiation.
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However, it remains unclear whether cognitive impairment predicts long-term psychological distress among treatment seeking patients with pSUD. The association between polysubstance use disorder (pSUD), mental illness, and cognitive impairments is well established and linked to negative outcomes in substance use disorder treatment.