The following is a summary of “Cognitive impairment as a predictor of long-term psychological distress in patients with polysubstance use disorders: a prospective longitudinal cohort study,” published in the February 2024 issue of Psychiatry by Hetland et al.

The correlation between polysubstance use disorder (pSUD), mental health issues, and cognitive deficits is widely recognized and connected to adverse outcomes in substance use disorder treatment. Yet, it’s uncertain if cognitive impairment forecasts prolonged psychological distress in individuals seeking treatment for pSUD.

Researchers conducted a retrospective study to examine the connections and predictive capacity of cognitive impairment regarding psychological distress both one and five years post-treatment commencement.

They initially sampled 164 treatment-seeking patients with pSUD at the onset of treatment. The study examined the correlations between cognitive impairment, evaluated through the Montreal Cognitive Assessment^® (MoCA^®), Wechsler Abbreviated Scale of Intelligence (WASI), and Behaviour Rating Inventory of Executive Function – Adult version (BRIEF-A) at treatment initiation, and psychological distress, as defined by the Symptom Check List-90-Revised (SCL-90-R), at treatment initiation, one year, and five years later. They conducted hierarchical logistic regressions to evaluate the predictive capacity of the respective cognitive assessments administered at treatment initiation on psychological distress measured at one and five years later while controlling for psychological distress and substance intake at each time point.

The results showed that both the MoCA^® and BRIEF-A assessments successfully predicted psychological distress at both one and five years post-treatment initiation. The predictive power of the BRIEF-A diminished when considering psychological distress levels at treatment initiation. Additionally, while the WASI assessment predicted psychological distress at the one-year mark, it did not maintain its predictive ability at the five-year follow-up.

Investigators concluded that while cognitive impairment at the treatment start might predict future psychological distress, tests like MoCA^® and WASI weren’t as effective in detecting this link, leaving its clinical utility unclear.

Source: bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-024-05600-x