摘要
目的:调查甲基苯丙胺成瘾者的认知功能特征,探讨其与渴求的关系。方法:抽取安徽某戒毒所的男性甲基苯丙胺成瘾者72名(MA组)和某社区男性居民60名(对照组),采用一般情况调查表和蒙特利尔认知评估量表测量其认知功能和渴求情况,采用视觉模拟标尺法评价MA组渴求情况,并分析MA组认知功能及其与渴求的相关性。结果:MA组视空间、注意、语言、抽象、延迟回忆5个因子得分和蒙特利尔认知评估量表总分均明显低于对照组(P<0.01);2组命名、定向因子得分差异无统计学意义(P>0.05)。相关分析显示,MA组受试者的注意(r=-0.328,P<0.01)、延迟回忆(r=-0.245,P<0.05)得分和蒙特利尔认知评估量表总分(r=-0.448,P<0.01)与渴求均呈负相关关系,而视空间、命名、语言、抽象、定向5个因子和渴求无明显相关关系(P>0.05)。结论:甲基苯丙胺成瘾者存在广泛的认知功能损害,认知功能与渴求具有相关性,可帮助预测其渴求程度,为通过改善认知功能降低渴求、减少复吸提供了理论依据。
Objective:To investigate the characteristics of cognitive function in methamphetamine addicts,and explore its relationship with craving.Methods:Seventy-two male methamphetamine addicts from a compulsory isolated detoxification center in Anhui Province and sixty male residents from a community were divided into the MA group and control group,respectively.The cognitive function and craving in two groups were measured using general situation questionnaire and Montreal cognitive assessment scale(MoCA).The craving in MA group was evaluated using visual analogue scale,and the correlation of cognitive function with craving in MA group was analyzed.Results:The visual space score,attention score,language score,abstraction score and delayed recall score,and total score of MoCA in MA group were significantly lower than those in control group(P<0.01),and the differences of the scores of naming and orientation factors between two groups were not statistically significant(P>0.05).The correlation analysis results showed that the attention score,delayed recall score,and total score of MoCA in MA group were negatively correlated with craving(P<0.05 and P<0.01),and there was not significant correlation between visual space,naming,language,abstraction and orientation,and craving(P>0.05).Conclusions:There is extensive cognitive impairment in methamphetamine addicts.Cognitive function is correlated with craving,and can predict the degree of craving,which can provide a theoretical basis for reducing craving and relapse by improving cognitive function.
引文
[1] 国家禁毒委员会.2017年中国禁毒报告[M].北京:中国国家禁毒委员会办公室,2017.
[2] KHALKHALI M,GOLSHAHI M,HASANDOKHT T,et al.Cognitive functioning in schizophrenia,methamphetamine-induced psychotic disorder,and healthy people:A comparative study[J].Adv Biomed Res,2018,7(8):123.
[3] 何红波,王达平,郑朝盾,等.冰毒滥用患者和酒精滥用患者韦氏智力测试结果比较[J].中外医学研究,2012,10(18):57.
[4] 孔伶俐,孙忠国,周田田,等.蒙特利尔认知评估量表在轻度认知功能障碍诊断中的应用[J].中国健康心理学杂志,2015,23 (8):1212.
[5] 钟娜,赵敏.甲基苯丙胺对人类认知功能的影响[J].中国药物依赖性杂志,2013(5):324.
[6] WANG TY,FAN TT,BAO YP,et al.Pattern and related factors of cognitive impairment among chronic methamphetamine users[J].Am J Addict,2017,26(2):145.
[7] RUSYNIAK DE.Neurologic manifestations of chronic methamphetamine abuse[J].Psychiatric Clin North Am,2013,36(2):261.
[8] KIYATKIN EA.The hidden side of drug action:brain temperature changes induced by neuroactive drugs[J].Psychopharmacologia,2013,225(4):765.
[9] 张志学,李平,樊丽丹,等.长期戒断甲基苯丙胺依赖患者脑结构影像学改变[J].中南大学学报(医学版),2018,43(1):41.
[10] VAN HOLST RJ,SCHILT T.Drug- related decrease in neuropsychological functions of abstinent drug users[J].Curr Drug Abuse Rev,2011,4(1):42.
[11] NAKAMA H,CHANG L,FEIN G,et al.Methamphetamine users show greater than normal age-related cortical gray matter loss[J].Addiction,2011,106(8):1474.
[12] CARATI C,SCHENK S.Role of dopamine D1- and D2-like receptor mechanisms in drug-seeking following methamphetamine self-administration in rats[J].Pharmacol Biochem Behav,2011,98(3):449.