Substance Use Patterns and Cognitive Function in Patients with Methamphetamine Use: A Study of 131 Cases

物質使用模式對於131個甲基安非他命使用者之中的認知功能關聯影響

鄭映芝(Ying Chih Cheng) ； 王亮人(Liang-Jen Wang) ； 陳枻志(Yi-Chih Chen) ； 黃名琪(Ming-Chyi Huang) ； 林式穀(Shih-Ku Lin) ； 陳志根(Chih-Ken Chen)

《台灣精神醫學》 30卷2期 (2016/06) Pp. 128-136+iv

摘要

目的：物質使用模式曾被報告會影響甲基安非他命使用者的認知功能，本研究主要是要探討哪些甲基安非他命使用變量可以預測甲基安非他命濫用者的認知功能缺損。方法：本研究為一橫斷面研究，本研究記錄甲基安非他命使用者的使用變量包括首次使用甲基安非他命年齡，使用總時間，使用量及使用其他非法藥物的經驗，並且使用遺傳研究診斷問卷表, 簡短思覺失調症認知評估 (BACS) 及簡短精神症狀量表來評估個案的精神科診斷、認知功能及精神病症狀。結果：本研究共招募131 位甲基安非他命使用者，在控制年齡、性別及教育程度等因素後，較長期使用甲基安非他命以及曾經使用愷他命與較差的工作記憶 (p ＜ 0.01)、執行功能 (p ＜ 0.05) 及BACS 綜合分數 (p ＜ 0.01 與p ＜ 0.05 ) 分析有顯著的關聯性，而甲基安非他命使用的總時間與曾經使用鴉片類物質則與注意力 (p ＜ 0.05) 及處理速度 (p ＜ 0.05) 有顯著的關聯，較年輕開始使用甲基安非他命則有較差的口語記憶 (p ＜ 0.05)，甲基安非他命的使用量則與運動速度有關聯 (p ＜ 0.05)。結論：在甲基安非他命使用個案上，甲基安非他命使用的總時間與曾經使用愷他命可預測後續認知缺損。各種甲基安非他命使用變項與不同領域的認知功能相關聯的機轉值得更深入探討。

關鍵字

甲基安非他命 ； 認知功能 ； 愷他命 ； 物質濫用

並列摘要

Objective: Substance use patterns are among many factors been reported to influence the result of cognitive function in patients with methamphetamine (meth) use. In this study, we intended to study what meth use parameters can predict cognitive deficits in patients with meth use. Methods: In this cross-sectional study, we recruited meth users, to collect meth use parameters-onset age, duration, dose, and experience of other illicit drugs. The psychiatric diagnoses, cognitive function, and clinical psychopathology of each patient were evaluated using the Diagnostic Interview for Genetic Study, the Brief Assessment of Cognition in Schizophrenia (BACS), and the Brief Psychiatric Rating Scale, respectively. Results: We enrolled 131 patients with meth use. After controlling for age, sex and education, we found that long duration of meth use and experience of ketamine use were significantly associated with poor performance in working memory (p ＜ 0.01), executive function (p ＜ 0.05) and composite BACS score (p ＜ 0.01 and p ＜ 0.05, respectively), duration of meth use and experience of opioid use were significantly associated with poor attention (p ＜ 0.05), and processing speed (p ＜ 0.05). We also found that earlier age of first meth use was significantly associated with poor verbal memory (p ＜ 0.05). Amount of meth consumption was also found to be significantly associated with deficit in motor speed (p ＜ 0.05). Conclusion: Duration of meth use and experience of ketamine use predicted cognitive deficits in meth users in this study. The mechanisms behind association of various meth use parameters with deficits in different domains of cognition warrant further investigation.

並列關鍵字

methamphetamine ； cognition ； ketamine ； substance abuse

參考文獻

Panenka WJ, Procyshyn RM, Lecomte T, et al.: Methamphetamine use: a comprehensive review of molecular, preclinical and clinical findings. Drug Alcohol Depend 2013; 129: 167-79.

Chou YH, Huang WS, Su TP, Lu RB, Wan FJ, Fu YK: Dopamine transporters and cognitive function in methamphetamine abuser after a short abstinence: a SPECT study. Eur Neuropsychopharmacol 2007; 17: 46-52.

Hart CL, Marvin CB, Silver R, Smith EE: Is cognitive functioning impaired in methamphetamine users? a critical review. Neuropsychopharmacology 2012; 37: 586-608.

Scott JC, Woods SP, Matt GE, et al.: Neurocognitive effects of methamphetamine: a critical review and meta-analysis. Neuropsychol Rev 2007; 17: 275-97.

Simon SL, Domier C, Carnell J, Brethen P, Rawson R, Ling W: Cognitive impairment in individuals currently using methamphetamine. Am J Addict 2000; 9: 222-31.