Clinical and Cognitive Effects of Computer Assisted Cognitive Remediation Method in Turkish Men with Opioid Use Disorder: A Randomized Controlled Trial

Abstract

Objective: Substance use disorders are associated with significant cognitive impairments causing many individual or social problems besides poor treatment outcomes. The cognitive remediation method is effective in so many neuropsychiatric disorders. This study aimed to evaluate the effects of this method among individuals with opioid use disorder. Method:60 patients diagnosed with opioid use disorder under buprenorphine–naloxone treatment and who accepted the informed consent were included. Seven patients left the study initially. 53 male patients were randomly assigned to receive treatment in the usual control or cognitive remediation–intervention group. The intervention group completed 3 to 4 sessions a week, 8 different exercises in each session, for 4 weeks, a total of 12 sessions, individually. Addiction Profile Indeks, Barrat Impulsivity Scale-SF, CGI, and Delay Discounting scores were measured before and after the 1 month cognitive Remediation practices. Three months later, patients were contacted, and their remission status was evaluated. Results: In the intervention group; 17(89.5%) people had remission and 2(10.5%) people had relapse. In the control group, 7(31.8%) individuals had remission, and 15(68.2%) had relapsed at the end of the 3 months. It was determined that craving, addiction severity, and self-reported and behavioral impulsivity values decreased while the improvement in treatment response was higher in the intervention group. Conclusion: Our results showed that the computer-assisted cognitive remediation method, in addition to buprenorphine–naloxone treatment, improves treatment response, increases remission, and has positive clinical and cognitive effects on individuals with opioid use disorder. It suggests that cognitive remediation practices can be added to the treatment programs for addiction.

Keywords:

• Addiction
• cognitive remediation
• opioid use disorder
• impulsivity
• delay reward discounting

Acknowledgments

We want to thank MD psychiatrist Muhammet Enes Özel for his contributions to the study’s design process and Elif Çinka, an specialist psychologist who contributed by calculating the WAIS scales in the study.

Disclosure statement

Researchers have no conflict of interest.

Funding

This research received no specific grant from the public, commercial, or not-for-profit funding agencies.