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Gautron MA, Clergue-Duval V, Chantre J, Lejoyeux M, Geoffroy PA. Predictive factors of cognitive impairment in alcohol use disorder inpatients. Addict Behav 2024; 158:108132. [PMID: 39146925 DOI: 10.1016/j.addbeh.2024.108132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 07/03/2024] [Accepted: 08/12/2024] [Indexed: 08/17/2024]
Abstract
BACKGROUND Cognitive impairments are common in patients with AUD and worsen the prognosis of addiction management. There are no clear guidelines for screening cognitive impairments in hospitalized patients with AUD. METHODS Fifty-seven patients with an AUD history who were admitted to an acute hospital and assessed by the addiction care team were included. Those patients were screened for cognitive impairments using the Montreal Cognitive Assessment (MoCA) test. We collected clinical information regarding addiction history, comorbidities, and current treatments. Chi-square tests, t-tests, and Mann-Whitney tests were performed to determine factors associated with a pathological MoCA score (<26). RESULTS A pathological MoCA score was positively associated with spatial-temporal disorientation, difficulty in recalling addiction history, patient underreporting of AUD and a date of last alcohol consumption lower than 11 days ago, and negatively associated with a reason for hospitalization due to alcohol-related health issues. No medication was associated with cognitive impairments. CONCLUSIONS Clinical elements from assessment by the addiction care team allow for relevant indication for screening cognitive impairments.
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Affiliation(s)
- Marie-Astrid Gautron
- Unité de Traitement Ambulatoire des Maladies Addictives, Département d'Addictologie et de Psychiatrie, Hôpital Beaujon, APHP GHU Nord, 100 bd du général Leclerc, 92110 Clichy, France; ResAlCog (Réseau pour la prise en charge des troubles cognitifs liés à l'alcool), 51 bis Rue des Epinettes, 75017 Paris, France.
| | - Virgile Clergue-Duval
- ResAlCog (Réseau pour la prise en charge des troubles cognitifs liés à l'alcool), 51 bis Rue des Epinettes, 75017 Paris, France; Département de Psychiatrie et de Médecine Addictologique, Site Lariboisière Fernand-Widal, APHP GHU Nord, 200 rue du faubourg Saint-Denis, 75010 Paris, France; UFR de Médecine, Université Paris Cité, 85 boulevard Saint-Germain, 75006 Paris, France; UMRS-1144 Optimisation thérapeutique en neuropsychopharmacologie, Inserm, Université Paris Cité, 4 avenue de l'Observatoire, 75006 Paris, France; FHU Network of Research in Substance Use Disorders (NOR-SUD), 4 avenue de l'Observatoire, 75006 Paris , France
| | - Janice Chantre
- Unité de Traitement Ambulatoire des Maladies Addictives, Département d'Addictologie et de Psychiatrie, Hôpital Beaujon, APHP GHU Nord, 100 bd du général Leclerc, 92110 Clichy, France; ResAlCog (Réseau pour la prise en charge des troubles cognitifs liés à l'alcool), 51 bis Rue des Epinettes, 75017 Paris, France; Département de psychiatrie et d'addictologie, AP-HP, DMU Neurosciences, Hôpital Bichat - Claude Bernard, APHP GHU Nord, 46 rue Henri Huchard, 75018 Paris, France
| | - Michel Lejoyeux
- UFR de Médecine, Université Paris Cité, 85 boulevard Saint-Germain, 75006 Paris, France; Département de psychiatrie et d'addictologie, AP-HP, DMU Neurosciences, Hôpital Bichat - Claude Bernard, APHP GHU Nord, 46 rue Henri Huchard, 75018 Paris, France; 22ème secteur de psychiatrie parisienne GHU Paris - Psychiatry & Neurosciences, 1 rue Cabanis, 75014 Paris, France
| | - Pierre A Geoffroy
- UFR de Médecine, Université Paris Cité, 85 boulevard Saint-Germain, 75006 Paris, France; Département de psychiatrie et d'addictologie, AP-HP, DMU Neurosciences, Hôpital Bichat - Claude Bernard, APHP GHU Nord, 46 rue Henri Huchard, 75018 Paris, France; Centre ChronoS, GHU Paris - Psychiatry & Neurosciences, 1 rue Cabanis, 75014 Paris, France; CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, Strasbourg, France
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Haller J. Herbal Cannabis and Depression: A Review of Findings Published over the Last Three Years. Pharmaceuticals (Basel) 2024; 17:689. [PMID: 38931356 PMCID: PMC11206863 DOI: 10.3390/ph17060689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 05/22/2024] [Accepted: 05/24/2024] [Indexed: 06/28/2024] Open
Abstract
Public perception contrasts scientific findings on the depression-related effects of cannabis. However, earlier studies were performed when cannabis was predominantly illegal, its production was mostly uncontrolled, and the idea of medical cannabis was incipient only. We hypothesized that recent changes in attitudes and legislations may have favorably affected research. In addition, publication bias against cannabis may have also decreased. To investigate this hypothesis, we conducted a review of research studies published over the last three years. We found 156 relevant research articles. In most cross-sectional studies, depression was higher in those who consumed cannabis than in those who did not. An increase in cannabis consumption was typically followed by an increase in depression, whereas withdrawal from cannabis ameliorated depression in most cases. Although medical cannabis reduced depression in most studies, none of these were placebo-controlled. In clinical studies published in the same period, the placebo also ameliorated depression and, in addition, the average effect size of the placebo was larger than the average effect size of medical cannabis. We also investigated the plausibility of the antidepressant effects of cannabis by reviewing molecular and pharmacological studies. Taken together, the reviewed findings do not support the antidepressant effects of herbal cannabis.
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Affiliation(s)
- Jozsef Haller
- Drug Research Institute, 1137 Budapest, Hungary;
- Department of Criminal Psychology, Faculty of Law Enforcement, Ludovika University of Public Service, 1083 Budapest, Hungary
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Kessels RPC, de Vent NR, Bruijnen CJWH, Jansen MG, de Jonghe JFM, Dijkstra BAG, Oosterman JM. Regression-Based Normative Data for the Montreal Cognitive Assessment (MoCA) and Its Memory Index Score (MoCA-MIS) for Individuals Aged 18-91. J Clin Med 2022; 11:4059. [PMID: 35887823 PMCID: PMC9318507 DOI: 10.3390/jcm11144059] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/07/2022] [Accepted: 07/12/2022] [Indexed: 01/07/2023] Open
Abstract
(1) Background: There is a need for a brief assessment of cognitive function, both in patient care and scientific research, for which the Montreal Cognitive Assessment (MoCA) is a psychometrically reliable and valid tool. However, fine-grained normative data allowing for adjustment for age, education, and/or sex are lacking, especially for its Memory Index Score (MIS). (2) Methods: A total of 820 healthy individuals aged 18-91 (366 men) completed the Dutch MoCA (version 7.1), of whom 182 also completed the cued recall and recognition memory subtests enabling calculation of the MIS. Regression-based normative data were computed for the MoCA Total Score and MIS, following the data-handling procedure of the Advanced Neuropsychological Diagnostics Infrastructure (ANDI). (3) Results: Age, education level, and sex were significant predictors of the MoCA Total Score (Conditional R2 = 0.4, Marginal R2 = 0.12, restricted maximum likelihood (REML) criterion at convergence: 3470.1) and MIS (Marginal R2 = 0.14, REML criterion at convergence: 682.8). Percentile distributions are presented that allow for age, education and sex adjustment for the MoCA Total Score and the MIS. (4) Conclusions: We present normative data covering the full adult life span that can be used for the screening for overall cognitive deficits and memory impairment, not only in older people with or people at risk of neurodegenerative disease, but also in younger individuals with acquired brain injury, neurological disease, or non-neurological medical conditions.
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Affiliation(s)
- Roy P. C. Kessels
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, 6525 GD Nijmegen, The Netherlands; (M.G.J.); (J.M.O.)
- Vincent van Gogh Institute for Psychiatry, Center of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, 5803 DN Venray, The Netherlands;
- Klimmendaal Rehabilitation Specialists, 6813 GG Arnhem, The Netherlands
- Tactus Addiction Care, 7400 AD Deventer, The Netherlands
- Department of Medical Psychology and Radboudumc Alzheimer Center, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands
| | - Nathalie R. de Vent
- Department of Psychology, University of Amsterdam, 1018 WS Amsterdam, The Netherlands;
| | - Carolien J. W. H. Bruijnen
- Vincent van Gogh Institute for Psychiatry, Center of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, 5803 DN Venray, The Netherlands;
- Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), Radboud University, 6525 GD Nijmegen, The Netherlands;
| | - Michelle G. Jansen
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, 6525 GD Nijmegen, The Netherlands; (M.G.J.); (J.M.O.)
| | | | - Boukje A. G. Dijkstra
- Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), Radboud University, 6525 GD Nijmegen, The Netherlands;
- Novadic-Kentron, Addiction Care Center, 5261 LX Vught, The Netherlands
| | - Joukje M. Oosterman
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, 6525 GD Nijmegen, The Netherlands; (M.G.J.); (J.M.O.)
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