Executive functions and social cognition in adult patients with substance use disorder

Heroin and methamphetamine use is known to have permanent effects on the social lives of individuals. In this study, we aimed to determine whether there are impairments in executive functions and social cognition in patients with substance (heroin-methamphetamine) use compared to healthy controls and to determine the factors associated with the duration of remission in follow-up. Our study was conducted with 35 patients diagnosed with methamphetamine use disorder (MUD) according to DSM-5, 38 patients diagnosed with heroin use disorder (HUD) and 30 healthy controls (HC) without a diagnosis of substance use disorder who were treated in the AMATEM outpatient clinic and AMATEM service of Pamukkale University (PAU) Faculty of Medicine Hospital and who agreed to participate in the study. Sociodemographic data form, Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), Adult Attention Deficit Hyperactivity Disorder Scale (ASRS), Barratt Impulsivity Scale (BIS), and Childhood Trauma Scale (CTS) were applied to the participants. Stroop Test (ST), Wisconsin Test (WT), Go/NoGo Test and Mind Reading Through Eyes Test (MRT) for social cognition were applied as neuropsychological tests to evaluate executive functions. Early remission status of the patients was evaluated three months after the tests and scales were performed. Sociodemographic data, initial scales and tests were evaluated in the remission and non-remission groups. When the groups were evaluated according to gender, 89.5% in EG, 82.9% in MF, and 86.7% in C were male (p>0.05). Statistically significant differences between the groups were found in marital status, region of residence, employment status, smoking status, and education status of the participants enrolled in the study (p=0.043; p=0.004; p<0.0001; p<0.0001; p<0.0001). On the Hamilton Anxiety and Depression Rating Scale, ECB and MDD scores were significantly higher than K (p<0.050). Total scores on the scales used in our study, namely the CTS, BDI,and ASRS, were significantly higher in the ECU and MDR groups than in the K group (p<0.0001; p<0.050; p<0.050, respectively). No significant relationship was found between VST and the groups. In Wisconsin card matching and Go/No Go test, ECK and MDT scores were significantly higher than K (p<0.050). In the Social Cognition Test, GZOT, ECK and MDR scores were significantly higher than K (p<0.050). There was no significant difference between the groups in terms of early remission status according to the scales. The ability to remain in remission for three months differed significantly between the MDR group and the ECT group, and the early remission rates were lower in the MDR group (p=0.005). The VST test partC/D (high interference sensitivity) was significantly higher in substance users who were not in early remission compared to those who were (p=0,040). As a result, we found that people with heroin and methamphetamine use disorders showed lower performance in social cognition and executive functions compared to healthy individuals. We think that the type of substance used is effective in early remission, methamphetamine users are less in early remission, and executive functions may be related to deficits in cognitive flexibility. Considering the limitations of the study, it is recommended that similar studies be repeated in future studies with a larger study group and longer follow-up periods. It is thought that our study may contribute to the literature in terms of planning pharmacological and cognitive treatment interventions that can be applied and staying in treatment in people with substance abuse. Keywords: Heroin, methamphetamine, substance use disorder, AMATEM, executive functions