Comparison of the executive functions in patients with opioid use disorder and gambling disorder

With this study, it is aimed to compare and evaluate patients diagnosed with opiate use disorder (OUD) gambling disorder (GD) according to DSM-V, who have completed detoxification treatment, with healthy controls in terms of executive functions, and to contributing to the development of addiction treatment plans. Our research was conducted with a total of 150 participants, including 50 male patients diagnosed with opiate use disorder meeting the criteria for inclusion and exclusion in the Amatem Clinic of Erenköy Mental and Neurological Diseases Hospital, 50 male patients diagnosed with gambling disorder, and 50 male patients who were also taken as a healthy control. Participants were given demographic information form, Beck depression and anxiety scale, short symptom inventory, to evaluate clinical and demographic features, Stroop test to evaluate executive functions, Çapa form, Wisconsin card sorting test, Trail making test A and B form, digit span forward and backward test, verbal fluency test and London tower test from computer and Iowa gambling test. Sociodemographic data were given as percentage, frequency, mean, standard deviation, median, minimum, and maximum values. Binary data were analyzed by Pearson Chi-square test. Since the findings were not normally distributed, group comparisons were evaluated using the Kruskall Wallis test and post hoc bonferonni with the comparative Mann Whitney U test. The relationship between demographic and clinical variables and executive functions were checked by age and education, and analyzed by partial Spearman correlation analysis. The effect of age, education and executive function tests in opiate, gambling, and healthy control groups in diagnosing opiate use disorder was analyzed with the Enter method of Logistic Regression analysis. According to the findings obtained as a result of the study, it may be due to the neurotoxic effects of long term opiate use, the Stroop test of the opiate use disorder group, Wisconsin card sorting test, digit span forward and backward test, verbal fluency test, trail making test A and B section, London tower test It was determined that the scores obtained from some parts of Iowa gambling tests were lower than the gambling disorder and healthy control group, and the scores obtained from the gambling disorder group were lower than the healthy control group. It was found that there was a weakly correlation between gambling time and trail making test A section score only. A weakly correlation was found between the last daily opiate use amount and the WCST 7 score. There was a negative weakly significant correlation between opiate use time and the number of corrections of trail making test A, and a weakly negatively significant correlation between total opiate use time and the number of corrections of trail making test A section. While there was a weakly positive correlation between the age of starting substance use and the number of errors of trail making test A and the age of starting opiate and the scores of trail making test B/A; There was a weakly negative correlation between the age of starting drug use and digit span forward and sum of digit span forward and backward scores. In the logistic regression models that are found to be significant between the OUD-GD groups, the risk factors that predict the diagnosis of OUD the most are; WKET 1, İSM, Stroop D interference resistance time and SAT total letter perseveration score; In models that are found to be significant between the OUD-HC groups ie, the risk factors that predict the diagnosis of OUD most; Stroop C, Stroop C spontaneous correction number and trail making test B-A time were determined. Neurocognitive features and related brain areas, which were affected by OUD-GD, and neurocognitive properties and related brain areas that were affected only in OPKB, were identified and recommendations were made to apply treatment modalities for them. In addition, suggestions were made for the limitations of the research and future studies. In the context of these findings, it is thought that adding cognitive rehabilitation programs to addiction treatments for the development of personal cognitive functions can contribute to the solution of problems related to addictions.