The Effect of Cognitive Functioning on Treatment Attendance and Adherence in Comorbid Bipolar Disorder and Cocaine Dependence

Fagan, Colleen S.; Carmody, Thomas; McClintock, Shawn M.; Surís, Alina; Nakamura, Alyson; Jeon–Slaughter, Haekyung; Lo, Alexander X.; Brown, E. Sherwood

doi:10.1016/j.jsat.2014.06.008

Cited by 17 publications

(6 citation statements)

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“…These differences might be explained by methodological differences and more restrictive inclusion criteria, that is, patients with less residual symptoms and without substance use disorder. Similarly, a study including 120 patients with BD with current depressed or mixed episode and cocaine dependence, found that baseline cognitive functioning measured by the Stroop Color–Word test and performance in simple visual attention tasks, assessed by the Stroop Word condition, was inversely associated with treatment adherence [ 20 ]. By contrast, another study [ 22 ] found no difference in neurocognitive performance according to adherence in a sample of 101 patients with BD, who were mostly euthymic, and 154 patients with a schizophrenia spectrum disorder.…”

Section: Discussionmentioning

confidence: 99%

Neuropsychological functioning, age, and medication adherence in bipolar disorder

et al. 2017

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ObjectivesPoor adherence to medication is frequent in bipolar disorder (BD) and has been associated with several factors. To date, the relationship between low adherence and neuropsychological functioning in BD is still unclear. As age and neuropsychological functioning might have opposing influences on adherence, our aim was to investigate this link with a particular focus on the effect of age.MethodsIn a cross-sectional study, we included 353 patients divided into two age-groups (16–46; 47–71) from a French cohort diagnosed with BD (type I, II, NOS) and strictly euthymic. All patients had a standardized clinical and neuropsychological assessment and were categorized as high (n = 186) or low (n = 167) adherent based on their score from the Medication Adherence Rating Scale. Clinical information was collected based on a standardized interview and clinical validated scales. Neuropsychological performances were evaluated with an established standardized neuropsychological battery for bipolar disorder patients. After univariate analysis, neuropsychological and clinical predictors of low adherence were included in two age-specific stepwise multiple logistic regressions.ResultsA smaller number of hospitalizations (OR = 0.846, p = 0.012), a shorter illness duration (OR = 0.937, p = 0.003) and higher adverse effects (OR = 1.082, p<0.001) were associated with a greater risk of low adherence in the younger patients. In the older patients, low adherence was also predicted by a smaller number of hospitalizations (OR = 0.727, p = 0.008) and higher adverse effects (OR = 1.124, p = 0.005). Interestingly poor inhibition performance was also a significant predictor of low adherence in older patients (OR = 0.924, p = 0.030).ConclusionsWe found an age-specific relationship between cognitive functioning and adherence in patients with BD. Poor inhibition performances predicted low adherence in older patients only. Our results highlight the need to provide age-adapted therapeutic interventions to improve adherence in patients with BD.

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Section: Discussionmentioning

confidence: 99%

Neuropsychological functioning, age, and medication adherence in bipolar disorder

et al. 2017

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“…However, few pharmacological and behavioral interventions have effectively addressed the clinical management of dual populations, probably because they may not be well-suited for this cognitively-impaired population (Bradizza et al, 2014 ). Indeed, neurocognitive dysfunction may represent a barrier for dual patients to benefit from psychosocial treatments, and probably also from pharmacological agents through indirect effects on diminished adherence (Martinez-Aran et al, 2009 ; Vieta et al, 2012 ; Jónsdóttir et al, 2013 ; Fagan et al, 2015 ). Preventative and treatment strategies should target neurocognitive dysfunction as a major driver of patients' functional outcomes (Tabarés-Seisdedos et al, 2008 ).…”

Section: Implications For Clinical Practice and Researchmentioning

confidence: 99%

Bipolar disorder comorbid with alcohol use disorder: focus on neurocognitive correlates

et al. 2015

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Bipolar disorder (BD) and alcohol use disorders (AUDs) are usually comorbid, and both have been associated with significant neurocognitive impairment. Patients with the BD-AUD comorbidity (dual diagnosis) may have more severe neurocognitive deficits than those with a single diagnosis, but there is paucity of research in this area. To explore this hypothesis more thoroughly, we carried out a systematic literature review through January 2015. Eight studies have examined the effect of AUDs on the neurocognitive functioning of BD patients. Most studies found that BD patients with current or past history of comorbid AUDs show more severe impairments, especially in verbal memory and executive cognition, than their non-dual counterparts. Greater neurocognitive dysfunction is another facet of this severe comorbid presentation. Implications for clinical practice and research are discussed. Specifically, the application of holistic approaches, such as clinical staging and systems biology, may open new avenues of discoveries related to the BD-AUD comorbidity.

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“…G. Moeller, et al, 2001;Torregrossa, Corlett, & Taylor, 2011;Volkow, Fowler, Wang, & Goldstein, 2002). Poor Color-Word Stroop behavioral performance has been associated with worse treatment adherence (Fagan, et al, 2015) and cocaine use, and performance has improved across treatment (Nuijten, Blanken, Van den Brink, Goudriaan, & Hendriks, 2016). In cocaine users, fMRI Stroop measures differ from healthy controls (Mayer, Wilcox, Teshiba, Ling, & Yang, 2013;Mitchell, et al, 2013; S. J.…”

Section: Introductionmentioning

confidence: 99%

fMRI Stroop and behavioral treatment for cocaine-dependence: Preliminary findings in methadone-maintained individuals

DeVito

Kober

Carroll

et al. 2019

Addictive Behaviors

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Diminished Stroop-related activity following treatment may be consistent with improved efficiency of cognitive-control-related activity. Although preliminary, this study is the first to demonstrate a relationship between better treatment outcomes (lower cocaine use during treatment) and greater reduction in Stroop-related activity at post- versus beginning-of-treatment in cocaine users. These findings extend prior work.

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The Effect of Cognitive Functioning on Treatment Attendance and Adherence in Comorbid Bipolar Disorder and Cocaine Dependence

Cited by 17 publications

References 40 publications

Neuropsychological functioning, age, and medication adherence in bipolar disorder

Neuropsychological functioning, age, and medication adherence in bipolar disorder

Bipolar disorder comorbid with alcohol use disorder: focus on neurocognitive correlates

fMRI Stroop and behavioral treatment for cocaine-dependence: Preliminary findings in methadone-maintained individuals

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