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ddiction is characterized by inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response. Like other chronic diseases, addiction often involves cycles of relapse and remission. Meanwhile, without treatment or engagement in recovery activities, addiction is progressive and can result in disabilities as cognitive impairment.
Based on that, this study was conducted at Institute of psychiatry, Ain shams university hospital, Cairo, Egypt, aiming to study cognitive affection among tramadol and synthetic cannabinoids users. Thirty (60) patients were included in this study (30 of them were tramadol users and the other 30, were SC users) and compared with 30 healthy control matched for age and sex. Their age ranges between 18-45 years. The study took place from October 2018 till August 2019. All subjects of the study were assessed by using: Structured Clinical Interview for DSM-IV Axis I (SCID I): to diagnose any psychiatric disorder; Structured Clinical Interview for DSM-IV Axis II (SCID II): to diagnose personality disorders; Addiction severity index (ASI): to assess the severity of addiction; trail making test A&B: for assessment of attention and processing speed; Benton visual retention test (BVRT): for assessment of visual memory, visual reconstruction ability and processing and delayed memory; Wechsler memory scale (WMS): for assessment of visual, auditory, immediate, delayed & working memory.
This study found that there was no statistically significant difference in age between cases and controls (P>0.05). Moreover, it was found that tramadol cases are older that SC cases, as the mean age of tramadol cases (N=30) is (33.8) in comparison to that of SC cases (N=30) is (22.4), and that was high statistically significant (P<0.001).
The main findings in the study were that the tramadol as well as SC use disorder cases had high statistically significant cognitive impairment compared to healthy controls. Cognitive impairment involved attention, visual, auditory, immediate, delayed & working memory as well as visual reconstruction ability and processing speed (P value <0.001).
By using SCID I, forty-seven percent of tramadol use disorder cases had comorbid major depressive disorder in comparison to three percent of SC cases had major depressive disorder. Moreover, twenty-three percent of SC use disorder cases had bipolar affective disorder and thirty percent had schizophrenia.
By using SCID II, seventy-seven percent of tramadol use disorder cases had borderline personality disorder, forty-seven percent of the cases had antisocial personality disorder in comparison to ninety percent of SC use disorder cases had borderline personality disorder and sixty-three percent of SC use disorder cases had antisocial personality disorder.
This study found that, there was no statistically significant correlation between Benton visual retention test as well as Wechsler memory scale and trail making A&B in relation to age of tramadol and SC use disorder cases. The study found that, there is no correlation between cognitive impairment and duration of addiction.
This study found that, there this positive statistical significant correlation between drug dimension of Addiction severity index and Trail making B results of tramadol use disorder cases. Also, there was negative statistically significant correlation between (psychiatric dimension of ASI and information), (alcohol dimension of ASI and verbal PA2) and (drug dimension of ASI and visual PA2) of tramadol use disorder cases (P>0.05).
It was found that, there was positive statistically significant correlation between psychiatric dimension of Addiction severity index and Digit span results of SC use disorder cases (P>0.05).
Finally, this study showed that tramadol as well as synthetic cannabinoids addiction were associated with negative effects on various cognitive functions of the patients. These impairments were more in synthetic cannabinoids use disorder cases than tramadol use disorder cases.