Executive dysfunction and clinical outcome in chronic alcoholics.
BACKGROUND
The purpose of this study was to investigate which of 12 neuropsychological tests predict alcoholic patients' alcohol-specific and/or alcoholic-nonspecific outcome. Our hypothesis was that the ecologically valid neuropsychological tests that measure executive function are better predictors of alcoholics' functional outcome.


METHODS
We administered 12 neuropsychological tests to chronic alcoholics. Included in the tests were tasks of Reaction Time, Symbol Digit Modalities, Figure Position, Digit Span, Block Design, Trail Making, and six subtests of a battery called the Behavioral Assessment of the Dysexecutive Syndrome (BADS). Previous investigators have suggested that the BADS has ecological validity. Twenty-two male alcoholics were compared with 15 nonalcoholic control subjects on these neuropsychological measures 7 weeks after detoxification. Two functional outcome indices, i.e., resumption of drinking and occupation, were evaluated 18 months after discharge.


RESULTS
The total profile score and the score on three of the six subtests of the BADS were lower in alcoholics than in nonalcoholic controls. Alcoholics' performance on the BADS predicted alcohol-nonspecific outcome (occupation) but not alcohol-specific (drinking) outcome. In contrast, other neuropsychological tests did not predict either of the two outcome indices.


CONCLUSIONS
The BADS total profile score is related to alcohol-nonspecific outcome but not to alcohol-specific outcome.
Department of Psychiatry, Komagino Hospital, 273 Uratakao, Hachioji, Tokyo 193-8505, Japan. yamori@rg7.so-net.ne.jp
Yasushi
Y
Moriyama
Masaru
M
Mimura
Motoichiro
M
Kato
Aihide
A
Yoshino
Tsunekatsu
T
Hara
Haruo
H
Kashima
Akinobu
A
Kato
Akiharu
A
Watanabe
D000437:Alcoholism / Q000523:psychology* / Q000628:therapy; D000704:Analysis of Variance; D003071:Cognition; D003657:Decision Making; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D011237:Predictive Value of Tests; D011340:Problem Solving; D016896:Treatment Outcome