title: Impairment of cognitive abilities and decision making after chronic use of alcohol: the impact of multiple detoxifications.
abstract: OBJECTIVE
  In the present study, the effect of previous detoxifications on prefrontal function and decision making was examined in alcohol-dependent patients. Further, we examined whether the length of abstinence affects cognitive function.
  
  
  METHODS
  Forty-eight alcohol-dependent patients were recruited from an inpatient detoxification treatment facility and cognitive function was compared to a control group of 36 healthy controls. The patient population was then divided into a group of patients with less than two previous detoxifications (LO-detox group, n = 27) and a group of patients with two or more previous detoxifications (HI-detox group, n = 21) and cognitive function was compared. In addition, cognitive function of recently (i.e. less than 16 days; median split) and longer abstinent patients was compared. We assessed prefrontal function, memory function and intelligence.
  
  
  RESULTS
  Alcoholics, when compared to healthy controls, performed worse with regard to the performance index Attention/Executive function. Cognitive impairment in these tasks was pronounced in recently abstinent patients. We found no significant differences between HI-detox and LO-detox patients with regard to the Attention/Executive function. However, in the IOWA gambling Task, the HI-detox group seemed to be less able to learn to choose cards from the more advantageous decks over time.
  
  
  CONCLUSIONS
  Our results provide additional evidence for cognitive impairment of alcohol-dependent patients with regard to tasks sensitive to frontal lobe function and underline the importance of abstinence for these impairments to recover. We found only little evidence for the impairing effects of repeated withdrawal on prefrontal function and we suggest that executive function is affected earlier in dependence.
authors.affiliation: Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, 68159 Mannheim, Germany. sabine.loeber@zi-mannheim.de
authors.forename: Sabine
authors.initials: S
authors.lastname: Loeber
authors.forename: Theodora
authors.initials: T
authors.lastname: Duka
authors.forename: Helga
authors.initials: H
authors.lastname: Welzel
authors.forename: Helmut
authors.initials: H
authors.lastname: Nakovics
authors.forename: Andreas
authors.initials: A
authors.lastname: Heinz
authors.forename: Herta
authors.initials: H
authors.lastname: Flor
authors.forename: Karl
authors.initials: K
authors.lastname: Mann
mesh_terms: D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000523:psychology* / Q000628:therapy*; D003071:Cognition / Q000502:physiology*; D003657:Decision Making / Q000187:drug effects; D005260:Female; D005715:Gambling / Q000523:psychology; D006801:Humans; D008297:Male; D008568:Memory / Q000187:drug effects; D008875:Middle Aged; D009483:Neuropsychological Tests; D011597:Psychomotor Performance / Q000502:physiology; D014706:Verbal Learning; D014825:Vocabulary; D014888:Wechsler Scales; D055815:Young Adult