title: The effect of cognitive functioning on treatment attendance and adherence in comorbid bipolar disorder and cocaine dependence.
abstract: Although bipolar disorder and substance dependence are both associated with treatment non-adherence and cognitive impairment, no studies have investigated relationships between treatment adherence and cognitive functioning in this population. As part of a clinical trial, baseline performance on two neuropsychological tests in 120 outpatients with bipolar disorder and cocaine dependence was used to examine whether cognitive functioning was associated with appointment attendance, medication adherence, and return of medication bottles. This study found that higher baseline cognitive functioning measured by the Stroop Color-Word condition predicted better treatment adherence. However, this study also reports measurement sensitivity of cognition as it relates to treatment adherence when applied to this dual diagnosis population. Poorer performance in simple visual attention tasks as assessed by the Stroop Word condition was inversely associated with some measures of adherence. Future studies are warranted that include a comprehensive neuropsychological battery and advanced medication adherence measures to confirm these findings.
authors.affiliation: The University of Texas at Arlington, Arlington, TX; Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX.
authors.forename: Colleen S
authors.initials: CS
authors.lastname: Fagan
authors.affiliation: Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Carmody
authors.affiliation: Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX; Neurocognitive Research Laboratory, Division of Brain Stimulation and Neurophysiology, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC.
authors.forename: Shawn M
authors.initials: SM
authors.lastname: McClintock
authors.affiliation: Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX.
authors.forename: Alina
authors.initials: A
authors.lastname: Suris
authors.affiliation: Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX.
authors.forename: Alyson
authors.initials: A
authors.lastname: Nakamura
authors.affiliation: Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX.
authors.forename: Haekyung
authors.initials: H
authors.lastname: Jeon-Slaughter
authors.affiliation: Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX.
authors.forename: Alexander
authors.initials: A
authors.lastname: Lo
authors.affiliation: Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX. Electronic address: Sherwood.Brown@utsouthwestern.edu.
authors.forename: E Sherwood
authors.initials: ES
authors.lastname: Brown
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000503:physiopathology; D019970:Cocaine-Related Disorders / Q000188:drug therapy* / Q000503:physiopathology; D003072:Cognition Disorders / Q000503:physiopathology*; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006801:Humans; D000077213:Lamotrigine; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology*; D016032:Randomized Controlled Trials as Topic; D026941:Sodium Channel Blockers / Q000627:therapeutic use; D014227:Triazines / Q000627:therapeutic use
chemical_list: D026941:Sodium Channel Blockers; D014227:Triazines; D000077213:Lamotrigine
keywords: Bipolar disorder; Cocaine dependence; Cognition; Medication adherence; Substance use disorder; Treatment adherence; Treatment retention