title: Neurocognitive Functioning and Treatment Outcome Following Detoxification Among Asian Alcohol-Dependent Inpatients.
abstract: BACKGROUND
  The prevalence of alcohol use disorders in Asia is increasing and relapse among treated populations remains the norm, not the exception. The extent to which cognitive impairment influences clinical outcome remains unclear, with research dominated by studies of Caucasian populations.
  
  
  OBJECTIVE
  This study examines behavioral and self-reported cognitive functioning in detoxified alcohol-dependent (AD) patients in Singapore and its association with outcome.
  
  
  METHODS
  The cognitive performance of 30 recently-detoxified AD inpatients and 30 demographically-matched controls was compared using visuospatial memory, working memory, set-shifting, planning and reflection impulsivity tests of the CANTAB®, and self-reported dysexecutive symptoms and everyday cognitive difficulties. Patients' alcohol use and self-reported cognitive functioning were reassessed 3-months post-discharge.
  
  
  RESULTS
  Compared to matched controls, AD inpatients exhibited significantly poorer fluid intelligence, visuospatial memory, working memory, set-shifting flexibility and planning/organization, but not reflection impulsivity. In support of Western studies, a significant proportion (three-quarters) were "clinically impaired" on subtests. Significant reductions were observed in alcohol units, frequency and dependency scores at follow-up, though improvements in self-reported cognitive functioning were limited to abstainers. Baseline cognitive performance did not differentiate those who had abstained from alcohol and relapsed at follow-up.
  
  
  CONCLUSIONS
  Memory and executive functioning impairments were evident among Asian AD patients alongside self-reported cognitive difficulties, thus cognitively demanding psychological interventions may have limited impact during early detoxification. Future studies can build on these findings, with larger samples and measurement of moderating and mediating factors to extend our understanding of how cognitive impairment influences outcome.
authors.affiliation: a Institute of Mental Health, National Addictions Management Service , Singapore , Singapore.|b Turning Point, Eastern Health , Melbourne , Australia.|c Eastern Health Clinical School , Monash University , Melbourne , Australia.
authors.forename: Victoria
authors.initials: V
authors.lastname: Manning
authors.affiliation: a Institute of Mental Health, National Addictions Management Service , Singapore , Singapore.
authors.forename: Hui Chin
authors.initials: HC
authors.lastname: Teo
authors.affiliation: a Institute of Mental Health, National Addictions Management Service , Singapore , Singapore.
authors.forename: Song
authors.initials: S
authors.lastname: Guo
authors.affiliation: a Institute of Mental Health, National Addictions Management Service , Singapore , Singapore.
authors.forename: Kim Eng
authors.initials: KE
authors.lastname: Wong
authors.affiliation: d Department of Psychiatry , Duke University , Durham , North Carolina , USA.
authors.forename: Ting-Kai
authors.initials: TK
authors.lastname: Li
mesh_terms: D000328:Adult; D000435:Alcoholic Intoxication / Q000523:psychology* / Q000534:rehabilitation; D000437:Alcoholism / Q000523:psychology* / Q000534:rehabilitation; D044466:Asian People / Q000523:psychology*; D016022:Case-Control Studies; D003071:Cognition; D056344:Executive Function; D005260:Female; D006801:Humans; D007175:Impulsive Behavior; D008658:Inactivation, Metabolic; D007297:Inpatients; D008297:Male; D008570:Memory, Short-Term; D008875:Middle Aged; D009483:Neuropsychological Tests; D011446:Prospective Studies; D012846:Singapore; D016896:Treatment Outcome; D055815:Young Adult
keywords: Alcohol dependence; Asia; executive function; neuropsychological tests; treatment outcome