The effect of cognitive functioning on treatment attendance and adherence in comorbid bipolar disorder and cocaine dependence.

Colleen S Fagan, Thomas J Carmody, Shawn M McClintock, Alina Suris, Alyson Nakamura, Haekyung Jeon-Slaughter, Alexander Lo, E Sherwood Brown

Journal: Journal of substance abuse treatment 2015;49():15-20

PMID: 25108685

Full Text on Elsevier Science View on PubMed

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.

Address: The University of Texas at Arlington, Arlington, TX; Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX.; Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX.; 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.; Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX. Electronic address: [email protected].

DOI: 10.1016/j.jsat.2014.06.008

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MeSH Terms: Adult, Bipolar Disorder, Cocaine-Related Disorders, Cognition Disorders, Diagnosis, Dual (Psychiatry), Female, Humans, Lamotrigine, Male, Middle Aged, Patient Compliance, Randomized Controlled Trials as Topic, Sodium Channel Blockers, Triazines