GLOBAL PSYCHIATRY

Abstract

Objective:  Alcohol use disorder (AUD) is a global health concern. Patients with AUDs often relapse. Various psychosocial factors, as well as cognitive factors, determine relapse. Failure of response inhibition is often associated with relapse. This study aimed to evaluate the association of craving and relapse precipitants with executive function in AUD.
Materials and methods: The study was conducted in the outpatient setting of a tertiary care hospital in North India (between September 2017 to August 2018) on patients with AUD, who presented with a recent relapse.
A total of 46 adult patients with AUD, who relapsed after a quit attempt were enroled in the study. Cross-sectional assessment of relapse precipitants (by using relapse precipitant inventory), craving (by using the obsessive-compulsive drinking scale (OCDS)), and executive function (EF) (by using the Wisconsin Card Sorting Test (WCST)) was done along with various socio-demographic and clinical variables.
Results: The mean age of onset of alcohol use was 21.48±4.25years and the mean duration of alcohol use was 15.13±7.70 years. The average number of relapses in the study population was 3.59±2.06. There is a significant positive correlation between a negative mood state (as a relapse precipitant) and total relapse score with craving. There is a significant association of relapse and craving with deficits of EF (perseverative and non-perseverative errors). Similarly, lessened cognitive vigilance also significantly correlate with EF deficits resulting in a relapse of AUD.
Conclusion: There is a close association of craving, and relapse with deficits of EF, in AUD. Craving and relapse in AUD may be the result of deficits in EF. Future research addressing the cognitive deficits may help in the prevention of craving and relapse.