UKRAINS'KYI VISNYK PSYKHONEVROLOHII

The Scientific and Practical Journal of Medicine
ISSN 2079-0325(p)
DOI 10.36927/2079-0325

COGNITIVE IMPAIRMENTS AND THE EFFICACY OF PSYCHOCORRECTIONAL AND REHABILITATION INTERVENTIONS IN PATIENTS UNDERGOING OPIOID AGONIST MAINTENANCE THERAPY

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Abstract

Opioid dependence remains a significant medical and social issue, with opioid agonist maintenance therapy (OAMT) using methadone being the primary treatment approach in Ukraine. However, the potential impact of methadone on cognitive functioning continues is a matter of scientific debate. This study aimed to evaluate the cognitive outcomes of OAMT and the effectiveness of psychocorrective and rehabilitation interventions in patients with opioid dependence. A total of 150 patients were examined and divided into two groups: the main group (n = 101; OAMT + psychotherapeutic and psychocorrective interventions) and the comparison group (n = 49; OAMT only). Cognitive functioning was assessed using the MoCA scale, the SCL‑90-R questionnaire, and the WHOQOL-BREF. At baseline, mild cognitive impairment was observed in 54.67 % of participants, more frequently in the comparison group. After intervention, the proportion of patients without cognitive deficits significantly increased in the main group (59.3 % vs. 15.8 % in the comparison group), while mild impairment predominated in the control group (81.6 %). After the intervention, MoCA scores in the main group were 26.0 [25.0; 27.0] points, and in the comparison group — 24.0 [23.0; 25.0] points, i.e. there was a decrease in the variability of the results in both groups, with a greater concentration of high scores in patients receiving multicomponent treatment. The between-group difference remained statistically significant (p< 0.05). The calculated Cohen’s d (~0.5) indicates a moderate effect size of the psychocorrective intervention. These findings demonstrate the positive impact of a multicomponent treatment approach that combines OAMT with psychotherapeutic programs, contributing to improved cognitive functioning and enhancing the effectiveness of patient resocialization.

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References

  1. Volkow ND, Blanco C. The  changing opioid crisis: development, challenges and opportunities. Mol Psychiatry. 2021;26(1):218-233. doi:https://doi.org/1038/s41380-020-0661-4
  2. Ardakani, S.K., Mahmoudi, S., Rahmani, K., et al. Memory function in patients with opioid dependence treated with buprenorphine and methadone in comparison with healthy persons. Sci Rep 15, 17780 (2025). doi:https://doi.org/10.1038/s41598-025-02832-z
  3. Wang GY, Wouldes TA, Russell BR. Methadone maintenance treatment and cognitive function: a systematic review. Curr Drug Abuse Rev. 2013;6(3):220-230. doi:https://doi.org/2174/18744737112059990020
  4. Zhao W., Duan F., Li X., et al. Cognitive control in individuals with heroin use disorder after prolonged methadone maintenance treatment. BMC Psychiatry. 25. 78 (2025). https://doi.org/10.1186/s12888-025-06523-x
  5. Khezrian K., Zanjani Z., Rasouli Azad M. Effects of Dialectical Behavior Therapy on Cognitive and Executive Functions in Men With Substance Use Disorder Under Methadone Maintenance Treatment: A Randomized Clinical Trial.  J Addict Nurs. 2024;35(4):189-195. doi:https://doi.org/1097/JAN.0000000000000596
  6. Marsden J, Stillwell G, James K, et al. Efficacy and costeffectiveness of an  adjunctive personalised psychosocial intervention in treatment-resistant maintenance opioid agonist therapy: a pragmatic, open-label, randomised controlled trial. Lancet. Psychiatry. 2019;6(5):391-402. doi:https://doi.org/1016/S2215-0366(19)30097-5
  7. The Universal Declaration on  Bioethics and Human Rights. Int Soc Sci J. 2005;57(186):745–753. https://onlinelibrary.wiley.com/doi/10.1111/j.1468-2451.2005.00592.x
  8. World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191-2194. doi:https://doi.org/1001/jama.2013.281053
  9. Dembitsky, S. Leonard Derogatis' Symptom Checklist (SCL 90 R): validation in Ukraine / S. Dembitsky, Yu. Sereda // Sociology: theory, methods, marketing. 2015. № 4. С. 40—71. Dembitskiy S., Sereda Yu. [Leonard DeRogatis Symptom Checklist (SCL-90-R): Validation in Ukraine]. Sotsiologiya: teoriya, metody, marketing [Sociology: Theory, Methods, Marketing]. 2015;4:40-71. URI: https://nasplib.isofts.kiev.ua/handle/123456789/142132 (In Russian).
  10. Nasreddine ZS, Phillips NA., Bédirian V, et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53(4):695- 699. doi:https://doi.org/1111/j.1532-5415.2005.53221.x
  11. Development of the World Health Organization WHOQOL BREF quality of life assessment. The WHOQOL Group. Psychol Med. 1998;28(3):551-558. doi:https://doi.org/1017/s0033291798006667
  12. Torres D., Normando D. Biostatistics: essential concepts for the clinician. Dental Press J Orthod. 2021;26(1):e21spe1. Published 2021 Mar 10. doi:https://doi.org/10.1590/2177-6709.26.1.E21SPE1
  13. Chamakalayil S, Stohler R, Moldovanyi A, Gerber M, Brand S, Dürsteler KM. Neurocognitive performance of patients undergoing intravenous versus oral opioid agonist treatment: a prospective multicenter study on three-month treatment effects. Front psychiatry. 2024;15:1375895. Published 2024 Jul 23. doi:https://doi.org/3389/fpsyt.2024.1375895
  14. Shahzadi M., Mahmood K. Cognitive behaviour therapy as an evidence-based intervention for opioid use disorder: A  systematic review. J Pak Med Assoc. 2024;74(5):946-952. doi:https://doi.org/47391/JPMA.9940
  15. Elkana O, Adelson M, Doniger GM, Sason A, Peles E. Cognitive function is largely intact in methadone maintenance treatment patients. The world journal of biological psychiatry. 2017;20(3):219-229. doi:https://doi.org/10.1080/15622975.2017.1342047