MARIELLA OMETTO SCARPARO
Projetos de Pesquisa
Unidades Organizacionais
LIM/21 - Laboratório de Neuroimagem em Psiquiatria, Hospital das Clínicas, Faculdade de Medicina
2 resultados
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- The role of neurocognitive functioning, substance use variables and the DSM-5 severity scale in cocaine relapse: A prospective study(2019) LIM, Danielle Ruiz; GONCALVES, Priscila Dib; OMETTO, Mariella; MALBERGIER, Andre; AMARAL, Ricardo Abrantes; SANTOS, Bernardo dos; CAVALLET, Mikael; CHAIM-AVANCINI, Tiffany; SERPA, Mauricio Henriques; FERREIRA, Luiz Roberto Kobuti; DURAN, Fabio Luis de Souza; ZANETTI, Marcus Vinicius; NICASTR, Sergio; BUSATTO, Geraldo Filho; ANDRAD, Arthur Guerra; CUNH, Paulo JannuzziBackground: The severity of substance use disorder (SUD) is currently defined by the sum of DSM-5 criteria. However, little is known about the validity of this framework or the role of additional severity indicators in relapse prediction. This study aimed to investigate the relationship between DSM-5 criteria, neurocognitive functioning, substance use variables and cocaine relapse among inpatients with cocaine use disorder (CUD). Methods: 128 adults aged between 18 and 45 years were evaluated; 68 (59 males, 9 females) had CUD and 60 (52 males, 8 females) were healthy controls. For the group with CUD, the use of other substances was not an exclusion criterion. Participants were tested using a battery of neurocognitive tests. Cocaine relapse was evaluated 3 months after discharge. Results: Scores for attention span and working memory were worse in patients compared to controls. Earlier onset and duration of cocaine use were related to poorer inhibitory control and global executive functioning, respectively; recent use was related to worse performance in inhibitory control, attention span and working memory. More DSM-5 criteria at baseline were significantly associated with relapse. Conclusions: Recent cocaine use was the most predictive variable for neurocognitive impairments, while DSM-5 criteria predicted cocaine relapse at three months post treatment. The integration of neurocognitive measures, DSM-5 criteria and cocaine use variables in CUD diagnosis could improve severity differentiation. Longitudinal studies using additional biomarkers are needed to disentangle the different roles of severity indicators in relapse prediction and to achieve more individualized and effective treatment strategies for these patients.
- Distinct effects of cocaine and cocaine plus cannabis on neurocognitive functioning and abstinence: A six-month follow-up study(2019) OLIVEIRA JUNIOR, Hercilio Pereira de; GONCALVES, Priscila di; OMETTO, Mariella; SANTOS, Bernardo dos; MALBERGIER, Andre; AMARAL, Ricardo; NICASTRI, Sergio; ANDRADE, Arthur Guerra de; CUNHA, Paulo JannuzziBackground and Aims: Cannabis use is frequent among individuals with cocaine use disorder. Despite recent non-controlled studies advocating a therapeutic role of smoked cannabis, there is a paucity of evidence-based data on potential therapeutic and cognitive side-effects of this association. Methods: We examined 63 cocaine-addicted subjects who used cannabis more than 50 times in lifetime (COC + CAN), 24 cocaine-addicted patients who use cannabis less than 50 times (COC), and 36 controls (CON). Participants were evaluated with an extensive battery of neurocognitive tests after two weeks of supervised detoxification in an inpatient treatment program. Patients were followed up in one, three, and six months after discharge. Results: Both groups of patients performed worse than CON on working memory, processing speed, inhibitory control, mental flexibility, and decision making. COC + CAN performed worse than COC on speed processing, inhibitory control and sustained attention, while COC performed worse than COC + CAN on mental flexibility. Concomitant cannabis use did not decrease relapses to cocaine use after one, three and six months. Among COC + CAN, earlier cocaine and cannabis use, and impaired executive functioning were predictive of relapse on cocaine after six months. Conclusion: Our results did not support the recommendation of smoked cannabis as a safe therapeutic approach for cocaine-addicted patients due to significant negative cognitive side-effects and absence of efficacy. Further studies investigating frontal brain morphology, neuromaturation, and prescription of the non-psychoactive constituent of cannabis sativa cannabidiol among cocaine-addicted patients who use cannabis are warranted.