MARIELLA OMETTO SCARPARO

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LIM/21 - Laboratório de Neuroimagem em Psiquiatria, Hospital das Clínicas, Faculdade de Medicina

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Assunto: Addiction ×

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  • article 13 Citação(ões) na Scopus
    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 Jannuzzi
    Background: 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.
  • article 24 Citação(ões) na Scopus
    Distinct cognitive performance and patterns of drug use among early and late onset cocaine users
    (2017) LOPES, Bruna Mayara; GONCALVES, Priscila Dib; OMETTO, Mariella; SANTOS, Bernardo dos; CAVALLET, Mikael; CHAIM-AVANCINI, Tiffany Moukbel; SERPA, Mauricio Henriques; NICASTRI, Sergio; MALBERGIER, Andre; BUSATTO, Geraldo F.; ANDRADE, Arthur Guerra de; CUNHA, Paulo Jannuzzi
    Introduction: Adolescence is a crucial period for neurodevelopment, but few studies have investigated the impact of early cocaine use on cognitive performance and patterns of substance use. Methods: We evaluated 103 cocaine dependent inpatients divided in two groups: early-onset users (EOG; n = 52), late-onset users (LOG; n = 51), and 63 healthy controls. Neuropsychological functioning was evaluated using Digits Forward (DF) and Backward (DB), Trail Making Test (TMT), Stroop Color Word Test (SCWT), Controlled Oral Word Association Test (COWAT), Wisconsin Card Sorting Test (WCST), Rey Osterrieth Complex Figure Test (ROCFT), Frontal Assessment Battery (FAB), and Iowa Gambling Test (IGT). Use of alcohol and other drugs was assessed with the Addiction Severity Index (ASI-6). Results: Analyses of covariance controlling for age, IQ and years of education showed that EOG presented worse performance in attention span (DF, p = 0.020), working memory (DB, p = 0.001), sustained attention (WCST, p = 0.030), declarative memory (ROCFT, p = 0.031) and general executive functioning (FAB, p = 0.003) when compared with the control group. LOG presented impairments on divided attention (TMT, p = 0.003) and general executive functioning (FAB, p = 0.001) in relation to the control group. EOG presented higher use of cannabis and alcohol than LOG (p <= 0.001). Conclusion: Early-onset cocaine users display more pronounced neuropsychological alterations than controls, as well as a greater frequency of polydrug consumption than LOG. The prominent cognitive deficits in EOG probably reflect the deleterious interference of cocaine use with early stages of neurodevelopment. This may be related to more severe clinical characteristics of substance disorder in this subgroup, including polysubstance abuse.