Zamani Dehyaghobi, Elham

Simorgh Research Repository

    وزارت ﺑﻬﺪاﺷﺖ، درﻣﺎن و آﻣﻮزش ﭘﺰﺷﻜﻲ  ﻛﺮﻣﺎن و ﺧﺪﻣﺎت ﺑﻬﺪاﺷﺘﻲ درﻣﺎﻧﻲ اﺳﺘﺎن داﻧﺸﮕﺎه ﻋﻠﻮم ﭘﺰﺷﻜﻲ داﻧﺸﻜﺪه ﭘﺰﺷﻜﻲ ﻣﻬﻨﺪس اﻓﻀﻠﻲ ﭘﻮر    : ﻧﺎﻣﻪ ﭘﺎﻳﺎن ﺟﻬﺖ درﻳﺎﻓﺖ درﺟﻪ دﻛﺘﺮاي ﺗﺨﺼﺼﻲ رواﻧﭙﺰﺷﻜﻲ  ﻋﻨﻮان:  ﺑﺮرﺳﻲ ﻋﻤﻠﻜﺮد ﺷﻨﺎﺧﺘﻲ در ﻣﺼﺮف ﻛﻨﻨﺪﮔﺎن اﭘﻴﻮﺋﻴﺪﻫﺎ در ﻣﻘﺎﻳﺴﻪ ﺑﺎ ﻣﺼﺮف ﻛﻨﻨﺪﮔﺎن  اﭘﻴﻮﺋﻴﺪﻫﺎ ﺗﻮام ﺑﺎ ﻣﺘﺎﻣﻔﺘﺎﻣﻴﻦ و ﮔﺮوه ﻛﻨﺘﺮل   اﺳﺘﺎد راﻫﻨﻤﺎ:  دﻛﺘﺮ ﻣﻬﻴﻦ اﺳﻼﻣﻲ ﺷﻬﺮﺑﺎﺑﻜﻲ  اﺳﺘﺎد ﻣﺸﺎور:  دﻛﺘﺮ ﻧﻮﺷﻴﻦ ﭘﺮورش  ﭘﮋوﻫﺶ و ﻧﮕﺎرش:  دﻛﺘﺮاﻟﻬﺎم زﻣﺎﻧﻲ ده ﻳﻌﻘﻮﺑﻲ   8931ﺗﻴﺮﻣﺎه     ﻣﺼﺮف ﻣﺰﻣﻦ ﻣﻮاد ﺑﺎ ﻃﻴﻔﻲ از اﺧﺘﻼﻻت ﺷﻨﺎﺧﺘﻲ ﻫﻤﺮاه اﺳﺖ و اﺧﺘﻼل ﺷﻨﺎﺧﺘﻲ در ﻣﺼﺮف  :ﻣﻘﺪﻣﻪدر اﻳﻦ راﺳﺘﺎ . ﻣﺎﻧﺪن در درﻣﺎن اﺳﺖﻛﻨﻨﺪﮔﺎن ﻣﻮاد ﺑﻪ ﻋﻨﻮان ﻧﺸﺎﻧﮕﺮي ﺑﺮاي ﭘﻴﺶ ﺑﻴﻨﻲ ﻋﻮد و ﭘﺎﻳﺒﻨﺪي ﺿﻌﻴﻔﺘﺮ ﺑﻪ ﭘﮋوﻫﺶ ﺣﺎﺿﺮ ﺑﺎ ﻫﺪف ﻣﻘﺎﻳﺴﻪ ﻋﻤﻠﻜﺮد ﺷﻨﺎﺧﺘﻲ در ﺳﻪ ﮔﺮوه ﻣﺼﺮف ﻛﻨﻨﺪﮔﺎن اﭘﻴﻮﺋﻴﺪﻫﺎ ﺑﻪ ﺗﻨﻬﺎﻳﻲ در ﻣﻘﺎﻳﺴﻪ ﺑﺎ   . ﻣﺼﺮف ﻛﻨﻨﺪﮔﺎن اﭘﻴﻮﺋﻴﺪﻫﺎ ﺗﻮام ﺑﺎ ﻣﺘﺎﻣﻔﺘﺎﻣﻴﻦ و اﻓﺮاد ﺳﺎﻟﻢ ﻏﻴﺮ ﻣﺼﺮف ﻛﻨﻨﺪه ﻣﻮاد ﺻﻮرت ﮔﺮﻓﺖﻧﻔﺮ ﻣﺼﺮف ﻛﻨﻨﺪه اﭘﻴﻮﺋﻴﺪ ﺗﻮام  03ﻣﺼﺮف ﻛﻨﻨﺪﮔﺎن اﭘﻴﻮﺋﻴﺪﻫﺎ، ﻧﻔﺮ از  03دراﻳﻦ ﻣﻄﺎﻟﻌﻪ ﻣﻘﻄﻌﻲ،  :روش ﻛﺎر( ﺑﻴﻤﺎرﺳﺘﺎن TMMﺑﺎ ﻣﺘﺎﻣﻔﺘﺎﻣﻴﻦ از ﺑﻴﻦ ﺑﻴﻤﺎران ﻣﺮاﺟﻌﻪ ﻛﻨﻨﺪه ﺑﻪ ﻛﻠﻴﻨﻴﻚ ﺳﺮﭘﺎﻳﻲ درﻣﺎن ﻧﮕﻬﺪارﻧﺪه ﻣﺘﺎدون)ﻧﻔﺮﮔﺮوه ﻛﻨﺘﺮل)ﺳﺎﻟﻢ( از ﭘﺮﺳﻨﻞ آن ﺑﻴﻤﺎرﺳﺘﺎن، از ﻧﻈﺮ ﻋﻤﻠﻜﺮد  03رواﻧﭙﺰﺷﻜﻲ داﻧﺸﮕﺎه ﻋﻠﻮم ﭘﺰﺷﻜﻲ ﻛﺮﻣﺎن و ﺳﻪ ﮔﺮوه از ﻧﻈﺮ ﺳﻦ، ﺟﻨﺲ و ﺗﺤﺼﻴﻼت ﻣﻄﺎﺑﻘﺖ داده ﺷﺪﻧﺪ. ﺟﻬﺖ ﺑﺮرﺳﻲ . ﻣﻮرد ﺑﺮرﺳﻲ ﻗﺮار ﮔﺮﻓﺘﻨﺪﺷﻨﺎﺧﺘﻲ اﺳﺘﻔﺎده ﺷﺪ ﻛﻪ ﭘﺎﻳﺎﻳﻲ و ( SCAB) اﺧﺘﻼل ﺷﻨﺎﺧﺘﻲ از ﻧﺴﺨﻪ ﻓﺎرﺳﻲ اﺑﺰار ارزﻳﺎﺑﻲ ﻛﻮﺗﺎه ﺷﻨﺎﺧﺖ در اﺳﻜﻴﺰوﻓﺮﻧﻴﺎ  . رواﻳﻲ آن ﺑﻪ زﺑﺎن ﻓﺎرﺳﻲ ﺑﺮرﺳﻲ ﺷﺪه اﺳﺖن داد ﻛﻪ ﮔﺮوه ﻣﺼﺮف ﻛﻨﻨﺪه اﭘﻴﻮﺋﻴﺪﻫﺎ و ﻣﺼﺮف ﻛﻨﻨﺪﮔﺎن اﭘﻴﻮﺋﻴﺪ ﻳﺎﻓﺘﻪ ﻫﺎي اﻳﻦ ﺗﺤﻘﻴﻖ ﻧﺸﺎ :ﻳﺎﻓﺘﻪ ﻫﺎﺷﺎﻣﻞ ﺣﺎﻓﻈﻪ ﻛﻼﻣﻲ، ﺗﻮاﻟﻲ ارﻗﺎم، رواﻧﻲ ( SCABﺗﻮام ﺑﺎ ﻣﺘﺎﻣﻔﺘﺎﻣﻴﻦ در ﻫﻔﺖ زﻳﺮ ﻣﺠﻤﻮﻋﻪ ﺗﺴﺖ ﻣﺠﺰاي آزﻣﻮن )ﻛﻼم، ﺗﻜﻠﻴﻒ ﺣﺮﻛﺘﻲ ژﺗﻮﻧﻲ، دﺳﺘﻮراﻟﻌﻤﻞ ﺑﺮج ﻟﻨﺪن، ﺗﻜﻠﻴﻒ ﻛﺪﮔﺬاري ﺳﻤﺒﻞ ﻫﺎ، ﺑﻄﻮر ﻣﻌﻨﻲ داري داراي ﻋﻤﻠﻜﺮد ﻋﻼوه ﺑﺮ اﻳﻦ در دوﮔﺮوه ﺑﻴﻤﺎر ﻳﻌﻨﻲ ﻣﺼﺮف ﻛﻨﻨﺪه اﭘﻴﻮﺋﻴﺪﻫﺎ ﺑﻪ ﺗﻨﻬﺎﻳﻲ و ﻣﺼﺮف . ﺘﺮي از ﮔﺮوه ﻛﻨﺘﺮل ﺑﻮدﻧﺪﺿﻌﻴﻔدر ﺑﺎ ﻫﻢ  ﺗﻔﺎوت ﻣﻌﻨﻲ داري داﺷﺘﻨﺪ ﺑﻠﻜﻪ  SCABﻛﻨﻨﺪﮔﺎن اﭘﻴﻮﺋﻴﺪ ﺗﻮام ﺑﺎ ﻣﺘﺎﻣﻔﺘﺎﻣﻴﻦ ﻧﻪ ﺗﻨﻬﺎ در ﻧﻤﺮه ﻛﻠﻲ  – nekoT( و rebmun  laireS( ، ﺗﻮاﻟﻲ اﻋﺪاد )yromem  labreVزﻳﺮﻣﺠﻤﻮﻋﻪ ﻫﺎي ﺣﺎﻓﻈﻪ ﻛﻼﻣﻲ )ﺑﻌﺒﺎرﺗﻲ در ﮔﺮوه ﻣﺼﺮف ﻛﻨﻨﺪه ﺗﻮام ﻣﻮاد ﻋﻤﻠﻜﺮد ﺷﻨﺎﺧﺘﻲ ﺑﻴﺸﺘﺮ ﺗﺨﺮﻳﺐ ﻧﻴﺰ اﻳﻦ ﺗﻔﺎوت ﻣﻌﻨﻲ داراﺳﺖ.  rotomﻳﺎﻓﺘﻪ ﺑﻮد. ﻧﺘﺎﻳﺞ ﻧﺸﺎن داد اﺧﺘﻼل ﻋﻤﻠﻜﺮد ﺷﻨﺎﺧﺘﻲ ﺑﺎ ﻣﻘﺪار و ﻣﺪت زﻣﺎن ﻣﺼﺮف و ﺳﻦ ﺷﺮوع ﻣﺼﺮف ﻣﻮاد   . ارﺗﺒﺎﻃﻲ ﻧﺪاردﻋﺎت ﺑﺪﺳﺖ آﻣﺪه در ﻣﻄﺎﻟﻌﻪ ﺣﺎﺿﺮ ﻣﺼﺮف ﻣﻮاد اﭘﻴﻮﺋﻴﺪي و ﻣﺘﺎﻣﻔﺘﺎﻣﻴﻦ ﺑﺮ ﺑﺎ ﺗﻮﺟﻪ ﺑﻪ اﻃﻼ :ﻧﺘﻴﺠﻪ ﮔﻴﺮيﻋﻤﻠﻜﺮد ﺷﻨﺎﺧﺘﻲ ﻣﺼﺮف ﻛﻨﻨﺪﮔﺎن ﺗﺎﺛﻴﺮ ﻣﻲ ﮔﺬارﻧﺪ و ﺗﺨﺮﻳﺐ ﺗﻮاﻧﺎﻳﻲ ﻫﺎي ﺷﻨﺎﺧﺘﻲ در ﻣﻮارد ﻣﺼﺮف ﺗﻮام ﻣﻮاد ﺑﻴﻦ دو ﮔﺮوه  ﺑﻴﻤﺎر ﺗﻔﺎوت ﻣﻌﻨﻲ داري دارد ﺑﻠﻜﻪ در  SCABﺑﻴﺸﺘﺮ اﺳﺖ. در اﻳﻦ ﻣﻄﺎﻟﻌﻪ ﻧﻪ ﺗﻨﻬﺎ ﻧﻤﺮه ﻛﻠﻲ  – nekoT( و rebmun  laireS(، ﺗﻮاﻟﻲ اﻋﺪاد )yromem  labreVﺮﻣﺠﻤﻮﻋﻪ ﻫﺎي ﺣﺎﻓﻈﻪ ﻛﻼﻣﻲ )زﻳاﻳﻦ ﺗﺎﺛﻴﺮ ﺑﺎ ﻣﻘﺪار و ﻣﺪت زﻣﺎن ﻣﺼﺮف و ﺳﻦ ﺷﺮوع ﻣﺼﺮف ﻣﻮاد ارﺗﺒﺎﻃﻲ ﻧﻴﺰ اﻳﻦ ﺗﻔﺎوت ﻣﻌﻨﻲ داراﺳﺖ.  rotom  . ﻧﺪارد SCAB.ﻛﻠﻴﺪ واژه ﻫﺎ: ﻋﻤﻠﻜﺮد ﺷﻨﺎﺧﺘﻲ، اﭘﻴﻮﺋﻴﺪ، ﻣﺘﺎﻣﻔﺘﺎﻣﻴﻦ                 ABSTRACT: Introduction: Chronic substance use has been associated with a wide range of neuropsychological deficits. Cognitive impairments are predictors of relapse and poor outcome in most substance users. In this study we compared the cognitive functions among three groups of opioids users and opioids comorbid with methamphetamine users with healthy people in control group.  Method: In this cross-sectional study, 30 opioids users, 30 opioids comorbid with methamphetamine users were selected via convenient sampling from patients admitted to academic clinic of MMT (Methadone Maintenance Treatment) of Kerman mental hospital and 30 healthy individuals were selected from personnel of the hospital. All of them were matched on age, sex and education. BACS test was used to assess the cognitive function of subjects.  Result: The study showed that opioids user and opioids comorbid with methamphetamine users in seven subscales BACS test comprises Verbal  memory, Verbal fluency, Serial number, Token motor test, Tower of London test, Symbol  coding testhave more impairment in cognitive tasks than control group. The results of ANOVA test showed that there was a significant difference between the two patient groups in domain of Token Motor, opioids comorbid with methamphetamine had lower scores than opioids users.  Conclusion: These results showed that opioids use and comorbid opioids methamphetamine use disorder are similarly associated with broad cognitive impairments that was not associated with amount, duration and age onset of use and comorbid opioids methamphetamine had lower scores in domain of Token Motor. Therefore with increases number of substance, cognitive impairments are more in individuals of user. Key Words: Cognitive Functions, opioids, methamphetamine, BACS  litKerman University Medical SciencesFaculty of MedicineAfzalipour School of MedicineA Dissertation Submitted as a Partial Fulfillment of theRequirements for the Degree of Doctor of Philosophy in PsychiatryTitle:cognitive functions in opioids users compared to opioids withmethamphetamin users and normal subjectsbyDr Elham Zamani Deh yaghoubiSupervisor:Dr Mahin Eslami ShahrbabakiAdvisor:Dr Nooshin ParvereshJuly 2019

cognitive functions in opioids users compared to opioids with methamphetamin users and normal subjects

http://eprints.kmu.ac.ir/31650/1/7307.pdf

cognitive functions in opioids users compared to opioids with methamphetamin users and normal subjects

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