INS NYC 2024 Program

Poster	Poster Session 05 Program Schedule 02/15/2024 02:30 pm - 03:45 pm Room: Shubert Complex (Posters 1-60) Poster Session 05: Neuropsychiatry \| Addiction/Dependence \| Stress/Coping \| Emotional/Social Processes Final Abstract #25 Neuropsychological Performance of Past Substance Abusers in Depressed Samples at Risk for Suicidal Behavior Katherine Desrosiers, New York State Psychiatric Institute, New York, United States John Keilp, New York State Psychiatric Institute, New York, United States Marianne Gorlyn, New York State Psychiatric Institute, New York, United States Ainsley Burke, New York State Psychiatric Institute, New York, United States John Mann, New York State Psychiatric Institute, New York, United States Category: Mood and Anxiety Disorders Keyword 1: neurocognition Keyword 2: substance abuse Keyword 3: depression Objective: Neuropsychological deficits are a risk factor for suicidal behavior, but it is unclear if these deficits are simply a reflection of other attempter characteristics, such as a history of past substance abuse. Even after abstaining, past substance abusers may experience long-term neurocognitive impairment. This study examined the effects of past substance abuse in a sample of depressed patients to determine if deficits related to past substance abuse were similar to or different than those that have been associated with suicidal behavior. Participants and Methods: The depressed patient sample consisted of 365 unmedicated patients in a current depressive episode (74.2% unipolar, 25.8% bipolar). Current substance abusers were excluded from the sample, but those who had remitted for at least 6 months were included. Participants were evaluated clinically and completed a battery of neuropsychological measures assessing reaction time, processing speed, sustained attention, attention control/interference processing, memory, abstraction, working memory, language fluency, and impulse control. The sample was divided into those with no prior substance abuse history (N=244), those who had abused a single drug (N=73), or those who had abused two or more drugs (N=48). Groups were compared on demographic, clinical, and neuropsychological measures. Results: Past substance abusers who had abused a single substance primarily abused alcohol (75.3%, N=55) or marijuana (20.5%, N=15). Polydrug abusers primarily abused alcohol (89.6%, N=43) in combination with, most commonly, marijuana (65.1%, N=28) and/or cocaine (37.2%, N=16). Groups were comparable in age, education, estimated intellectual ability level, race, and ethnicity. Polydrug abusers exhibited the highest level of depression severity (Hamilton Depression Rating Scale, p=.013; Beck Depression Inventory, p=.019), while both past substance abusing groups were more likely than non-abusers to have made a past suicide attempt (p=.002). Both past substance abuse groups also exhibited higher scores on measures of impulsiveness (p=.016), hostility (p=.001), and aggression (p<.001), with past polydrug abusers exhibiting the highest levels of past aggressive behavior. On neuropsychological measures, however, groups were statistically comparable on all but one test, the Wisconsin Card Sorting Test (WCST, p=.045), where past polydrug abusers exhibited the poorest error scores (both perseverative and non-perseverative). These differences were maintained when controlling for depression severity. On the other hand, on neurocognitive measures that have been associated with past suicidal behavior in previous studies, including measures of attention control/interference processing (Stroop interference, p=.329), memory (Buschke Selective Reminding, p=.701), working memory (A Not B Reasoning Test, p=.441), or language fluency (Category Fluency, p=.619), past substance abusing groups did not differ from non-abusers. Conclusions: Depressed past substance abusers in this sample were more likely to have a history of suicide attempt, but neurocognitive differences related to past substance abuse were minimal. Neuropsychological deficits that have previously distinguished suicide attempters were not associated with past substance abuse history, suggesting that deficits associated with suicidal behavior are not primarily driven by the consequences of past substance abuse. However, deficits in executive functioning were characteristic of those who had previously abused multiple drugs, suggesting some potential consequences for this prior behavior.

Poster

02/15/2024
02:30 pm - 03:45 pm
Room: Shubert Complex (Posters 1-60)

Poster Session 05: Neuropsychiatry | Addiction/Dependence | Stress/Coping | Emotional/Social Processes

Final Abstract #25

Neuropsychological Performance of Past Substance Abusers in Depressed Samples at Risk for Suicidal Behavior

Katherine Desrosiers, New York State Psychiatric Institute, New York, United States
John Keilp, New York State Psychiatric Institute, New York, United States
Marianne Gorlyn, New York State Psychiatric Institute, New York, United States
Ainsley Burke, New York State Psychiatric Institute, New York, United States
John Mann, New York State Psychiatric Institute, New York, United States

Category: Mood and Anxiety Disorders

Keyword 1: neurocognition
Keyword 2: substance abuse
Keyword 3: depression

Objective:

Neuropsychological deficits are a risk factor for suicidal behavior, but it is unclear if these deficits are simply a reflection of other attempter characteristics, such as a history of past substance abuse. Even after abstaining, past substance abusers may experience long-term neurocognitive impairment. This study examined the effects of past substance abuse in a sample of depressed patients to determine if deficits related to past substance abuse were similar to or different than those that have been associated with suicidal behavior.

Participants and Methods:

The depressed patient sample consisted of 365 unmedicated patients in a current depressive episode (74.2% unipolar, 25.8% bipolar). Current substance abusers were excluded from the sample, but those who had remitted for at least 6 months were included. Participants were evaluated clinically and completed a battery of neuropsychological measures assessing reaction time, processing speed, sustained attention, attention control/interference processing, memory, abstraction, working memory, language fluency, and impulse control. The sample was divided into those with no prior substance abuse history (N=244), those who had abused a single drug (N=73), or those who had abused two or more drugs (N=48). Groups were compared on demographic, clinical, and neuropsychological measures.

Results:

Past substance abusers who had abused a single substance primarily abused alcohol (75.3%, N=55) or marijuana (20.5%, N=15). Polydrug abusers primarily abused alcohol (89.6%, N=43) in combination with, most commonly, marijuana (65.1%, N=28) and/or cocaine (37.2%, N=16). Groups were comparable in age, education, estimated intellectual ability level, race, and ethnicity. Polydrug abusers exhibited the highest level of depression severity (Hamilton Depression Rating Scale, p=.013; Beck Depression Inventory, p=.019), while both past substance abusing groups were more likely than non-abusers to have made a past suicide attempt (p=.002). Both past substance abuse groups also exhibited higher scores on measures of impulsiveness (p=.016), hostility (p=.001), and aggression (p<.001), with past polydrug abusers exhibiting the highest levels of past aggressive behavior. On neuropsychological measures, however, groups were statistically comparable on all but one test, the Wisconsin Card Sorting Test (WCST, p=.045), where past polydrug abusers exhibited the poorest error scores (both perseverative and non-perseverative). These differences were maintained when controlling for depression severity. On the other hand, on neurocognitive measures that have been associated with past suicidal behavior in previous studies, including measures of attention control/interference processing (Stroop interference, p=.329), memory (Buschke Selective Reminding, p=.701), working memory (A Not B Reasoning Test, p=.441), or language fluency (Category Fluency, p=.619), past substance abusing groups did not differ from non-abusers.

Conclusions:

Depressed past substance abusers in this sample were more likely to have a history of suicide attempt, but neurocognitive differences related to past substance abuse were minimal. Neuropsychological deficits that have previously distinguished suicide attempters were not associated with past substance abuse history, suggesting that deficits associated with suicidal behavior are not primarily driven by the consequences of past substance abuse. However, deficits in executive functioning were characteristic of those who had previously abused multiple drugs, suggesting some potential consequences for this prior behavior.