Neuropsychology of Addictions in Therapeutic Communities: assessing and understanding cognitive recovery through a residential treatment of substance use disorders

Therapeutic Communities (TCs) are care units welcoming people with Alcohol and Drug Use Disorder (AUD/DUD) associated with frequent psychiatric comorbidities. These substance disorders can lead to neuropsychological impairments which are likely to hinder the benefit of addiction treatment. However, neuropsychological impairments are rarely considered during the support of TCs residents. The aims of this study are therefore (1) to estimate the risk of neuropsychological impairments of TCs resident and describe their nature and (2) to characterize the evolution of these risks during the stay in TCs.

Residents of three French TCs underwent clinical interviews and questionnaires (health, psychiatric history, DSM-V substance use criteria, consumption data) and a neuropsychological screening with BEARNI tool at their entry and at 8 months in the TCs. BEARNI scores of TCs residents will be compared to the scores of a healthy control (HC) group matched for age, gender and education. Then, residents’ BEARNI scores at entry and at the follow-up will be compared. Experimentation is still in progress.

Preliminary analysis made at entry showed that all TCs residents had AUD and used tobacco. Most of them were polyconsumers, with 80% using cannabis and 65% cocaine among the most frequent substances used. Regarding cognition, TCs residents had a lower BEARNI total score than HCs. This pattern was also found on ataxia, working memory, episodic memory and visuospatial abilities subscores, but no difference was found on flexibility subtest. Follow-up results are to come.

Results indicate a heterogeneous polyconsumption profile in TCs residents and show a significant risk of having neuropsychological impairments. These impairments are depicted as hindering the addiction care. This is a first step in better understanding specific TCs residents’ consumption profiles and promote the interest of a study on the sensitivity of BEARNI tool compared to a complete neuropsychological assessment in the TC context.