Assessing Clinically Significant Cognitive Impairment Using the NIH Toolbox in Individuals with Co-occurring Serious Mental Illness and Alcohol Use Disorder. Jett, J. D., Kordas, G., Parent, S., Keshtkar, M., Shin, R., King, P., McPherson, S. M., Ries, R., Roll, J. M., McDonell, M. G., & Chaytor, N. Journal of Addiction Medicine, 17(3):305, June, 2023.
Assessing Clinically Significant Cognitive Impairment Using the NIH Toolbox in Individuals with Co-occurring Serious Mental Illness and Alcohol Use Disorder [link]Paper  doi  abstract   bibtex   
Objective  Serious mental illnesses (SMI) and alcohol use disorder (AUD) co-occurrence (SMI-AUD) is common, yet little is known about the prevalence and risk factors of cognitive impairment for this population. We used the National Institutes of Health (NIH) Toolbox to identify clinically significant cognitive impairment (CSCI), describe the cognitive profile, and investigate whether psychiatric and AUD severity measures are associated with CSCI in individuals with SMI-AUD. Methods  CSCI was defined as 2 or more fully corrected fluid subtest T scores below a set threshold based on an individual’s crystalized composite score. Psychiatric severity measures included the Structured Clinical Interview for DSM-V (SCID-5) for SMI diagnosis and the Positive and Negative Syndrome Scale. AUD severity measures included the SCID-5 for AUD symptom severity score, years of alcohol use, and urine ethyl glucuronide levels. A multivariable logistic regression was used to investigate the adjusted effects of each variable on the probability of CSCI. Results  Forty-one percent (N = 55/135) of our sample had CSCI compared with the base rate of 15% from the NIH Toolbox normative sample. Subtests measuring executive function most frequently contributed to meeting criteria for CSCI (Flanker and Dimensional Change Card Sort). A history of head injury (P = 0.033), increased AUD symptom severity score (P = 0.007) and increased negative symptom severity score (P = 0.027) were associated with CSCI. Conclusions  Cognition should be considered in the treatment of people with SMI-AUD, particularly in those with history of brain injury, higher AUD symptom severity, and/or negative symptom severity.
@article{jett_assessing_2023,
	title = {Assessing {Clinically} {Significant} {Cognitive} {Impairment} {Using} the {NIH} {Toolbox} in {Individuals} with {Co}-occurring {Serious} {Mental} {Illness} and {Alcohol} {Use} {Disorder}},
	volume = {17},
	issn = {1932-0620},
	url = {https://journals.lww.com/journaladdictionmedicine/Fulltext/2023/05000/Assessing_Clinically_Significant_Cognitive.12.aspx},
	doi = {10.1097/ADM.0000000000001105},
	abstract = {Objective 
          Serious mental illnesses (SMI) and alcohol use disorder (AUD) co-occurrence (SMI-AUD) is common, yet little is known about the prevalence and risk factors of cognitive impairment for this population. We used the National Institutes of Health (NIH) Toolbox to identify clinically significant cognitive impairment (CSCI), describe the cognitive profile, and investigate whether psychiatric and AUD severity measures are associated with CSCI in individuals with SMI-AUD.
          Methods 
          CSCI was defined as 2 or more fully corrected fluid subtest T scores below a set threshold based on an individual’s crystalized composite score. Psychiatric severity measures included the Structured Clinical Interview for DSM-V (SCID-5) for SMI diagnosis and the Positive and Negative Syndrome Scale. AUD severity measures included the SCID-5 for AUD symptom severity score, years of alcohol use, and urine ethyl glucuronide levels. A multivariable logistic regression was used to investigate the adjusted effects of each variable on the probability of CSCI.
          Results 
          Forty-one percent (N = 55/135) of our sample had CSCI compared with the base rate of 15\% from the NIH Toolbox normative sample. Subtests measuring executive function most frequently contributed to meeting criteria for CSCI (Flanker and Dimensional Change Card Sort). A history of head injury (P = 0.033), increased AUD symptom severity score (P = 0.007) and increased negative symptom severity score (P = 0.027) were associated with CSCI.
          Conclusions 
          Cognition should be considered in the treatment of people with SMI-AUD, particularly in those with history of brain injury, higher AUD symptom severity, and/or negative symptom severity.},
	language = {en-US},
	number = {3},
	urldate = {2023-07-05},
	journal = {Journal of Addiction Medicine},
	author = {Jett, Julianne D. and Kordas, Gordon and Parent, Sara and Keshtkar, Mohammad and Shin, Rachel and King, Paige and McPherson, Sterling M. and Ries, Richard and Roll, John M. and McDonell, Michael G. and Chaytor, Naomi},
	month = jun,
	year = {2023},
	pages = {305},
}

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