The effect of methadone maintenance treatment on decision-making biases in male heroin dependent patients / 中华行为医学与脑科学杂志

ABSTRACT

Objective To investigate the characteristics of decision-making impairment in male patients with heroin dependence in methadone maintenance treatment(MMT). Methods A total of 45 male patients in MMT were compared with matched 32 health controls on the Iowa Gambling Task. Results Participants with anxiety or depression had to be excluded, MMT subjects were required to have negative urine toxicology screening tests.The MMT group selected more net disadvantageous cards (number of cards selected from the disadvantageous decks minus number of cards selected from advantageous decks) than health controls( (9.11 ± 19.60, -4.25 ±10.27 respectively), t=3. 884, P＜0.01). A 2(group) ×5(block) ANOVA (analysis of variance) on the cards of net disadvantageous from the gambling task revealed a significant main effect of group( F= 12.414, P＜0.01 ).The ANOVA also revealed a significant main effect of block( F=6.871, P＜0.01 ). The study indicated the totalnumber of net disadvantageous cards for MMT subjects was negative correlation to the age of initial drug use ( r=- 0. 320, P ＜ 0. 05 ). Meanwhile, methadone dose and the time of enrollment MMT did not reveal a significant main effect on decision-making biases. Conclusion The deficit of decision making for male heroin dependent patients might be attributed to the dysfunction of the ventromedial prefrontal cortex, and this effect does not resolve with abstinence, even very long term abstinence. Methadone may not get worse this impairment in male patients who have a history of heroin use during maintenance treatment intervention.