Effectiveness of an Integrated Intervention Program for Alcoholism: Electrophysiological Findings.

BACKGROUND: Neuroelectrophysiological measures such as electroencephalograms (EEGs) in resting state and event-related potentials (ERPs) provide valuable information about the vulnerability and treatment-related changes in persons with alcoholism. This study examined the effectiveness of an Integrated Intervention Program for Alcoholism (IIPA) using electrophysiological measures. METHODS: Fifty individuals with early onset of alcohol dependence participated. They were grouped randomly into two: the treatment as usual (TAU) group and the treatment group, matched on age (±1 year) and education (±1 year). eyes closed and resting state EEGs and ERPs on cognitive tasks (flanker task, alcohol Go/No-Go task, and single outcome gambling task) were recorded before and after treatment. The TAU group received pharmacotherapy, six days/week yoga sessions, and three sessions/week group therapy on relapse prevention while the treatment group received IIPA along with usual treatment (except yoga) for 18 days. RESULTS: There was no significant difference between the groups pre-treatment. RM-ANOVA for pre- and post-treatment stages showed a significant difference between the two groups in the absolute power of alpha, beta, theta, and delta, during eye closure, in the resting-state EEGs. The treatment group showed significantly larger N200/N2 amplitude in congruent and incongruent conditions (flanker task), N200/N2 amplitude for alcohol No-Go, P300/P3 amplitude for neutral No-Go on alcohol Go/No-Go task, and outcome-related positivity (ORP) amplitude on single outcome gambling task. CONCLUSION: This exploratory study suggests that IIPA is effective for enhancing relaxation state and attentiveness, decreasing hyperarousal, and ameliorating neurocognitive dysfunctions of conflict-monitoring, response inhibition, and reward processing.

Study of neuropsychological deficits in late onset depression.

BACKGROUND: Older adults with depression often have cognitive deficits contributing to higher morbidity and increased risk for conversion to dementia. Research on this area is limited from India. OBJECTIVE: The objective of the current study is to examine the neuropsychological measures in older adults with Late-onset depression (LOD) compared to healthy controls (HC). METHOD: Sample included older adults with depression as per DSM-IV TR criteria seeking treatment from Geriatric Clinic and Services, National Institute of Mental Health and Neurosciences (NIMHANS). Geriatric depression scale, Montgomery Asberg depression rating scale and Hamilton anxiety rating scale were applied to screen and measure the severity of depression. Comprehensive assessment of neurocognitive function was done using NIMAHNS Neuropsychological Battery for Elderly (NNBE, 2013). RESULTS: Sample included 76 LOD patients and 76 healthy controls (HC) who were matched for age, gender and education. The mean age of onset of illness was 63.17(SD-6.54) years and median duration of total illness was 29.5 months. In the standard assessments, the mean score on GDS was 9.28 (SD-3.32) and MADRS was 18.88 (SD-6.07). The LOD group had lower Hindi Mental Status Examination (HMSE) score compared to HC (28.64 ± 2.09 vs 30.05 ± 1.26, p < 0.001). Compared to HC, LOD group performed poorly on tasks of attention, executive function, verbal and visual memory, verbal fluency and visuo-spatial skills. Recognition memory and logical memory were relatively preserved in LOD compared to HC. DISCUSSION AND CONCLUSION: Cognitive deficits were seen predominantly in attention and executive function, visuo-spatial skills and memory similar to previous studies. It is advisable to routinely assess cognitive symptoms in older adults presenting with depression.

Cognitive and behavioural dispositions in offspring at high risk for alcoholism.

OBJECTIVES: Offspring with family history of alcoholism are considered to be at high risk for alcoholism. The present study sought to expand our understanding of cognitive and behavioural dispositions associated with executive control and self-regulation in alcohol naïve offspring with and without family history of alcoholism. METHODS: Sample comprised of alcohol naive offspring in two groups: (i) at high risk (n = 34) and (ii) at low risk for alcoholism (n = 34). Both groups were matched on age (+/-1 year), education (+/-1 year) and gender. Measures used were: Mini-International Neuropsychiatric Interview, Family Interview for Genetic Studies, Socio-demographic Data Sheet, Annett's Handedness Questionnaire, Barratt's Impulsiveness Scale-version 11, Digit Span Test, Spatial Span Test, Tower of London, Wisconsin Card Sorting Test, Iowa Gambling Task (IGT) and Game of Dice Task (GDT). RESULTS: Results showed that alcohol naive offspring at high risk for alcoholism reported significantly high impulsivity and demonstrated significant differences on executive functions and decision making tasks. Correlation analysis revealed that high impulsivity was significantly associated with poor performance on explicit decision making task (GDT) and executive function task (WCST). There was no significant correlation between two decision making tasks (IGT and GDT) in both groups and performance on IGT was not significantly associated with impulsivity and executive functions. CONCLUSIONS: The present study indicates cognitive and behavioural dispositions in alcohol naive offspring at high risk for alcoholism and support the sub-optimal balance between reflective and impulsive system responsible for addiction. Furthermore, present study supports separability between two different types of decision making tasks.