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Screening Tools for Cognitive Impairment in Adults with Substance Use Disorders: A Systematic Review

Published online by Cambridge University Press:  26 August 2021

Katherine Y. Ko ,
Nicole Ridley ,
Shayden D. Bryce Open the ORCID record for Shayden D. Bryce [Opens in a new window] ,
Kelly Allott ,
Angela Smith  and
Jody Kamminga Open the ORCID record for Jody Kamminga [Opens in a new window]
Katherine Y. Ko
Affiliation:
Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
Nicole Ridley
Affiliation:
Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, New South Wales, Australia
Shayden D. Bryce
Affiliation:
Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia Orygen, Parkville, Victoria, Australia
Kelly Allott
Affiliation:
Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia Orygen, Parkville, Victoria, Australia
Angela Smith
Affiliation:
Hunter New England Health Libraries, Hunter New England Local Health District, Newcastle, New South Wales, Australia
Jody Kamminga*
Affiliation:
Drug and Alcohol Clinical Services, Hunter New England Local Health District, Newcastle, New South Wales, Australia
*
*Correspondence and reprint requests to: Jody Kamminga, Drug and Alcohol Clinical Services, Hunter New England Local Health District, Level 3, 670 Hunter Street, Newcastle West, NSW 2304, Australia. E-mail: Jody.Kamminga@health.nsw.gov.au
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Abstract

Objectives:

Cognitive impairment is common in individuals with substance use disorders (SUDs), yet no evidence-based guidelines exist regarding the most appropriate screening measure for use in this population. This systematic review aimed to (1) describe different cognitive screening measures used in adults with SUDs, (2) identify substance use populations and contexts these tools are utilised in, (3) review diagnostic accuracy of these screening measures versus an accepted objective reference standard, and (4) evaluate methodology of included studies for risk of bias.

Methods:

Online databases (PsycINFO, MEDLINE, Embase, and CINAHL) were searched for relevant studies according to pre-determined criteria, and risk of bias and applicability was assessed using the Quality Assessment of Diagnostic Accuracy Studies–2 (QUADAS–2). At each review phase, dual screening, extraction, and quality ratings were performed.

Results:

Fourteen studies met inclusion, identifying 10 unique cognitive screening tools. The Montreal Cognitive Assessment (MoCA) was the most common, and two novel screening tools (Brief Evaluation of Alcohol-Related Neuropsychological Impairments [BEARNI] and Brief Executive Function Assessment Tool [BEAT]) were specifically developed for use within SUD populations. Twelve studies reported on classification accuracy and relevant psychometric parameters (e.g., sensitivity and specificity). While several tools yielded acceptable to outstanding classification accuracy, there was poor adherence to the Standards for Reporting Diagnostic Accuracy Studies (STARD) across all studies, with high or unclear risk of methodological bias.

Conclusions:

While some screening tools exhibit promise for use within SUD populations, further evaluation with stronger methodological design and reporting is required. Clinical recommendations and future directions for research are discussed.

Keywords

CognitionScreeningAdultsSubstance-related disordersNeuropsychology
Type
Critical Review
Information
Journal of the International Neuropsychological Society , Volume 28 , Issue 7 , August 2022 , pp. 756 - 779
Copyright
Copyright © INS. Published by Cambridge University Press, 2021

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