Aims: To assess the influence of methadone and buprenorphine maintenance treatment on the driving aptitude of opioid-dependent patients. Design: Prospective, open label, outpatient maintenance, single-blind (investigator) study. Participants and Setting: Thirty opioid-dependent patients maintained on either methadone or buprenorphine were recruited from the drug-addiction outpatient clinic in Vienna. Measurements: The traffic-relevant performance dimensions of the participants were assessed 22 h after receiving synthetic opioid maintenance therapy, by a series of seven tests constituting the Act & React Test System (ART) 2020 Standard test battery, developed by the Austrian Road Safety Board (ARSB). To test for additional consumption of illicit substances, blood and urine samples were taken at the beginning of the tests. Findings: The patient group only differed from control subjects in two of the ART 2020 Standard tests. During a task to test the subject’s attention under monotonous circumstances (Q1 test), patients had a significantly greater number of reactions (p = 0.027) and a significantly higher percentage of incorrect reactions than control subjects. When driving in a dynamic environment (DR2 test) patients had a significantly longer mean decision time (p = 0.029) and mean reaction time (p = 0.009) compared with control subjects. Interestingly, when separated into treatment groups, the mean decision and reaction times of buprenorphine-maintained patients in the DR2 test did not differ from controls, whereas patients maintained on methadone showed significantly prolonged mean decision (p = 0.009) and reaction times (p = 0.004). In this same test, patients who had consumed additional illicit drugs had a longer mean reaction time compared with control subjects (p = 0.036). Conclusion: The synthetic opioid-maintained subjects investigated in the current study did not differ significantly in comparison to healthy controls in the majority of the ART 2020 Standard tests.
Based on a sample of 300 psychiatric patients the items of the Standard Progressive Matrices test are analyzed in terms of classical and probabilistic methods, and a version shortened to 30 items is developed. This new version of the test is then standardized from a new sample of 1,200 patients. A table of selected percentiles is computed. Validation with respect to rough classification of intelligence is proved by comparison with results of the WIP.
The "levels of processing" theory (Craik and Lockhart) and "dual coding" theory (Paivio) provide new aspects for clinical memory research work. Therefore, an incidental learning paradigm on the basis of these two theoretical approaches was chosen to test aspects of memory performances with lithium therapy. Results of two experiments, with controlled non-semantic processing (rating experiment "comparison of size") and additive semantic processing (rating "living--non-living") indicate a slight reduction in recall (Fig. 1) and recognition performance (Fig. 2) in lithium patients. Effects on encoding strategies are of equal quality in patients and healthy subjects (Tab. 1, 2) but performance differs between both groups: poorer systematic benefit from within code repetitions ("word-word" items, "picture-picture" items) and dual coding (repeated variable item presentation "picture-word") is obtained. The less efficient encoding strategies in the speeded task are discussed with respect to cognitive rigidity and slowing of performance by emotional states. This investigation of so-called "memory deficits" with lithium is an attempt to explore impairments at an early stage of processing; the characterization of the perceptual cognitive analysis seems useful for further clinical research work on this topic.
Saccadic eye movements were stimulated with the aid of 11 light spot stimuli, 10 of which were arranged at 3 degrees, 6 degrees, 9 degrees, 12 degrees, and 15 degrees to the left and right of the central stimulus. The parameters average and maximal eye movement velocity and latency were precisely investigated. 19 patients averaging 6.6 years on lithium prophylaxis were compared with 23 healthy controls. Significant differences between the two groups could not be found at this level of function.
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