Carolien Zeetsen

47 CHAPTER Validating the MoCA in addiction health care 3 Neuropsychological assessment The tests included in the NPA, that was administered at follow–up, were selected based on the cognitive domains targeted by the MoCA, thus assessing a broad range of cognitive functions. The allocation of the NPA (sub)tests and MoCA elements to each cognitive domain was based on DSM–5 criteria for NCD (APA, 2013, pp. 593–595) and is summarized in Table 3.1. Measurements in the addictions for triage and evaluation The Measurements in the Addictions for Triage and Evaluation (MATE 2.1; Schippers et al., 2011) is part of the intake procedure and consists of an interview and self–report questionnaires for collecting relevant patient characteristics. In this study, Section 1 ‘Substance use’ and Section 3 ‘History of treatment for substance use disorders’ were used. Procedure At baseline, the MATE 2.1 was administered and written informed consent was obtained. MoCA version 7.1 was administered by trained professionals during intake procedure. For administration of the NPA (follow–up) an appointment approximately six to eight weeks later was made. The NPA procedure was fixed for all institutions and administration was done by trained psychologists. All professionals were trained in MoCA and/or NPA administration in accordance with the test manuals, by the coordinator of this study. Recruitment for follow–up was based on random selection (i.e. one in eight patients of the large study were randomly selected for a follow–up), indication (i.e. based on care as usual), or both. Three patients with a behavioural disorder without substance use were excluded for this study. At follow–up, MoCA version 7.2 was administered preceding the NPA. Prior to both baseline and follow–up, a self–reported estimation of substance use in the week before administration, or abstinence duration (if > 7 days) was obtained. Analyses Patient characteristics For determining the presence of NCD, criteria for substance–induced NCD of the DSM–5 (APA, 2013) were combined with the ‘cognitive impairment, no dementia’ criteria as outlined in van den Berg et al. (2005). All raw scores of the NPA were transformed into standard z –scores, according to the normative data. These standard z –scores were classified as: 0 = average (≥ −1.00); −1 = below average (between −1.00 and −1.65); −2 = impaired (≤ −1.65). An average score for a domain of ≤ −1.00 was considered to be impaired. If at least two out of all seven NPA domains were impaired, the patient was classified as having substance–induced NCD. Nine patients had missing data in one or more NPA domain, but