Harmen Beurmanjer

56 Chapter 4 off-score of 25 on the MoCA at T1, compared to patients who relapsed. No relationship was found between treatment outcome and MoCA scores on T2. The results are shown in Table 2. Given that only the MoCA scores on T1 were related to treatment outcome, only these scores were used in the backward logistic regression analyses to explore the predictive value of the MoCA for relapse. The logistic regression model was statistically significant, χ 2 (1) = 8.617, p < .003, with only memory as a significant predictor in the final model. The model explained between 10.2% and 14.1% (Nagelkerke R 2 ) of the variance in relapse and correctly classified 68.8% of the cases. Each point scored on the subscale T1 Memory increases the odds of abstinence with 1.64. Discussion This study investigated cognitive impairment in patients with GUD, and its relationship with 1) GHB use patterns and 2) relapse in GHB use after detoxification. Using the MoCA, a substantial number of patients with GUD screened positive for cognitive impairment before detoxification (56.3%). Cognitive functioning improved after detoxification with still about one third screening positive for impairment (30.6%). The cognitive domain showing the strongest impairment was memory. No correlation was found between Table 2 Treatment outcome and MoCA scores T1 T2 Abstinent (n=28) Mean score (sd) Relapse (n=52) Mean score (sd) p-value Abstinent (n=29) Mean score (sd) Relapse (n=33) Mean score (sd) p-value Executive Function & Visuospatial Abilities 4.42(1.14) 4.33(1.24) 0.721 4.80(1.08) 4.69(1.26) 0.750 Attention 5.32(0.86) 4.83(1.13) 0.047* 5.27(1.07) 5.00(1.09) 0.319 Language 4.46(1.04) 4.37(1.07) 0.691 4.72(0.59) 4.61(0.66) 0.463 Abstract Reasoning 1.57(0.69) 1.65(0.59) 0.576 1.72(0.53) 1.89(0.33) 0.167 Memory 3.61(1.42) 2.58(1.55) 0.005* 3.83(1.47) 3.24(1.58) 0.138 Orientation 5.82(0.39) 5.85(0.45) 0.810 5.83 (0.47) 5.76(0.50) 0.574 Total* 25.21(2.91) 23.60(2.94) 0.021* 26.17 (2.24) 25.21(2.91) 0.163 Below cut-off 56.6% 76.9% 0.030* 27.6% 42.4% 0.171 *P<.05