Long-Term Changes in the Personality and Psychopathological Profile of Opiate Addicts after Nucleus Accumbens Ablative Surgery Are Associated with Treatment Outcome
| Autor: | Li Gao, Shun-Nan Ge, Xiaozan Chang, Guo-Dong Gao, Haikang Zhao, Jing Wang, Chongwang Chang, Xuelian Wang, John R. Adler, He-Ming Wu, Nan Li |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male medicine.medical_specialty Neurotic Disorders Personality Inventory media_common.quotation_subject Nucleus accumbens Severity of Illness Index Nucleus Accumbens Olfaction Disorders Recurrence Interview Psychological mental disorders Severity of illness Humans Medicine Personality skin and connective tissue diseases Psychiatry media_common Memory Disorders Morphine Heroin Dependence business.industry Addiction Magnetic Resonance Imaging Psychosurgery Treatment Outcome Psychotic Disorders Socioeconomic Factors Catheter Ablation Quality of Life Female Surgery sense organs Neurology (clinical) Symptom Assessment Personality Assessment Inventory Opiate business Clinical psychology Psychopathology |
| Zdroj: | Stereotactic and Functional Neurosurgery. 91:30-44 |
| ISSN: | 1423-0372 1011-6125 |
| DOI: | 10.1159/000343199 |
| Popis: | Objective: To investigate the long-term outcome and changes of the personality and psychopathological profile of opiate addicts after bilateral stereotactic nucleus accumbens (NAc) ablative surgery. Methods: 60 patients were followed up for 5 years and abstinent status and adverse events were evaluated. NAc lesion volumes and locations were obtained by postoperative MRI scans. The Chinese version of the Eysenck Personality Questionnaire (EPQ-RSC), the Symptom Checklist-90-Revised (SCL-90-R), the Beck Depression Inventory (BDI), the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the World Health Organization’s Quality of Life Questionnaire – Brief Version (WHOQOL-BREF) were administered to the patients before and 5 years after the stereotactic surgery. Results: The total abstinence rate of all patients in their 5th postoperative year was 47.4%. The abstinent patients had a significantly larger lesion volume than the relapsed ones, but a larger lesion volume also increased the risk of adverse events. 5 years after surgery, the abstinent patients showed significant decreases on the Psychoticism (EPQ-P) and Neuroticism (EPQ-N) scores by EPQ-RSC, a significant decline on the Global Severity Index and the subscores in all 10 dimensions by SCL-90-R, significant decreases on the BDI and Y-BOCS scores, and significant improvements on the scores of all domains by WHOQOL-BREF, while for the relapsed patients, only the subscores of obsessive-compulsive by SCL-90-R and the Y-BOCS scores significantly decreased. Postoperative analysis revealed that the abstinent patients had a significantly better score than the relapsed ones by various instruments, and NAc lesion volumes and locations did not correlate with the outcome of any of these instruments. Conclusion: The bilateral ablation of NAc by stereotactic neurosurgery was a feasible method for alleviating psychological dependence on opiate drugs and preventing a relapse. Long-term follow-up suggested that surgery can improve the personality and psychopathological profile of opiate addicts with a trend towards normal levels, provided persistent abstinence can be maintained; relapse, on the other hand, may ruin this effect. |
| Databáze: | OpenAIRE |
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