藥物濫用的潛藏危機－－從注意力、記憶力的功能減損到輕度認知障礙症

The potential crisis of drug addicts: Attention-deficit, working memory dysfunction and mild cognitive impairment disorder

濫用藥物對身心健康帶來諸多負面影響，多數研究聚焦於各種物質所引起的各項身心功能影響或不同損害層面、疾病共病現象和交互作用、成癮歷程與復發風險、過量致死及平均餘命下降…等。然而無論濫用何種藥物，皆有一個共同且過去較少被關注的功能缺損現象：輕度認知障礙症。近廿年來，學者開始關注輕度認知障礙症，係起因於對失智症的相關研究，漸次發現無論是失智症、腦傷及腦部腫瘤、退化性神經疾患…等患者，在疾病初期都會先呈現出輕度認知障礙的症狀，其中當然包括了藥癮者。美國精神疾病診斷準則（DSM-5）列出輕度認知障礙症的主要診斷標準，包括有：注意力功能、執行功能、學習、記憶、語言、知覺動作、社會認知等認知功能，本文除了簡略說明輕度認知障礙之於個體功能的影響層面外，亦希望能透過實證研究來說明藥癮者認知功能變化的情形，以期未來有機會進一步瞭解輕度認知障礙對於復發與復原的影響。我們運用魏氏成人智力測驗（第三版）中有關於注意力、記憶力之相關分測驗，藉以瞭解濫用藥物與兩者之間的關聯，除呈現出實際的態樣外，亦希望能建立我國第一份關於藥癮與相關功能變化的基礎樣本資料。

Drug abuse brings a lot of negative effects on the physical and mental health. Many previous studies focused on aspects such as the impact of various substances on abusers' functions or damage, co-morbidity and interaction of physical and mental illness, addiction and risks of relapse, overdose to death and reducing average life. However, there is little concern about the phenomenon of functional defect: mild cognitive impairment. In recent years, many studies, with original focus on dementia, have begun to pay attention to mild cognitive impairment. Obviously, found that patients with dementia, brain injury and brain tumors, degenerative neurological disorders, or drug addicts, the target subjects in our study, show symptoms of mild cognitive impairment at the early stages. According to the American Diagnostic Criteria for Mental Disorders (DSM-5), the primary diagnostic criteria for mild cognitive impairment cover cognitive functions such as attention, executive, learning, memory, language, perceptual action and social cognition. In this paper, we try to give a summarized explanation for the impact of mild cognitive impairment on the individual's cognitive functions. Hopefully we can use our experimental results to explain the drug addicts' changes in their cognitive function. In this study, we use the sub-test of the Wechsler Intelligence Test (third edition), with focus on attention and memory, is used to get the understanding of the association between cognitive impairment and drug addicts. Finally, we also hope to establish a preliminary fundamental data about drug abuse and functional impairment in Taiwan.