Emotional empathy: fantasy, empathic concern, personal distress. 2. Cognitive empathy: perspective taking. â« Multifaceted Empathy Test (MET):. 1. Emotional ...
Non-medical prescription opioid use & its impact on social cognition Kroll S.L.1,5, Nicolic E.1, Bieri F.1, Baumgartner M.R.2, Soyka M.3,4 & Quednow B.B.1,5 1Experimental
and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland 2 Center for Forensic Hair Analysis, Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland 3 Psychiatric Hospital of the University of Munich, Germany 4 Medical Park Chiemseeblick, Fachklinik für Psychosomatik, Bernau, Germany 5Neuroscience Center Zurich, University of Zurich and Swiss Federal Institute of Technology Zurich (ETH), Switzerland
Background
Results
In the last two decades, non-medical prescription opioid use (NMPOU) has become an increased public health concern in North America where the risen use of prescription opioids (i.e. morphine, oxycodone, fentanyl, codeine,…) has reached epidemic dimensions. Although recent reports indicate an emerging problem of NMPOU in Europe, there is still a lack of knowledge regarding its sequelae on social cognition. Studies with heroine users or heroine substituted patients have shown deficits in emotion perception [1,2]. But for this population, it is difficult to attribute postulated findings to pure opioid effects because of confounding factors such as comorbid physical and psychiatric diseases. Therefore, we designed the present study to investigate the effects of opioids other than heroine on social cognition.
NMPOU group showed reduced emotion perception overall and in both channels of communication. Furthermore, NMPOU showed less cognitive empathy in comparison to controls (Fig. 1). Pearson’s correlation revealed dose-dependent deficits in affective recognition and cognitive empathy (Fig. 2). Subjective ratings of emotional and cognitive empathy showed no significant differences between NMPOU and controls (Tab. 1).
We compared 23 individuals with NMPOU with 29 healthy and drug-naïve controls. NMPOU were recruited through flyer advertisement in hospitals and addiction centres, social media, and newspaper. For NMPOU, exclusion criteria required polytoxic drug use, i.v. drug use, and history of heroine dependence. The groups were matched for age and sex distribution, tobacco consumption, and years of education (Tab. 1). NMPOU (n=23) 6/17 27.96 (10.25) 11.17 (2.02) 106.39 (11.22) 17/6 9.39 (7.72) 15.26 (7.00)
Value χ2 = 0.42 t = -0.55 t = 0.54 t = -0.37 χ2 = 0.82 t = -3.71 t = -2.65
df 1 50 39.2 50 1 28.25 50
p 0.56 0.58 0.54 0.72 0.37 < 0.01 0.01
*
50
Controls
40
**
30 20 10
CATS ARQ
51.28 (62.17) 11.20 (10.18)
t = -6.30 t = -2.71 t = -3.73
50 50 50 50 22 22 22
0.18 0.51 0.92 0.36 < 0.01 0.01 < 0.01
b)
50 30.49
0.31 0.14
28.19 (35.73) 5.28 (6.28)
60.44 (61.53) 3.82 (4.17)
t = -2.23 t = 0.96
33.46 50
0.03 0.34
0.07 (0.28) 3.73 (4.20)
0.36 (0.59) 4.78 (4.81)
t = -2.17 t = -0.84
29.64 50
0.04 0.40
0.08 (0.34)
36.27 (88.65)
t = -1.96
22
0.06
0.07 (0.16)
5.24 (14.57)
t = -1.63
20
0.12
Tab. 1: Demographic data and drug use (means and SD). T-test and Chi2 test for frequency distributions two-tailed.
Instruments for social cognition § Interpersonal Reactivity Index (IRI) = Subjective self-rating scale for trait empathy 1. Emotional empathy: fantasy, empathic concern, personal distress 2. Cognitive empathy: perspective taking § Multifaceted Empathy Test (MET): 1. Emotional empathy (EE): direct & indirect empathy (EEE & IEE) 2. Cognitive empathy (CE) § Comprehensive Affect Testing System (CATS) = Emotion perception 1. Emotion Recognition Quotient (ERQ) - overall 2. Affect Recognition Quotient (ARQ) – channel of communication 3. Prosody Recognition Quotient (PRQ) – channel of communication
60 40 20
CATS ERQ
emotional empathy (EE)
cognitive empathy (CE) 30
7 6 5 4 3 2 1
NMPOU Controls
EEE
*
25 20
* 15 10 5 0
IEE
COE
COE pos
COE neg
Fig. 1: Mean and SD for a) affect and prosody recognition (ARQ & PRQ) and the emotion recognition quotient (ERQ); b) for emotional (EEE & IEE) and cognitive empathy (COE). T-Test : *p
