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KMID : 0870520090130010012
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Journal of Korean Academy of Addiction Psychiatry
2009 Volume.13 No. 1 p.12 ~ p.20
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The Relationship between“Insight”& Cognitive Functions in Alcoholics
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Lee Kye-Seong
Shin Jong-Ho
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Abstract
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Objectives：The purpose of this study is to explore the proposition that, by the evaluation of neuropsychological test, chronic alcohol use can be pinpointed as a cause for frontal lobe dysfunction and that this dysfunction has relationship with both denial and insight level.
Methods：We enrolled 55 patients who were admitted as inpatients in alcohol treatment programs at Incheon Christian Hospital. The subjects were evaluated according to sociodemographic and clinical characteristics. After 3 weeks of detoxification, denial and insight level were measured, and neuropsychological test including the following were administered： the Korean version of Wechsler Adult Intelligence Scale (k-WAIS) for assessing Intelligence Quotient (IQ) and the EXIT (Executive Intelligence Test) which consists of stroop, verbal fluency, figural fluency, and auditory verbal learning test for assessing Executive Intelligence Quotient (EIQ).
Results：Mean IQ was 96.16 and EIQ was 86.25. But EIQ was decreased from an assumed premorbid level more than that of IQ. According to insight level poor insight group showed lower EIQ but not on IQ. And among subtests medial mand interference stroop and figural fluency showed the difference. Insight level was positively correlated with the denial. And EIQ and particularly among subtest figural fluency showed correlation with insight level but not in case of IQ and other subtests. Through simple regression test, EIQ can explain Insight level about 15.3%.
Conclusion： Cognitive impairment, especially executive dysfunction was identified. Denial itself is not correlated with cognitive function though. It seems that the more patient gaining insight, the more they admit their denial. The fact that Insight level is much more correlated with performance of EIQ, especially figural fluency test, than IQ reflect that Insight level is much more correlated with function of frontal lobe, particularly right hemisphere. Given this condition, level of cognitive function could be one of the factor that can evaluate a capacity for rehabilitation of patient, and concern over the need of neuroprotection from chronic alcohol use as well as cognitive rehabilitation as a part of alcoholism treatments should be increased.
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KEYWORD
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Alcoholism, Denial, Insight, Cognition, IQ Executive function, Frontal lobe
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