Deficits in social perception in opioid maintenance patients, abstinent opioid users and non-opioid users

Abstract

Aims: This study aimed to compare emotion perception and social inference in opioid maintenance patients with abstinent ex-users and non-heroin-using controls, and determine whether any deficits in could be accounted for by cognitive deficits and/or risk factors for brain damage.

Design: Case-control.

Setting: Sydney, Australia.

Participants: A total of 125 maintenance patients (MAIN), 50 abstinent opiate users (ABST) and 50 matched controls (CON).

Measurements: The Awareness of Social Inference Test (TASIT) was used to measure emotion perception and social inference. Measures were also taken of executive function, working memory, information processing speed, verbal/non-verbal learning and psychological distress.

Findings: After adjusting for age, sex, pre-morbid IQ and psychological distress, the MAIN group was impaired relative to CON (β = -0.19, P < 0.05) and ABST (β = -0.19, P < 0.05) on emotion perception and relative to CON (β = -0.25, P < 0.001) and ABST (β = -0.24, P < 0.01) on social inference. In neither case did the CON and ABST groups differ. For both emotion perception (P < 0.001) and social inference (P < 0.001), pre-morbid IQ was a significant independent predictor. Cognitive function was a major predictor of poor emotion perception (β = -0.44, P < 0.001) and social inference (β = -0.48, P < 0.001). Poor emotion recognition was also predicted by number of heroin overdoses (β = -0.14, P < 0.05). Neither time in treatment or type of maintenance medication (methadone or buprenorphine) were related to performance.

Conclusions: People in opioid maintenance treatment may have an impaired capacity for emotion perception and ability to make inferences about social situations.