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Heroin Addiction and Related Clinical Problems: 2024, 26, 44

Exploring Theory of Mind and Empathy Progression Alongside Cognitive Gains in Methadone Maintenance Treatment

Shlomit Zorani, and Einat Peles

Digital Object Identifier:
https://doi.org/10.62401/2531-4122-2024-44

Summary: Background: The theory of mind (ToM) is associated with cognition. Previous studies have indicated that individuals with opioid use disorder (OUD) receiving methadone maintenance treatment (MMT) show improvement in their cognitive indices following a year of treatment. We aimed to study whether an improvement in ToM and empathy measures would also be observed in MMT patients following six months of treatment. Methods: ToM (Reading the Mind in the Eyes, (RMET), empathy (Interpersonal Reactivity Index, IRI), Empathy Quotient Scale for Adults, (EQ60), Pain Empathy, (PE task), Pain Pressure Threshold ([PPT), Pain questionnaire (McGill), Catastrophising, Montreal Cognitive Assessment (MoCA), and Perceived Stress ([PSS) were studied among 22 individuals with OUD on admission to MMT and after six months. Drugs in urine were monitored. Results: Following six months, an increase in cognition (MoCA scores) and a decrease in catastrophising scores were observed, with no change in ToM global and sub-scales and empathy scores. The baseline catastrophising score inversely correlated with the female RMET sub-scale, and high catastrophising (scored ≥30) predicted shorter retention in MMT. Opioid discontinuation did not relate to ToM nor to cognition improvement. Conclusions: The increase in cognition, but not of ToM or empathy, may be due to more complicated skills needing more time or specific training. A longer follow-up and a larger sample size are required in order to confirm stable ToM independent of cognition improvement.

Keywords: Theory of mind; Empathy; Opioid use disorder; Methadone maintenance treatment; Follow-up study; Cognition