Neuropsychological assessment in users of psychotropic substances

Abstract

Cognitive damage tends to hinder the rehabilitation process of patients who use psychotropic substances, with or without neurological comorbidities, such as stroke or traumatic brain injury. These losses may affect patients' ability to adhere to treatment and rehabilitation. Given the importance of these aspects in the construction of an integral therapeutic process, this chapter focused on neuropsychological assessment, highlighting it as a broad and potentially therapeutic process, crossed by welcoming and reflecting on clinical perspectives and limitations. In order to be effective, it is necessary to exercise nonjudgment and the construction of the bond. It is necessary to evaluate and promote the motivation of patients, so motivational strategies and psychoeducation may be valid. Understanding the role of the family in promoting change is also important. Data should be collected through various sources, such as ecological tasks, interviews, contacts with other professionals, document analysis, and tests. Verbal and written returns should integrate patients' preserved and deficient aspects to guide the treatment plan, and the indication of places for follow-up can facilitate adherence. The neurobiological process involving the reward system was described, and particularities in terms of the evaluation of these patients were discussed, such as the possible indication of toxicological tests and the repercussion of the substances on mental functions. Some neuropsychological tests and implications of cognitive reassessments were presented and contextualized. In addition, the interdisciplinary character of neuropsychology was discussed, pointing out that each professional should be updated regarding the current legislation of professional councils at the time of the evaluation process.