Patterns of Executive Function Impairment in Abstinent Individuals with Alcohol Dependence Syndrome: A Cross-sectional Study

Introduction: Alcohol has historically been a part of human culture, but chronic alcohol use is linked to a range of neurocognitive and psychological impairments. In recent years, attention has turned to the cognitive effects of sustained abstinence in individuals previously diagnosed with Alcohol Dependence Syndrome (ADS). Executive dysfunction, in particular, remains underexplored in abstinent individuals, especially in Indian clinical settings. Aim: To assess the pattern of executive function impairments in abstinent individuals diagnosed with ADS and to evaluate associated factors. Materials and Methods: A prospective cross-sectional study was conducted at a tertiary care hospital over six months among 49 male patients aged 18-59 years, diagnosed with ADS {International Classification of Diseases (ICD)-10 F10.2} and abstinent for at least one month. Patients with psychiatric, neurological, or chronic medical illnesses were excluded. Cognitive assessments included the Digit Symbol Substitution Test (DSST), Trail Making Test Parts A and B (TMT-A and TMT-B), the Benton Visual Retention Test (BVRT), and the Wisconsin Card Sorting Test (WCST). Data were analysed using Statistical Package for the Social Sciences (SPSS) v22.0, and a p-value<0.05 was considered significant. Results: Cognitive impairment was present on TMT in 14 (28.57%), on the BVRT in 18 (36.73%), and on the WCST in 32 (65.31%) participants. A significant association was found between cognitive impairment and daily alcohol intake (mean±SD: 10.03±4.22 vs 7.06±2.59 units/day; p-value=0.011). Executive dysfunction was significantly associated with occupation but not with educational status, economic status, marital status, past treatment history, nicotine use, or family history of substance use. Conclusion: Executive dysfunction is prevalent among abstinent patients with ADS and is significantly associated with higher daily alcohol intake and greater dependence severity, highlighting the need for early cognitive screening.