Prevalence and predictors of depression among college going youth of Meghalaya: A cross-sectional study

Backgrounds: College years are characterized by transitioning from pre-adult to adulthood, a period of turmoil, adjusting to the new condition, separation from parental supervision, independence, and countering new things throughout everyday life. Depression and health-risk behaviors, including alcohol, tobacco, and illicit drug, are often found in college students, particularly during their first year. Aim: To study the prevalence and predictors of depression among college-going youth of Meghalaya, India. Materials and Methods: A cross-sectional community-based study has been undertaken to find the prevalence of depression, alcohol use, and drug use in college-going youth in Shillong, Meghalaya. A random sampling technique was used for the selection of colleges, and total enumeration was used for the selection of college-going students. A total of 358 respondents were selected for the present study. Permission from the college authority was obtained, and written informed consent was taken from the students. The participants have been explained the purpose of the study and the samples were selected voluntarily. The present study’s data were analyzed and interpreted using Statistical Package for Social Sciences version 20.0. Socio-demographic datasheet, Beck Depression Inventory-II, Hamilton Anxiety Rating Scale, Alcohol Use Disorder Identification Test, and drug abuse screening test were administered. Results: In the present study, 40.5% fall under the normal range of depression, while 38.3% had mild mood disturbance, 10.3% had borderline clinical depression, 9.7% had moderate depression, and severe depression was found in 1.1%. Alcohol use, drug use, and gender contribute significantly to the prediction of depression among college-going students ( F[5,19.551] = 855.3, P = 0.000) accounting for 21.7% variance. Conclusion: Our findings highlight the need for a college mental health program for early identification and screening of substance use and depression in college students.

Fatores associados à exposição ao HIV em usuários de álcool / Factors associated with HIV exposure in alcohol users

Introdução: A prevalência de HIV é maior em Porto Alegre comparada ao restante do país. O abuso de álcool afeta o juízo crítico, sendo associado a comportamentos de risco que podem levar à contaminação pelo HIV. Objetiva-se analisar fatores associados à exposição ao HIV em alcoolistas com práticas sexuais de risco comparando com aqueles que se previnem.Métodos: Estudo transversal com 126 homens alcoolistas (HIV negativo), divididos em 2 grupos: Exposto Sexual (n = 42) e Pouco Exposto Sexual (n = 84), considerando uso de preservativo e número de parceiros sexuais.Resultados: A maioria dos sujeitos do grupo Exposto Sexual era solteiro, sem ocupação laboral, com histórico de moradia de rua e de relação com profissional do sexo, apresentavam maior preocupação com infecção por HIV (p < 0,05).Conclusão: Sugere-se o desenvolvimento e monitoramento de intervenções preventivas específicas, considerando as características do abuso de álcool e seu papel na transmissão do HIV.

Introduction: The HIV prevalence is higher in Porto Alegre compared to other capitals in Brazil. Alcohol abuse affects critical judgment, being associated with risky behaviors that can lead to HIV infection. Aim:To analyze factors associated with exposure to HIV in alcohol users, comparing those with risky sexual practices and those who use prevention methods.Methods: Cross-sectional study with 126 male alcohol users (HIV negative), divided into 2 groups: Sexually Exposed (n = 42) and Less Sexually Exposed (n = 84), considering condom use and number of sexual partners.Results: Most subjects in the Sexually Exposed group were single, without a job, with a history of homelessness and a relationship with a sexual worker, and were more concerned about HIV infection (p < 0.05).Conclusion: The development and monitoring of specific preventive interventions is suggested, considering the characteristics of alcohol abuse and its role in HIV transmission.

Internações por transtornos mentais e comportamentais devidos ao uso de álcool no Brasil e regiões: análise de tendência temporal, 2010-2020 / Hospitalizaciones por trastornos mentales y de conducta por consumo de alcohol en Brasil y regiones: análisis de tendencia temporal, 2010-2020 / Hospitalizations for mental and behavioral disorders due to alcohol use in Brazil and regions: a temporal trend analysis, 2010-2020

Objective: to analyze the trend in hospitalization rates for mental and behavioral disorders due to alcohol use (ICD-10: F10.0), Brazil and its five regions, 2010-2020. Methods: this was an ecological time-series study using data from the Hospital Information System of the Brazilian National Health System; to calculate the trend in hospitalizations, we used the Prais-Winsten generalized linear regression model and the Stata Statistical Software 14.0; a decreasing trend was considered when p-value < 0.05, and the regression coefficient was negative. Results: in the period analyzed, there were 423,290 hospitalizations for mental and behavioral disorders due to alcohol use in the country; the data analyzed showed a decreasing trend in adult hospitalization rates for this cause in the country (p-value < 0.001; 95%CI -0.094;-0.079) and in all its regions, for both sexes (p-value < 0.001). Conclusion: hospitalizations for mental and behavioral disorders due to alcohol use have reduced in Brazil and in its macro-regions.

Objetivo: analizar la tendencia de las tasas de hospitalizaciones por trastornos mentales y comportamentales debidos al consumo de alcohol (CID-10 F10.0) en Brasil y sus regiones, entre 2010 y 2020. Métodos: estudio de series temporales ecológicas, con datos extraídos del Sistema de Información Hospitalaria del Sistema Único de Salud. Se utilizó la regresión lineal generalizada de Prais-Winsten para calcular la tendencia de las hospitalizaciones; los análisis se realizaron con el software Stata 14.0. La tendencia se consideró descendente cuando p-valor < 0,05 y coeficiente de regresión negativo. Resultados: 423.290 hospitalizaciones ocurrieron en Brasil en el período. Los datos analizados permitieron observar una tendencia decreciente en las tasas en adultos por esta causa en Brasil (p-valor < 0,001; IC95% -0,094;-0,079) y en todas las regiones para ambos sexos (p-valor< 0,001). Conclusión: hubo una reducción en las hospitalizaciones por trastornos mentales y comportamentales debido al consumo de alcohol en Brasil y regiones.

Objetivo: analisar a tendência das taxas de internações por transtornos mentais e comportamentais devidos ao uso de álcool (CID-10: F10.0), Brasil e suas cinco regiões, 2010-2020. Métodos: estudo ecológico de série temporal, com dados do Sistema de Informações Hospitalares do Sistema Único de Saúde; para o cálculo da tendência de internações, utilizou-se a regressão generalizada linear de Prais-Winsten e o software estatístico Stata 14.0; considerou-se tendência declinante quando p-valor < 0,05, com coeficiente da regressão negativo. Resultados: no período analisado, ocorreram 423.290 internações por transtornos mentais e comportamentais decorrentes do uso do álcool, no país; os dados analisados permitiram observar uma tendência declinante das taxas de internação de adultos por essa causa no país p-valor < 0,001; IC95% -0,094;-0,079) e em todas as suas regiões, para ambos os sexos (p-valor < 0,001). Conclusão: as internações por transtornos mentais e comportamentais devidos ao uso de álcool se reduziram, no Brasil e em suas macrorregiões.

Assistência de enfermagem na atenção psicossocial: revisão narrativa de literatura / Nursing assistance in psychosocial care: narrative review of literature / Asistencia de enfermería en atención psicosocial: revisión narrativa de la literatura

Introdução: O movimento da Reforma Psiquiátrica, que teve início em meados da década de 1970 e continua até os dias atuais, fez uma grande mudança na estrutura do modelo de atenção à saúde mental brasileiro, propondo integrar e fundamentar estratégias que facilitem a reinserção social e familiar dos utentes.A discussão sobre o cuidado domiciliar e em saúde mental vem dos autores que levantam a hipótese de que o cuidado é necessário dentro do lar porque faz a diferença, tem um efeito positivo na reabilitação psicossocial de pessoas com transtornos mentais ou sofrimento mental. Objetivo: Analisar as publicações sobre assistência de enfermagem na atenção psicossocial. Resultados e Discussão: Trata-se de um estudo bibliográfico do tipo revisão narrativa de literatura, método de pesquisa que permite incorporar evidências à prática clínica para coletar e sintetizar achados de pesquisa sobre determinado tema ou questão de forma sistemática e ordenada. Conclusão: O tema da saúde mental está sendo periodicamente visto e estudado, de diversas vertentes, alguns focam no ambiente que o usuário de álcool/drogas é cuidado, já outros na situação na qual ele se encontra, isso é de suma importância para que o usuário de álcool/drogas possa ser cuidado em um ambiente seguro, com bons profissionais, e que possa retornar a conviver em sociedade. PALAVRAS-CHAVE: Saúde Mental; Transtornos Relacionados ao Uso de Álcool; Enfermagem Psiquiátrica.

Introduction: The Psychiatric Reform movement, which began in the mid- 1970s and continues to the present day, has made a major change in the structure of the Brazilian mental health care model, proposing to integrate and substantiate strategies that facilitate the social and family reintegration of users.The discussion about home care and mental health comes from the authors who raise the hypothesis that care is necessary within the home because it makes a difference, has a positive effect on the psychosocial rehabilitation of people with mental disorders or mental suffering. Objective: To analyze publications on nursing care in psychosocial care. Results and Discussion: This is a bibliographic study of the type of narrative literature review, a research method that allows to incorporate evidence into clinical practice to collect and synthesize research findings on a given theme or question in a systematic and orderly manner. Conclusion: The theme of mental health is being periodically seen and studied, from various perspectives, some focus on the environment that the user of alcohol/drugs is cared for, while others in the situation in which he finds himself, this is of paramount importance so that the user of alcohol/drugs can be cared for in a safe environment, with good professionals, and that can return to live in society.

Introducción: El movimiento de la Reforma Psiquiátrica, que comenzó a mediados de la década de 1970 y continúa hasta el día de hoy, ha hecho un cambio importante en la estructura del modelo de atención de salud mental brasileño, proponiendo integrar y basar estrategias que faciliten la reintegración social y familiar de los usuarios. La discusión sobre la atención de salud mental y en el hogar viene de los autores que plantean la hipótesis de que la atención es la diferencia necesaria dentro del hogar porque hace una , tiene un efecto positivo en la rehabilitación psicosocial de las personas con trastornos mentales o sufrimientos mentales. Objetivo: analizar las publicaciones sobre la atención de enfermería en atención psicosocial. Resultados y Discusión: Se trata de un estudio bibliográfico del tipo de revisión narrativa de la literatura, un método de investigación que permite incorporar evidencia en la práctica clínica para recolectar y sintetizar los hallazgos de investigación sobre un tema o pregunta dada de manera sistemática y ordenada. Conclusión: El tema de la salud mental se está viendo y estudiando periódicamente, de diversas maneras, algunos se centran en el ambiente que se está cuidando al usuario de alcohol/drogas, mientras que otros en la situación en que se encuentra, esto es de gran importancia para el usuario de alcohol/drogas para ser capaz de ser cuidadoso en un ambiente seguro, con buenos profesionales, y que puede volver a vivir juntos en la sociedad.

Recaída en el consumo de alcohol después del trasplante de hígado por hepatopatía alcohólica / Alcohol relapse after liver transplantation for alcoholic liver disease

Introducción. La enfermedad hepática inducida por uso de alcohol se ha considerado una enferme-dad autoinfligida que limitaba el acceso al trasplante. Actualmente es una de las principales indicacio-nes de trasplante hepático en Colombia y el mundo, con excelente sobrevida. Metodología. Estudio descriptivo observacional donde se realizó una caracterización de los pacientes con trasplante hepá-tico por hepatopatía alcohólica en una institución de cuarto nivel, que incluyó un estudio cualitativo de la recaída en el consumo de alcohol postrasplante. Resultados. De 87 pacientes de una cohorte inicial de 96 pacientes trasplantados entre 2003 y 2021, se describieron características sociodemo-gráficas, comorbilidades previas y adquiridas posterior al trasplante, supervivencia del paciente y del injerto, y factores de riesgo asociados al consumo de alcohol. Adicionalmente, a 65 pacientes se les pudo realizar una entrevista estructurada para evaluar la recaída en el consumo de alcohol, 41,53 % volvieron a consumir alcohol; 23,07 % en patrón de riesgo de recaída y 18,46 % en patrón de slip (desliz). El antecedente de hepatitis alcohólica tuvo un RR de 3,273 (1,464­7,314) y p=0,007 para recaída en el consumo de alcohol, y la comorbilidad psiquiátrica un RR de 2,395 (1,002­5,722) y p=0,047. Finalmente, haber presentado al menos una recaída postrasplante tuvo un RR de 5,556 (1,499­20,588) con p=0,005 para rechazo del injerto. Conclusiones. La recaída en el consumo de alcohol fue frecuente, la hepatitis alcohólica previa y la comorbilidad psiquiátrica son factores de riesgo asociados. La recaída se asoció a rechazo del injerto sin afectar la sobrevida del paciente.

Introduction. Alcohol-induced liver disease has been considered a self-inflicted disease that limited access to transplantation. It is currently one of the main indications for liver transplantation in Colom-bia and the world, with excellent survival. Methodology. Observational descriptive study where a characterization of liver transplant patients due to alcoholic liver disease was carried out in a fourth level institution, which included a qualitative study of relapse in post-transplant alcohol consumption. Results. Of 87 patients from an initial cohort of 96 transplant patients between 2003 and 2021, sociodemographic characteristics, previous and acquired post-transplant comorbidities, patient and graft survival, and risk factors associated with alcohol consumption were described. Additionally, 65 patients were able to undergo a structured interview to assess relapse in alcohol consumption, 41.53% returned to alcohol consumption; 23.07% in risk relapse pattern, and 18.46% in slip pattern. The history of alcoholic hepatitis had a RR of 3.273 (1.464-7.314) and a p=0.007 for relapse in alcohol consumption, and psychiatric comorbidity a RR of 2.395 (1.002-5.722) and a p=0.047. Finally, having presented at least one post-transplant relapse had a RR of 5.556 (1.499-20.588) with ap=0.005 for graft rejection. Conclusions. Relapse in alcohol consumption was fre-quent, previous alcoholic hepatitis and psychiatric comorbidity were associated risk factors. Relapse was associated with graft rejection without affecting patient survival.

Identification of potential hub genes involved in alcohol use disorder via bioinformatics analysis / 四川精神卫生

BackgroundAlcohol use disorder （AUD） is a type of chronic relapsing brain disorder. Genetic factors play an important role in the pathogenesis of AUD. And screening for molecular markers of AUD is of great significance for further elucidating the pathogenesis of the disease， discovering novel therapeutic targets and preventing relapse. ObjectiveTo explore relevant hub genes and potential signal pathways associated with the development of AUD through bioinformatics analysis， and to provide a new direction for the prevention and treatment of AUD. MethodsThe GSE161986 dataset was acquired from the Gene Expression Omnibus （GEO） database. The limma package in R was utilized to identify differentially expressed genes （DEGs）. Gene set enrichment analysis （GSEA） was carried out using the Database for Annotation， Visualization and Integrated Discovery （DAVID）. A protein–protein interaction （PPI） network of DEGs was assessed using the STRING database and visualized by Cytoscape software. Finally， hub genes were validated in GSE44456 dataset. ResultsA total of 114 DEGs were identified. GSEA revealed that these genes were mainly involved in the regulation of signal transduction， protein binding， membrane trafficking and MAPK signaling pathway. PPI network and validation study indicated that GAD1， TIMP1 and CD44 were potential hub genes involved in AUD. ConclusionAberrant expression of GAD1 and TIMP1 as well as MAPK signaling pathway may play a key role in the pathogenesis of AUD， and may serve as potential molecular targets for the diagnosis and treatment of AUD. ［Funded by "Flying Project" of Shanghai Mental Health Center （number， 2022-FX-01）］

Perceived discrimination and alcohol consumption in an indigenous population / Discriminación percibida y consumo de alcohol en una población indígena

Abstract Introduction Indigenous populations are considered a vulnerable minority and have characteristics such as poverty, difficulties to access food, housing, and educational backwardness; these conditions make them prone to alcohol consumption problems. Dependence on alcohol consumption probably arises as a symbol of protest, challenge, and response to social anguish, which has in turn repercussions in marginal population sectors that have conditions of fragility due to exploitation and discrimination, such as indigenous people. Objective To know the effect of perceived discrimination on alcohol consumption in Mexican indigenous population. Method Research design was descriptive, correlational check-model, with a sample of 362 adults from two indigenous communities. Results A simple linear regression model was performed, which shows a significant effect in the entire model (F[248] = 78.312, p = .001), which explains 49% of the variance of alcohol consumption. A significant positive influence was also found from the perceived discrimination variable (β = .626, p < .001) on alcohol consumption. Discussion and conclusion The studied indigenous communities had characteristics that the literature highlights as risk factors for developing addictive behaviors of alcohol consumption. These results coincide with those of the National Commission for the Development of Indigenous Peoples. Indigenous population present discrimination problems that are associated with alcohol consumption problems.

Resumen Introducción Las poblaciones indígenas se consideran minoritarias y vulnerables, y se caracterizan por su pobreza, dificultad para acceder a la alimentación, la vivienda y el rezago educativo. Estas condiciones los vuelven propensos a presentar problemas de consumo de alcohol. La dependencia al consumo de alcohol surge probablemente como símbolo de protesta, reto y respuesta a la angustia social, lo cual repercute en los sectores poblacionales marginales que poseen condiciones de fragilidad por la explotación y discriminación como los pueblos indígenas. Objetivo Conocer el efecto de la discriminación percibida en el consumo de alcohol en poblaciones indígenas mexicanas. Método El diseño del estudio fue descriptivo, correlacional de comprobación de modelo, con una muestra de 362 adultos de dos comunidades indígenas. Resultados Se realizó el modelo de regresión lineal simple el cual muestra efecto significativo en la totalidad del modelo (F[248] = 78.312, p = .001), explica el 49% de la varianza del consumo de alcohol, además se encontró influencia positiva significativa de la variable discriminación percibida (β = .626, p < .001) sobre el consumo de alcohol. Discusión y conclusión Las comunidades indígenas estudiadas poseen características que la literatura destaca como factores de riesgo para desarrollar conductas adictivas de consumo de alcohol, estos resultados coinciden con lo expuesto por la Comisión Nacional para el Desarrollo de los Pueblos Indígenas. Las poblaciones indígenas presentan problemas de discriminación que se asocian con los problemas de consumo de alcohol.

Alcohol Use Disorders and Diabetes Mellitus

Alcohol use disorder is a chronic relapsing brain disorder and is associated with high mortality and morbidity. Chronic alcohol use worsens diabetes and associated diabetes-related complication. Alcohol use, especially over the long-term, can impact the glycemic control in persons with diabetes mellitus. Heavy consumption of alcohol in people with diabetes can lead to worsening of diabetes-related complications like diabetic ketoacidosis, altered lipid metabolism, peripheral neuropathy, sexual dysfunction and cardiovascular disease. This review aims to describe the association between alcohol use and glucose tolerance, effects of alcohol on the pre-existing diabetes; association between alcohol use, diabetes mellitus and diabetes-related complications and interaction of medicines used to treat diabetes with alcohol.

Prevalence and Pattern of Substance Abuse among 18 to 60 years Male in a Rural Area of District Etawah, Uttar Pradesh

Abstract: Adolescent and young people’s behavior is of major concern due to Substance abuse. According to WHO, Substance abuse is consistently or sporadic drug use inconsistent with or unrelated to acceptable medical practice. Globally, alcohol and tobacco as a risk factors cause 4.0% and 4.1% of the overall burden of disability respectively. Objective: To determine the prevalence of substance abuse among 18 to 60 years’ male in rural Etawah and to identify type and pattern of substance abuse. Material and Methods: It was a community based cross sectional study carried out in five block of district Etawah for a period of one and half year. 1500 participants were interviewed using pre designed pre-tested questionnaire and data regarding socio demographic profile and pattern of abuse were collected. Data was entered in Microsoft excel sheet and analyzed by SPSS version 24 using appropriate statistical test. Result: Among 1500 participants, majority were below 30 years of age (i.e. 42.8%). In this study prevalence of Substance use among was 47% [707/1500]. Among all the other substance use, smokeless tobacco showed highest prevalence. Conclusion: Substance use is common in both urban as well as in rural area. So there is a need to educate and aware people regarding bad effects of drug abuse.

What Persuades College Students to Take That First Sip? - A Study on The Influence of Society and Media on Attitude Towards Alcohol Consumption

Background: According to WHO statistics, close to 3 million deaths occur every year due to harmful use of alcohol of which 3.2 lakh people are aged between 15-29 years. College students are more prone to experimenting and risk taking behavior. Keeping this in mind, our study was aimed to assess the alcohol use patterns and factors associated with alcohol consumption among college students. Methodology: A cross-sectional study was conducted including college students from various streams in the South Indian states of Kerala and Tamil Nadu. Data was collected from 1129 participants using a self-administered questionnaire consisting of 4 sections including socio-demographic details, alcohol use patterns, attitude towards alcohol consumption and media exposure. Results: Prevalence of alcohol consumption in the sample population was found to be 31% (348). Among the 348, 30.2% (105) reported that one of the reasons for the consumption of the first drink of alcohol was peer-pressure. Higher prevalence of alcohol consumption seen among the groups with higher media exposure and higher tolerance to alcohol advertising was found to be statistically significant. The study statistics show that 600(53.14%) participants were exposed to actors consuming alcohol in media more than 10 times in the past 30 days while only 320(28.34%) reported seeing warnings or health education material in the same duration. Conclusion: Considering the above findings, it is high time policy makers focused on using media for health promotion and health education, since it is proving to have the potential to influence the decisions and lifestyles of the future generations.

Contingency Management applied to Alcohol Use Disorder: Systematic Review / Manejo de Contingência Aplicado ao Transtorno por Uso de Álcool: Revisão Sistemática

Abstract This systematic review evaluated the efficacy of applying Contingency Management (CM) to Alcohol Use Disorder. We followed the PRISMA recommendation and consulted the following databases: Cochrane Library, MEDLINE Complete, PsycINFO and Pubmed. A total of eight randomized controlled trials were included in this review, all of them with good methodological quality. In seven of these, CM was more effica​cious in promoting continuous abstinence. Both trials that evaluated treatment retention found statistically significant results favorable to CM. On two of the three trials presenting follow-up results, CM was more efficacious in promoting abstinence. The large-scale application of CM can promote substantial public health improvements and should be encouraged.

Resumo Esta revisão sistemática avaliou a eficácia do Manejo de Contingência (MC) no tratamento do Transtorno por Uso de Álcool. Para isso, foi utilizada a recomendação PRISMA e consultadas as bases de dados: Cochrane Library, MEDLINE Complete, PsycINFO e Pubmed. Foram incluídos oito ensaios clínicos randomizados nesta revisão. Em sete, o MC foi mais eficaz em promover abstinência continuada. Dos dois que avaliaram a retenção no tratamento, ambos encontraram resultados estatisticamente favoráveis ao MC. Dos três que apresentaram resultados de avaliação de seguimento, em dois o MC foi mais eficaz em promover abstinência. Todos apresentaram boa qualidade metodológica. A aplicação do MC em larga escala pode promover melhorias substanciais para a saúde pública e deve ser encorajada.

Comportamentos sexuais de risco, orientação sexual, uso de substâncias e saúde mental: Um estudo de base populacional no Brasil / Risky sexual behaviors, sexual orientation, substance use, and mental health: A population-based study in Brazil

A presente tese trata-se de um estudo de prevalências e associações no âmbito da sexualidade e dos comportamentos sexuais. Foram utilizados os dados do novo módulo de atividade sexual incluído na Pesquisa Nacional de Saúde (PNS) em 2019 voltado para a população de 18 anos ou mais de idade (n=85.859). No primeiro artigo, foi traçado um panorama dos comportamentos sexuais de risco na população adulta relacionados ao não uso de preservativo na última relação sexual e à iniciação sexual precoce (antes dos 15 anos). Foram calculadas as prevalências, e respectivos intervalos de confiança (IC), dos desfechos segundo características socioeconômicas, demográficas e regionais da população. Observou-se que a iniciação sexual precoce é mais prevalente entre pessoas das gerações mais novas, com menores níveis de instrução e rendimento domiciliar. O não uso de preservativo foi mais prevalente entre mulheres, mais velhos e casados ou em coabitação. Foram observadas disparidades relevantes no não uso do preservativo entre os sexos no grupo dos que não coabitam com parceiro. No segundo artigo, avaliou-se a associação entre o consumo pesado de álcool e o uso inconsistente de preservativo entre pessoas de 18 a 59 anos solteiras, viúvas ou divorciadas que não coabitavam com parceiro (n=15.835). Foram estimadas razões de prevalências ajustadas (RPa) com modelos de regressão de Poisson estratificados por sexo e grupos de idade. Verificou-se que indivíduos de todas as faixas etárias e ambos os sexos com padrão de consumo pesado de álcool foram significativamente mais propensos ao uso inconsistente de preservativo que os demais. As estimativas obtidas não foram consideradas estatisticamente diferentes entre adultos jovens (RPa 1,32, IC 95%: 1,14-1,54) e de meia idade (RPa 1,31; IC 95%: 1,19-1,44 para pessoas de 25 a 39 e RPa 1,26; IC 95%: 1,13-1,40 para 40 a 59 anos). No terceiro e último artigo da presente tese, o uso de substâncias (álcool e tabaco) e a depressão foram analisados segundo a orientação sexual autoidentificada da população adulta. Foram estimadas as prevalências e razões de prevalência ajustadas por meio de modelos de regressão de Poisson estratificados por sexo para cada um dos desfechos analisados. Após controle por covariáveis, homens gays apresentaram maior prevalência de depressão, uso diário de tabaco e uso nocivo de álcool e tabaco (RPa entre 1,71 e 1,92) e homens bissexuais com maiores prevalências (quase três vezes) de depressão que homens heterossexuais. Mulheres lésbicas apresentaram maior prevalência de binge drinking, heavy drinking, uso diário de tabaco e uso nocivo de álcool e tabaco que mulheres heterossexuais (RPa entre 2,55 e 4,44). Entre as mulheres bissexuais os resultados foram significativos para todos os desfechos analisado (RPa variou entre 1,83 e 3,26). Sendo assim, essa tese fornece evidências relevantes para subsidiar ações em saúde pública que visem a redução de comportamentos sexuais de risco e das disparidades em saúde relacionadas a orientação sexual da população adulta brasileira.

This thesis is a study of prevalence and associations in the scope of sexuality and sexual behavior. Data are from the new module of sexual activity included in the National Health Survey (PNS, for its Portuguese acronym) in 2019, aimed at the population aged 18 and over (n=85,859). In the first article, a panorama of risky sexual behaviors in the adult population related to the non-use of condoms in the last sexual intercourse and early sexual initiation (before 15 years of age) was performed. Prevalence, and respective confidence intervals (CI), of the outcomes were calculated according to socioeconomic, demographic and regional characteristics of the population. It was observed that early sexual initiation is more prevalent among younger generations, with lower education levels and household income. Non-use of condoms was more prevalent among women, older people and married/cohabiting with a partner. Relevant disparities in non-use of condom between the sexes were observed in the non-cohabiting unmarried group. In the second article, the association between heavy alcohol consumption and inconsistent condom use was investigated among unmarried not cohabiting with a partner people aged 18 to 59 years (n=15,835). Adjusted prevalence ratios (APR) were estimated with Poisson regression models stratified by sex and age groups. It was observed that individuals from all age groups and both sexes who have heavy drinking pattern were significantly more likely to inconsistent condom use. The estimates were not considered statistically different between young (APR 1.32, 95% CI: 1.14-1.54) and middle-aged adults (APR 1.31; 95% CI: 1.19-1.44 for aged 25 to 39 and APR 1.26; 95% CI: 1.13-1.40 for aged 40 to 59 years). In the third and last article of this thesis, substance use (alcohol and tobacco) and depression were analyzed according to the self-identified sexual orientation of the adult population. Prevalence and adjusted prevalence ratios were estimated using Poisson regression models stratified by sex for each outcome. After controlling for covariates, gay men had a higher prevalence of depression, daily tobacco use and hazardous use of alcohol and tobacco (APR between 1.71 and 1.92) and bisexual men had a higher prevalence (almost three times) of depression than heterosexual men. Lesbian women had a higher prevalence of binge drinking, heavy drinking, daily tobacco use and hazardous use of alcohol and tobacco than heterosexual women (APR between 2.55 and 4.44). Among bisexual women, the results were significant for all outcomes analyzed (APR ranged between 1.83 and 3.26). Therefore, this thesis provides relevant evidence to support public health actions aimed at reducing risky sexual behavior and health disparities related to sexual orientation in the Brazilian adult population.

O impacto da pandemia de covid-19 na assistência à saúde mental de usuários de álcool nos Centros de Atenção Psicossocial / The impact of the covid-19 pandemic on mental health care for alcohol users in Psychosocial Care Centers

Resumo A preocupação com o consumo prejudicial de álcool está na interseção da pandemia com a saúde mental. Mudanças nos padrões de consumo durante a crise sanitária têm sido documentadas no Brasil e internacionalmente. Este estudo avaliou o impacto da pandemia nos procedimentos a usuários de álcool no Brasil, por meio dos registros dos Centros de Atenção Psicossocial (CAPS). Selecionaram-se dados de janeiro de 2019 a dezembro de 2020, com discriminação por macrorregião geográfica, sexo, idade e raça/cor. Realizou-se análise descritiva, cálculo da variação percentual e distribuição em séries temporais. A análise comparativa apontou redução nos procedimentos no início da pandemia (-52,4%), com diferenças entre sexo e faixa etária. Observou-se diferenças entre macrorregiões, com pior resultado no Norte do país (-70,1%). O segundo semestre de 2020 apresentou retomada nos procedimentos, porém em quantidade aquém do realizado no ano anterior (-41,7%). Houve aprofundamento das desigualdades já existentes, especialmente com a queda mais elevada nas macrorregiões mais pobres, com maior fragilidade na rede de saúde mental. Dada a magnitude do álcool como problema de saúde pública e o papel central dos CAPS, ressalta-se a necessidade de instituir políticas e programas de saúde visando minimizar o impacto da pandemia na redução da assistência psicossocial.

Abstract The concern with harmful alcohol consumption is at the intersection of the pandemic and mental health, with changes in drinking patterns during the health crisis being documented in Brazil and internationally. This study assessed the impact of the pandemic on the mental health care of alcohol users in Brazil by analyzing the attendance records of Psychosocial Care Centers (CAPS). Data were collected from January 2019 to December 2020, broken down by geographic macro-region, gender, age, and ethnicity/color. Descriptive analysis, calculation of percentage variation, and time-series distribution were performed. Comparative analysis showed a reduction in care at the beginning of the pandemic (-52,4%), with differences between gender and age groups. As for the differences observed between macro-regions, the North had the worst results (-70,1%). The second semester of 2020 saw an increase in the number of appointments, but less than in the previous year (-41,7%). Pre-existing inequalities were worsened, especially in the poorest macro-regions, with greater fragility in the mental health network. Given the magnitude of alcohol as a public health issue and the key role played by CAPS, health policies and programs aimed at minimizing the impact of the pandemic in psychosocial care are urgent.

Effects of repetitive transcranial magnetic stimulation on attention to the cues for male patients with alcohol use disorder after acute withdrawal / 中华行为医学与脑科学杂志

Objective:To investigate the effect of high-frequency repetitive transcranial magnetic stimulation(rTMS)on cue attention in male patients with alcohol use disorder (AUD) after the acute withdrawal.Methods:A total of 90 male patients AUD who were hospitalized in the Second Affiliated Hospital of Kunming Medical University and Psychiatric Hospital of Yunnan province from May 2020 to December 2020 were enrolled, then they were divided into study group and control group using random number table.Because 18 cases fell out during the study, 36 cases were included in each of the two groups.After the alcohol withdrawal syndrome eliminated, the study group received high-frequency rTMS at 10 Hz for 14 consecutive days, and the control group was administrated by sham rTMS.At baseline and after true or sham rTMS, the cognitive psychology experiment Oddball paradigm was completed, and the behavioral data of the subjects were collected.Paired-sample t-test was used to compare the changes of the two groups before and after treatment.Data analysis were conducted using SPSS 21.0 software. Results:There was no statistical difference between the study group and the control group in terms of drinking level, cognition level and demographic data(all P>0.05). In the Oddball paradigm, compared with the control group((526.72±75.30)ms, (0.98±0.02))the reaction time((497.93±64.51)ms, t=3.145, P=0.008) and accuracy rate((0.99±0.01), t=-2.803, P=0.016) in alcohol-related cues were significantly improved in the study group after rTMS intervention, but in the control group, there were no statistical differences(both P>0.05), whether the cue was alcohol related or not. Conclusion:The results suggest that the rTMS can enhance the attention bias of alcohol-related cues and change the impulse process partly.

Research progress on mechanism of comorbid alcohol use disorder and depressive disorder / 四川精神卫生

In this paper， the latest research progress on the mechanism of comorbid alcohol use disorder and depressive disorder at home and abroad is elucidated from genetic， neurochemical， neuroendocrine and neuroimmunologic perspectives. It aims to identify the gaps in current research and predict future research directions， providing a further basis for the clinical management of comorbid alcohol use disorder and depressive disorder.

The Relation between Behavioral, Emotional and Cognitive Apathy and Everyday Executive Dysfunction in Alcoholic Korsakoff's Syndrome

ABSTRACT Background: Apathy is an important neuropsychiatric symptom in alcohol-related cognitive impairment in general, and Korsakoff's syndrome in specific. However, research in patients with Korsakoff's syndrome on the multifaceted nature of apathy is lacking. Objectives: Aim of the current study was to examine behavioral, cognitive and emotional apathy in alcoholic Korsakoff patients, also investigating the association with overall cognitive and executive dysfunction. Methods: We studied 43 patients with Korsakoff's syndrome (mean age 60.9, SD=6.5, range 38-70) using the Apathy Evaluation Scale - Informant Version (AES-I) and also administered the Montreal Cognitive Assessment and the Behavior Rating Inventory of Executive Function - Adult Version (BRIEF-A) as a measure of daily executive problems. Results: In our sample, 76% of the Korsakoff patients were classified as being apathetic. AES-I scores correlated with overall cognitive function and were related to observer-rated daily executive problems. Discussion: Apathy is highly prevalent in Korsakoff patients and related to overall cognitive dysfunction and everyday executive problems. Our results stress the need to further examine underlying mechanisms of apathy in Korsakoff patients and the need for interventions aimed at reducing apathy.

Disclosure Attitudes, Beliefs, and Behaviors in Recovery from Problematic Alcohol Use: A US Sample

Abstract Social support has been found to positively assist in recovery from problematic alcohol use. This project examined the relationship between disclosure of alcohol recovery status to social connections, and longest period of alcohol abstinence. This cross-sectional study had (N=154) adult participants from the US who were in recovery from problematic alcohol use. Beyond demographic data, participants reported on a variety of things including medical, psychiatric and recovery history. Longest period of alcohol abstinence was associated with participant's level of openness to disclosure, belief in the efficacy of disclosing, number of social connections disclosed to and categories of people one disclosed to. The most common social connections disclosed to were close friends, support groups, and healthcare providers. Disclosing to one's parents, grandparents and children corresponded to the longest periods of alcohol abstinence. Our findings suggest that disclosing recovery status to social connections may support longer periods of alcohol abstinence.

Resumen Se ha comprobado que el apoyo social contribuye positivamente a la recuperación del consumo problemático de alcohol. Este proyecto examinó la relación entre la divulgación del estado de recuperación del alcohol a las conexiones sociales y el período más largo de abstinencia de alcohol. Este estudio transversal tuvo (N=154) participantes adultos de los Estados Unidos que se estaban recuperando del consumo problemático de alcohol. Más allá de los datos sociodemográficos, los participantes informaron sobre una variedad de cosas, incluyendo historia médica, psiquiátrica y de recuperación. El período más largo de abstinencia de alcohol se asoció con el nivel de apertura de los participantes a la divulgación, el número de conexiones sociales reveladas y las categorías de personas a las que se reveló. Las conexiones sociales más comunes reveladas fueron amigos cercanos, grupos de apoyo y proveedores de atención médica. Revelar a los padres, abuelos e hijos correspondía a los períodos más largos de abstinencia al alcohol. Nuestros hallazgos sugieren que revelar el estado de recuperación a las conexiones sociales puede apoyar períodos más largos de abstinencia al alcohol.

Associated Factors Of Alcohol Use Disorder Among Men Who Have Sex With Men

@#Introduction: Considerable evidence exists that Man who have Sex with Men (MSM) experiences worse health disparities compared to the general population across the globe including higher rates of alcohol use disorder. This review summarized the available primary research information to provide a comprehensive understanding of the factors associated with Alcohol Use Disorder among MSM. Methods: A literature review of PubMed articles was done. A total of 85 papers about the MSM population were displayed. Twelve articles about Alcohol Use Disorder among MSM were reviewed to extract its associated factors. Afterward, these factors were arranged by themes. Results: The associated factors of Alcohol Use Disorder among the MSM were social and demographic factors, abuses, sexual behaviors, HIV-related factors, other mental health conditions, and previous Alcohol Use Disorder treatment. Conclusions: Some of the factors associated with Alcohol Use Disorder among MSM may be similar to the general population, while others may be unique to the MSM population. The associations between Alcohol Use Disorder and these factors may be explained by Alcohol’s biological factors, adverse social experiences based on their sexual minority background, cultural differences, and coping styles. These factors may also increase the risk of MSM for other

The correlation of HDAC2 polymorphisms with alcohol use disorder in male people of Han nationality / 中华行为医学与脑科学杂志

Objective:To explore the association between polymorphism of Histone Deacetylase 2 (HDAC2) gene and alcohol use disorder (AUD) in male people of Han nationality for seeking suitable single nucleotide loci(SNP), and provide reference for early diagnosis and intervention of alcohol use disorder(AUD).Methods:A total of 194 male AUD patients of Han nationality (case group) and 310 normal men of Han nationality (control group) were selected for the study. The genomic DNA of peripheral blood of the subjects in the two groups was extracted, and 13 SNP loci of HDAC2 gene were obtained from HapMap database. The subjects in the two groups were genotyped by Agena MassARRAY SNP genotyping method.SPSS 25.0 was used to statistically analyze the differences of genotype frequency and allele frequency between the two groups, and Haploview 4.2 software was used for linkage disequilibrium and haploid analysis. The multiple test correction was carried out by the replacement test with 50 000 replacement times.Results:The genotype frequency of the 3 SNP loci(rs9481408, rs6568819, rs9488289) of HDAC2 gene were statistically significant different between the case group and the control group (all P<0.05). Further analysis found that the three loci were significantly correlated with AUD in the recessive genetic model between case group and control group(T/T vs C/C-C/T: OR=1.78, 95% CI: 1.05-3.03, P=0.033; T/T vs C/C-C/T: OR=1.79, 95% CI: 1.05-3.03, P=0.032; G/G vs C/C-C/G: OR=1.85, 95% CI: 1.09-3.13, P=0.022). Seven SNP haplotypes were constructed and the association odds ratio of GATCTGCAATAA between the case group and control group was 2.44, and the difference was statistically significant ( P<0.05). Conclusion:The SNP loci rs9481408, rs6568819, rs9488289 in the HDAC2 gene and haplotype GATCTGCCAATAA are associate with AUD in male people of Han nationality. These results indicated that the HDAC2 gene is one of the susceptibility genes of AUD.

Métodos cognitivos e comportamentais para quando o paciente não está disponível para parar de beber / Cognitive and behavioral methods when the patient is not available to stop drinking

As orientações para a prática clínica dos Transtornos Relacionados ao Álcool (TRA) preconizam que a avaliação dos pacientes deve ser efetuada desde logo sob os princípios da abordagem motivacional e que devem ser disponibilizadas intervenções psicológicas baseadas na terapia cognitivo-comportamental para prevenção da recaída ou treinamento do beber "moderado" (quando apropriado), que possam ser combinadas com fármacos. Considerando que existem poucas evidências sobre o que fazer quando os pacientes não estão preparados para parar totalmente de beber ou no período que antecede o início de um programa de desintoxicação medicamente assistida, esta revisão incidiu sobre os vários métodos comportamentais e cognitivos que podem ser aplicadas nos casos em que a cessação total do consumo do álcool não se coloca como objetivo terapêutico imediato. As seguintes abordagens foram apresentadas: método BRENDA, Intervenção Comportamental para Preparação da Abstinência, Método Comportamental de Extinção de Sinclair, Experiência de um Mês de Abstinência e as Técnicas de Moderação/Controle. Foram discutidos e caracterizados vários métodos comportamentais que permitem repensar radicalmente os tratamentos tradicionais para os TRA.(AU)

Guidelines for the clinical practice of alcohol use disorders (AUD) suggest that patient assessment should be carried out immediately under the principles of the motivational approach and that psychological interventions based on cognitive behavioral therapy should be available to prevent relapse or "moderate" (when appropriate) drinking, which can be combined with medication. Given that there is little evidence on what to do when patients are not fully prepared to stop drinking or in the period preceding the start of a medically assisted detoxification program, this review focused on the various behavioral and cognitive methods that may be applied in cases where the total cessation of alcohol consumption is not an immediate therapeutic goal. The following approaches were presented: the BRENDA method, Behavioral Intervention for Abstinence Preparation, Sinclair's Behavioral Extinction Method, One Month Abstinence Experienceand the Moderation/Control Techniques. Several behavioral methods have been discussed and characterized allowing a radical rethinking of traditional treatments for AUD.(AU)

Las orientaciones para la práctica clínica de las perturbaciones del uso del alcohol (PUA) preconizan que la evaluación de los pacientes debe ser efectuada desde el principio bajo los principios del abordaje motivacional y que deben ser disponibles intervenciones psicológicas basadas en la terapia cognitivo-conductual para prevenir la recaída o entrenar el beber "moderado" (cuando sea apropiado), las cuales pueden ser combinadas con fármacos. Teniendo en cuenta que hay pocas evidencias sobre qué hacer cuando los pacientes no están preparados para parar totalmente de beber o en el período anterior al inicio de un programa de desintoxicación médicamente asistida, esta revisión se centró en los diversos métodos conductuales y cognitivos que pueden ser se aplican en los casos en que el cese total del consumo de alcohol no se plantea como objetivo terapéutico inmediato. Se presentaron los siguientes enfoques: método BRENDA, intervención conductual para la preparación de la abstinencia, método de extinción conductual Sinclair, Experiencia de un mes de abstinenciay técnicas de moderación/control. Se discutieron y caracterizaron varios métodos comportamentales que permiten repensar radicalmente los tratamientos tradicionales para las PUA.(AU)