Living frisbees: riesgos de patologías mentales en niños y niñas expuestos a thc durante su gestación / Living frisbees: risks of mental pathologies in boys and girls exposed to thc during their pregnancy

La Cannabis sativa es una planta que contiene componentes psicoactivos (principalmente tetrahidrocannabinol) y actualmente corresponde a la droga ilícita más consumida a nivel mundial. Además, desde el área de la salud mental, ha habido un creciente interés en evaluar la relación entre el consumo de marihuana y el desarrollo de trastornos mentales. En este contexto, considerando tanto este creciente aumento en su consumo a nivel mundial y el interés por conocer si está involucrada en la patogénesis de patologías de la esfera psiquiátrica, es clave analizar qué posibles riesgos de desarrollar patologías mentales presentan aquellos niños expuestos al tetrahidrocannabinol durante la gestación. A partir de esta situación, el objetivo de este FRISBEEs es determinar si los niños/as expuestos a THC durante su gestación tienen un mayor riesgo de patologías mentales, en comparación a aquellos niños no expuestos durante su gestación. Los materiales y métodos utilizados para responder esta pregunta fueron obtenidos a partir de una búsqueda bibliográfica en dos bases de datos, donde se analizó la evidencia disponible, y se seleccionó el estudio primario titulado "Maternal tobacco, cannabis and alcohol use during pregnancy and risk of adolescent psychotic symptoms in offspring", ya que era el que más se aproximaba a poder responder nuestra pregunta clínica. Este se analizó de forma crítica, llegando al resultado de que el estudio no fue concluyente en establecer una asociación entre el uso de cannabis y síntomas psicóticos. Como conclusión, dado que no se pudo llegar a establecer una asociación entre el uso de cannabis y el desarrollo de patologías mentales, se debería realizar más investigación sobre el tema dado la magnitud del consumo de cannabis a nivel mundial, para así poder llegar a conclusiones clínicas basadas en la evidencia y poder dar recomendaciones clínicas a las pacientes embarazadas.

Cannabis sativa is a plant that contains psychoactive components (mainly tetrahydrocannabinol) and currently corresponds to the most widely consumed illicit drug worldwide. In addition, from the area of mental health, there has been a growing interest in evaluating the relationship between marijuana use and the development of mental disorders. In this context, considering both this growing increase in its consumption worldwide and the interest in knowing if it is involved in the pathogenesis of pathologies in the psychiatric sphere, it is essential to analyze what possible risks of developing mental pathologies present those children exposed to tetrahydrocannabinol during gestation. Based on this situation, the objective of this FRISBEEs is to determine whether children exposed to THC during their pregnancy have a greater risk of mental pathologies, compared to those children not exposed during their pregnancy. The materials and methods used to answer this question were obtained from a bibliographic search in two databases, where the available evidence was analyzed, and the primary study entitled "Maternal tobacco, cannabis and alcohol use during pregnancy and risk of adolescent psychotic symptoms in offspring ", as he was the closest to answering our clinical question. This was critically analyzed, reaching the result that the study was not conclusive in establishing an association between the use of cannabis and psychotic symptoms. In conclusion, given that it was not possible to establish an association between the use of cannabis and the development of mental pathologies, more research should be carried out on the subject given the magnitude of cannabis use worldwide, in order to reach conclusions. evidence-based clinics and to be able to give clinical recommendations to pregnant patients

Padrões de uso de drogas e problemas associados em adolescentes judicializados / Drug use patterns and associated problems amongaAdolescent offenders / Patrones de consumo de drogas y problemas asociados en adolescentes infractores

Objetivou-se caracterizar uma amostra de adolescentes em conflito com a lei em relação ao consumo de substâncias e possíveis problemas associados. Participaram 120 adolescentes do sexo masculino, entre 13 e 18 anos, custodiados na Unidade de Atendimento Inicial da Fundação CASA, que responderam ao Drug Use Screening Inventory - Revised (DUSI-R). Análises descritivas indicaram que a maioria dos adolescentes teria feito uso de maconha (84%) e álcool (54%). Em relação ao padrão de consumo, 52% foram categorizados em uso abusivo ou de provável dependência. Quanto aos problemas associados ao consumo, os participantes possuem densidade média superior aos da população normativa nos dez domínios investigados pelo DUSI-R, com destaque aos Transtornos (M = 42), Escola (M = 50) e Pares (M = 55). Vale observar que 37% da amostra se declararam abstêmios, e que os desvios das densidades de problemas sugerem alta heterogeneidade nos níveis de necessidades/dificuldades, o que implica ultrapassar discursos que propalam a uniformidade dessa população. (AU)

This study aimed to characterize a sample of adolescents in conflict with the law regarding substance use and potential associated problems. The sample consisted of 120 male adolescents aged 13 to 18 in custody at the Initial Care Unit from Fundação CASA (Center for Adolescent Socio-Educational Care) in the state of São Paulo, who responded to the Drug Use Screening Inventory - Revised (DUSI-R). Descriptive analyses indicated that most adolescents were reported to have used marijuana (84%) and alcohol (54%). Regarding the pattern of consumption, 52% were categorized as abusive use or probable dependence. Regarding the problems associated with consumption, participants showed a higher mean density than the normative population in the ten domains investigated by the DUSI-R, with emphasis on Disorders (M = 42), School (M = 50), and Peers (M = 55). It is worth noting that 37% of the sample declared themselves abstainers and that the deviations of the problem densities suggest high heterogeneity in the levels of needs/difficulties, which implies overcoming discourses that promote the uniformity of this population. (AU)

Este estudio tuvo como objetivo caracterizar una muestra de adolescentes en conflicto con la ley por el consumo de sustancias y posibles problemas asociados. Participaron de la muestra 120 adolescentes varones de 13 a 18 años en custodia de la Unidad de Atención Inicial de la Fundación CASA, quienes respondieron al Drug Use Screening Inventory - Revised (DUSI-R). Los análisis descriptivos indicaron que la mayoría de los adolescentes habrían consumido marihuana (84%) y alcohol (54%). Respecto al patrón de consumo, el 52% fue categorizado como uso abusivo o probable dependencia. En cuanto a los problemas asociados con el consumo, los participantes tuvieron una densidad media/superior a la población normativa en los diez dominios investigados por DUSI-R, con énfasis en los Trastornos (M=42), la Escuela (M=50) y Parejas (M=55). Cabe destacar que el 37% de la muestra se declaró abstencionista y que las desviaciones de las densidades del problema sugieren una alta heterogeneidad en los niveles de necesidades/dificultades, lo que implica la superación de discursos que promueven la uniformidad de esta población. (AU)

Perception of freedom in leisure among substance users and nonusers / Percepção de liberdade no lazer entre usuários e não usuários de substâncias / La percepción de la libertad en el ócio entre usuarios y no usuarios de sustâncias

The aim of this study was to verify that substance use among adolescents would be linked to perceptions of freedom in leisure. It was selected for convenience sampling 186 adolescents at Projeto Quixote in a public school in Guarulhos. It used as questionnaire Data Sociodemographic and Leisure, The Leisure Diagnostic Battery, version B (PLL) to measure Perceived Freedom in Leisure and Drug Use Screening Inventory for classification of substance use, all self-administered. Based on 165 reviews analyzed, the frequency of use of ecstasy and marijuana in the last month were related to higher rates of PLL. The number of substances used in the last month had no significant effect. These data suggest specific components of leisure related to the frequency of substance use, such as perceived control and need at leisure. (AU)

O objetivo deste trabalho foi avaliar se o uso de substâncias entre adolescentes de estaria relacionado relacionado à percepção de liberdade no lazer (PLL). Selecionou-se por conveniência 186 adolescentes no Projeto Quixote e de uma escola estadual de Guarulhos. Utilizou-se o Questionário de Dados Sóciodemográficos e de Lazer, The Leisure Diagnostic Battery, version B (PLL) para mensurar a Percepção de Liberdade no Lazer, e o Drug Use Screening Inventory para classificação do uso de substâncias. Dentre as 165 avaliações analisadas, a frequência do uso de ecstasy e maconha no último mês relacionaram-se com maiores índices do PLL e o número de substâncias usadas no último mês não teve efeito significativo. Os dados indicaram que a frequência do uso de substâncias relaciona-se com subitens do PLL. Observou-se tendência ao aumento do PLL conforme o aumento do uso de substâncias. (AU)

El objetivo de este estudio fue verificar que el uso de sustancias entre los adolescentes podría estar vinculada a la percepción de la libertad en el ocio. Fue seleccionado para el muestreo de conveniencia 186 adolescentes en Proyecto Quijote en una escuela pública de Guarulhos. Se utiliza como cuestionario de datos sociodemográficos y de ocio, la batería de diagnóstico Ocio, versión B (PLL) para medir la percepción de la Libertad en Ocio y Uso de Drogas Inventario de cribado para la clasificación del uso de sustancias, todos los auto-administrado. Basado en 165 comentarios analizan, la frecuencia de uso de éxtasis y marihuana en el último mes se relacionaron con mayores tasas de PLL. El número de sustancias utilizadas en el último mes no tuvo ningún efecto significativo. Estos datos sugieren componentes específicos de ocio relacionadas con la frecuencia de uso de sustancias, como el control percibido y necesitan en el ocio. (AU)

Uso de sustancias psicoactivas y calidad de vida relacionada con la salud en adolescentes escolarizados / Psychoactive substances use and health-related quality of life among school age adolescents

Background The use of psychoactive substances among adolescents is a major social and public health concern. Aim To analyze association of substance abuse and multiple drug use with health-related quality of life (HRQOL) in adolescents attending a high school in Valparaiso, Chile. Material and Methods Analytical cross-sectional study conducted in a sample of adolescents attending high school. HRQOL was assessed using KIDSCREEN-52 questionnaire and substance use was measured using the Global school-based student health survey. Participants had to complete online, self-administered, anonymous questionnaires. Multiple logistic regression analyses were conducted to calculate Odd ratios. Results A total of 550 adolescents aged 16 ± 1 years old completed the questionnaires. Thirty nine percent consumed alcohol during the last month, 31% smoked, 33% used marijuana and 33% admitted the use of multiple drugs. High-risk alcohol consumption was associated with a lower perception of psychological well-being, self-perception and school environment. This last dimension was affected in those who admitted marijuana use during the last month. Multiple drug use (three substances) was associated with a lower perception of physical and psychological well-being, self-perception, relationship with parents, family life and school environment. Conclusions High-risk alcohol consumption and multiple drug use (three substances) have a negative impact on the HRQOL of school age adolescents.

Comorbid psychiatric disorders and stages of change in cannabis-dependent, treatment-seeking patients

Objectives: To determine whether and to what extent cannabis dependence is associated with comorbid psychiatric disorders and specific stages of change in treatment-seeking patients. Methods: We evaluated 80 cannabis-dependent, treatment-seeking patients residing in an urban area. Data on cannabis dependence, psychiatric disorders, and motivation were obtained using the Schedules for Clinical Assessment in Neuropsychiatry and the University of Rhode Island Change Assessment (URICA). Results: A diagnosis of schizophrenia was found to correlate with lower motivation scores (p = 0.038), which could have a negative effect on adherence to treatment. Conclusion: The high prevalence of concurrent psychiatric disorders in cannabis-dependent patients should serve as a stimulus for early screening and treatment of such disorders. Health care professionals should be aware of the magnitude of this association to increase the level of motivation in cannabis-dependent patients with severe concurrent psychiatric disorders. .

Padrão de uso de cannabis em dependentes de crack cocaína internados para desintoxicação / Pattern of cannabis use by crack cocaine addictsadmitted for detoxification

Introdução: O presente trabalho teve como objetivo verificar o padrão de uso de cannabis em dependentes de crack/cocaína internados para desintoxicação em uma unidade de internação especializada.Métodos: Pesquisa quantitativa com delineamento exploratório e transversal em amostra não aleatória (n=109) de dependentes de crack/cocaína segundo os critérios da Classificação Internacional de Doenças (CID-10). O protocolo de coleta foi composto por: informações sociodemográficas e descrição do padrão de uso de substâncias psicoativas, Inventário Beck de Ansiedade (BAI) e Inventário Beck de Depressão (BDI).Resultados: Os participantes, com média de idade de 27,82 anos (DP=6,68; 18-49) e com 8,19 (2,56; 4-16) de anos de estudo, estavam internados há cerca de 14,81 dias (DP=11,51; 7-64). Verificou-se que a idade média de início do uso de cannabis (15,17 +-3,29) é bastante inferior à idade de início do uso de crack (22,76 +-6,28). Achados indicam que a cannabis foi a primeira droga ilícita a ser consumida pelos dependentes de crack, sendo que 96,33% desses sujeitos apresentavam dependência de cannabis. Conclusão: Foi encontrada uma correlação positiva (r=0,385) de intensidade baixa entre a idade de início de consumo de crack e de cannabis, concluindo-se que, quanto mais cedo é iniciado o uso de cannabis, mais cedo é iniciado o uso de crack.

Introduction: This study aimed to determine the pattern of cannabis use by subjects addicted to crack/cocaine admitted for detoxification in a specialized unit.Methods: Quantitative research with an exploratory and cross-sectional design using a non-random sample (n= 109) of crack/cocaine addicts according to criteria from the International Classification of Diseases (ICD- 10). The data collection protocol was composed of sociodemographic information and description of the pattern of psychoactive substances use, the Beck Anxiety Inventory (BAI) and the Beck Depression Inventory (BDI). Results: Mean age was 27.82 years (SD= 6.68; 18-49), mean educational attainment was 8.19 years (2.56, 4-16), and patients were hospitalized for about 14,81 days (SD= 11.51;7-64). The average age of onset of cannabis use (15.17 + -3.29) was significantly earlier than the age of onset of crack use (22.76 + -6.28). Findings indicate that cannabis is the first illicit drug consumed by crack addicts, with 96.33% of these subjects presenting cannabis addiction. Conclusion: A positive, low-intensity correlation (0.385) between age of onset of crack use and cannabis use was found. This study concludes that the earlier the onset of cannabis use, the earlier the onset of crack/cocaine use.

Validação psicométrica do Marijuana Craving Questionnaire-Short Form – versão Brasil / Psychometric validation of Marijuana Craving Questionnaire-Short Form – Brazil version

Introdução: O objetivo deste estudo foi realizar a validação psicométrica do Marijuana Craving Questionnaire-Short Form - Versão Brasil (MCQ-SF – Versão Brasil). Métodos: Neste estudo transversal, uma amostra não aleatória de 120 participantes do sexo masculino foi dividida em dois grupos: Grupo 1, incluindo usuários de cannabis da população geral (n=34) e Grupo 2, incluindo pacientes internados em unidade de dependência química e que preenchiam critérios diagnósticos para dependência de cannabis pela CID-10 (n=86). Os indivíduos do Grupo 1, que foram recrutados pelo método snow-ball, deviam estar utilizando a cannabis há pelo menos um ano, tê-la utilizado pela última vez há no mínimo 24 e no máximo 48 horas, e não ser dependentes de outras substâncias psicoativas salvo a nicotina. Os indivíduos do Grupo 2 deviam apenas preencher critérios diagnósticos para dependência de cannabis, não sendo necessário que não fossem dependentes de outras substâncias psicoativas. Além disso, deviam estar utilizando a cannabis há pelo menos um ano e tê-la utilizado pela última vez há no mínimo 24 horas. Os instrumentos utilizados foram: entrevista clínica com dados sociodemográficos, SRQ20, MMSE, MCQ-SF – Versão Brasil, EAV do craving, BDI, BAI, estímulo visual indutor de craving. Resultados: Na análise fatorial, foram encontrados três fatores: Emocionalidade, Intencionalidade e Compulsividade. Os três fatores apresentaram variância total de 66,74%. O alfa de Cronbach do seu total de pontos foi 0,89. O instrumento no total de pontos foi correlacionado com a Escala Analógico-Visual (r=0,644; p<0,01) Conclusões: Conclui-se que o MCQ-SF – Versão Brasil demonstrou ter propriedades psicométricas satisfatórias.

Introduction: We aimed to conduct a psychometric validation of the Marijuana Craving Questionnaire-Short Form – Brazil Version (MCQ-SF – Brazil Version). Methods: In this cross-sectional study, a non-random sample of 120 males were allocated into two groups: Group 1, including cannabis users in the general population (n=34) or Group 2, including patients admitted to a chemical dependency unit and who met diagnostic criteria for cannabis dependence in the ICD-10 (n=86). The subjects in Group 1, who were recruited by the snowball method, should be using cannabis for at least 1 year and for the last time between 24 and 48 hours before data collection. Additionally, they should not have any other addiction except nicotine. Subjects in Group 2 should only fulfill diagnostic criteria for cannabis dependence and may also be dependent on other psychoactive substances. The subjects should be using cannabis for at least one year and for the last time at least 24 hours before data collection. The instruments used were: clinical interview with sociodemographic data, SRQ20, MMSE, MCQ-SF Brazil Version - VAS of Craving, BDI, BAI, and visual stimulus inducing craving. Results: Factor analysis revealed three factors: Emotionality, Intentionality and Compulsivity. The three factors showed a total variance of 66.74%. Cronbach’s alpha of the total score was 0.89. The instrument total score was correlated with the VAS (r=0.644, p<0.01). Conclusions: We conclude that the MCQ-SF – Brazil Version has demonstrated satisfactory psychometric properties.

Illegal psychoactive substance consumption amongst older schoolchildren in the city of Tunja, Colombia / Consumo de sustancias psicoactivas ilegales en adolescentes escolarizados de Tunja, Colombia

Objectives Assessing lifetime prevalence of illegal substance use and accessibility to such substances. Determining risk factors and the protective factors linked to them. Methods This was a cross-sectional study using descriptive and bivariate analysis. A survey was applied to 1,515 students from 8th to 11th grades in the city's schools, ages ranging from 12 to 18. Results An increase in lifetime prevalence and lower age for consumption onset were found. The main risk factors were determined to be academic environment and attitudes towards school authorities, linked to recreational and sports groups without control by elders, gang membership and engaging in risky and dangerous activities. Conclusions The results showed the need for a critical review of current promotion and prevention strategies aimed at controlling the use of psychoactive substances amongst children and adolescents, according to the current reality of trafficking and domestic consumption in Colombia.

Objetivo Evaluar la prevalencia de vida del consumo de sustancias ilegales y la accesibilidad a sustancias ilegales. Determinar factores de riesgo y factores protectores relacionados con el consumo. Métodos Se realizó un estudio de corte transversal mediante el análisis descriptivo y bivariado. Se aplicó una encuesta a 1 515 estudiantes de los grados 8 al 11 en las escuelas de la ciudad, entre las edades de 12 a 18. Resultados Se encontró un aumento de la prevalencia de vida y una disminución en la edad de inicio al consumo. Los principales factores de riesgo encontrados fueron: ambiente académico y las actitudes hacia las autoridades escolares, la vinculación a los grupos de deportes recreativos, no respeto a los mayores, pertenecer a pandillas y participar en actividades riesgosas y peligrosas. Conclusiones Los resultados mostraron la necesidad de una revisión crítica de la promoción actual y las estrategias de prevención destinadas a controlar el uso de sustancias psicoactivas entre los niños y adolescentes, de acuerdo a la nueva realidad de la tráfico y consumo interno en Colombia.

Norma subjetiva, intención y consumo de marihuana en jóvenes universitarios de México / Subjective norm, intention and consumption of marijuana in college students of México

Este artículo tuvo como propósito conocer la relación de la norma subjetiva con la intención y el consumo de marihuana en un grupo de jóvenes universitarios del Norte de México. El diseño del estudio fue descriptivo-correlacional, los datos fueron obtenidos a través de la aplicación de un instrumento sobre la Norma Subjetiva para el consumo de marihuana y analizados en el programa SPSS 18. Participaron 558 jóvenes de nueve facultades de una universidad pública. Los resultados mostraron que 15.1 por ciento ha consumido marihuana alguna vez en la vida. La prevalencia del consumo de marihuana fue mayor en hombres (χ2 =42.5, p<.001), en mayores de 20 años de edad (χ2 =11.64, p<.001) y en los estudiantes de ingenierías y ciencias agropecuarias (χ2=9.54, p<.023). La norma subjetiva se relacionó positivamente con la intención de consumo (rs=.224; p<.001). La norma subjetiva fue más alta en jóvenes que muestran intención de consumo que aquellos que no tienen intención (X= 15.85 y X=6.99; U=20561.5, p<.001), de la misma forma la norma subjetiva fue más alta en los jóvenes que han consumido marihuana que en aquellos que nunca han consumido (X =220.94 y X =7.05; U=28713.5, p<.001). Los resultados presentados aportan al conocimiento de la disciplina de enfermería y áreas a fines, principalmente en la línea de generación de conocimientos de prevención de adicciones y en un futuro podrán servir como base para la justificación de diseños de programas preventivos.

This article was aimed to determine the relationship between subjective norm with intention and marijuana consumption in a group of college students in northern Mexico. The study design was descriptive, co relational; data collection was obtained through the application of a Subjective Norm Instrument for marijuana consumption and analyzed with SPSS 18. Study participants were 558 students from nine faculties of a public university. Results showed that 15.1percent had used marijuana at some time in their life. The prevalence of marijuana consumption was higher in men (χ2=42.5, p<.001), older than 20 years of age (χ2=11.64, p<.001) and students in engineering and agricultural sciences (χ2=9.54, p<.023). The subjective norm is positively related with intention (rs=.224, p<.001). The subjective norm was higher in young people who displayed intention for consumption than those who have no intention (X=15.85 and X=6.99, U=20561.5, p<.001); in the same way, subjective norm was higher in young people that have used marijuana than those who have never used it (X=220.94 and X =7.05, U=28713.5, p<.001). The results are a contribution to the discipline of nursing knowledge and related areas, especially in the line of knowledge generation about addiction prevention, and in the future may serve as a basis for the rationale design of preventive programs.

¿Por qué los adolescentes consumen drogas? / ¿Why do teens use drugs?

La respuesta a esta pregunta es compleja, como complejo es el ser humano. Son muchos los factores y causalidades a tener en cuenta para poder dar respuesta a ella, y por lo tanto, variadas también serán las perspectivas y soluciones a dicha pregunta. Lo primero que hay que decir es que no sólo el adolescente consume drogas; lo hacen también los adultos y otros tipos de poblaciones, pero lo que sí se puede asegurar, es que el adolescente hace parte de la población más vulnerable al problema del consumo de sustancias psicoactivas. Y no sólo se consumen drogas; hoy vivimos en una época en la que se puede decir que se consume de todo, a tal punto que ya se habla de nuevas adicciones. Ya la adicción al alcohol y las drogas parece vieja; hoy se habla de la adicción a las nuevas tecnologías ­de la cual los adolescentes sí que hacen parte­, al juego ­ludopatía­, al sexo, al ejercicio ­vigorexia­, al trabajo, y en fin, casi que se podría ser adicto a cualquier objeto o actividad que el mercado ofrece hoy en día o que la contemporaneidad le demanda al sujeto.

The answer to this question is complex, as complex is the human being. There are many factors and causalities to take into account in order to respond to it, and therefore, the perspectives and solutions to this question will also be varied. The first thing to say is that not only adolescents use drugs; It is also done by adults and other types of populations, but what can be assured is that adolescents are part of the population most vulnerable to the problem of using psychoactive substances. And it's not just drugs; Today we live in a time when it can be said that everything is consumed, to the point that there is already talk of new addictions. Already the addiction to alcohol and drugs seems old; Today there is talk of addiction to new technologies ­of which adolescents do take part­, to gambling ­ludopathy­, to sex, to exercise ­vigorexia­, to work, and finally, you could almost be addicted to any object or activity that the market offers today or that contemporaneity demands of the subject.

Correlates of substance use during adolescent pregnancy in São Paulo, Brazil / Correlatos do uso de substâncias durante a gravidez na adolescência em São Paulo, Brasil

OBJECTIVE: To investigate the association of cocaine and marijuana use during adolescent pregnancy in São Paulo-SP, Brazil, with psychiatric disorders, social status and sexual history. METHOD: One thousand pregnant adolescents were assessed by using the Composite International Diagnostic Interview, and sociodemographic and socio-economic questionnaire at the obstetric center of a public hospital in São Paulo. Hair samples were collected for analysis. RESULTS: The following data were associated with cocaine and/or marijuana use during the third trimester of the pregnancy: being younger than 14 years of age, having a history of more than 3 sexual partners, and having psychiatric disorders, specifically, bipolar disorder, post-traumatic stress disorder, and somatoform disorder. CONCLUSION: In early adolescence pregnancy, having 3 or more sexual partners in life for this population is significantly associated with the use of cocaine or marijuana during gestation. This association suggests that specific intervention programs should target these young women.

OBJETIVO: Investigar, numa população de gestantes adolescentes de uma maternidade pública de São Paulo-SP, Brasil, a associação entre o consumo de cocaína e maconha durante a gravidez com distúrbios psiquiátricos, status social e história sexual. MÉTODO: Mil adolescentes grávidas foram avaliadas por meio do Composite International Diagnostic Interview e de um questionário sociodemográfico e socioeconômico no centro obstétrico de um hospital público de São Paulo. Destas, foi colhida amostra para análise de fios de cabelo. RESULTADOS: Os seguintes dados foram associados com o uso de cocaína e/ou maconha durante o terceiro trimestre de gravidez: ter menos de 14 anos, ter história de mais do que três parceiros sexuais e ter transtornos psiquiátricos, em especial, transtorno afetivo bipolar, transtorno do estresse pós-traumático e transtorno somatoforme. CONCLUSÃO: Na população de adolescentes grávidas avaliada, ter menos de 14 anos e ter três ou mais parceiros sexuais na vida está significativamente associado ao uso de maconha ou cocaína durante a gestação. Esta associação sugere que programas de intervenção específicos devem ser dirigidos a essas jovens.

Revisão: funcionamento executivo e uso de maconha / Review: executive functioning and cannabis use

OBJETIVO: A maconha é a droga ilícita mais consumida no mundo, porém ainda existem poucos estudos examinando eventuais prejuízos cognitivos relacionados ao seu uso. As manifestações clínicas associadas a esses déficits incluem síndrome amotivacional, prejuízo na flexibilidade cognitiva, desatenção, dificuldade de raciocínio abstrato e formação de conceitos, aspectos intimamente ligados às funções executivas, as quais potencialmente exercem um papel central na dependência de substâncias. O objetivo do estudo foi fazer uma revisão a respeito das implicações do uso da maconha no funcionamento executivo. MÉTODO: Esta revisão foi conduzida utilizando-se bases de dados eletrônicas (MedLine, Pubmed, SciELO and Lilacs). DISCUSSÃO: Em estudos de efeito agudo, doses maiores de tetrahidrocanabinol encontram-se associadas a maior prejuízo no desempenho de usuários leves em tarefas de controle inibitório e planejamento; porém, este efeito dose-resposta não ocorre em usuários crônicos. Embora haja controvérsias no que se refere a efeitos residuais da maconha, déficits persistentes parecem estar presentes após 28 dias de abstinência, ao menos em um subgrupo de usuários crônicos. CONCLUSÕES: Os estudos encontrados não tiveram como objetivo principal a avaliação das funções executivas. A seleção de testes padronizados, desenhos de estudos mais apropriados e o uso concomitante com técnicas de neuroimagem estrutural e funcional podem auxiliar na melhor compreensão das conseqüências deletérias do uso crônico da maconha no funcionamento executivo.

OBJECTIVE: Cannabis is the most used illicit drug worldwide, however only a few studies have examined cognitive deficits related to its use. Clinical manifestations associated with those deficits include amotivational syndrome, impairment in cognitive flexibility, inattention, deficits in abstract reasoning and concept formation, aspects intimately related to the executive functions, which potentially exert a central role in substance dependence. The objective was to make a review about consequences of cannabis use in executive functioning. METHOD: This review was carried out on reports drawn from MedLine, SciELO, and Lilacs. DISCUSSION: In studies investigating acute use effects, higher doses of tetrahydrocannabinol are associated to impairments in performance of nonsevere users in planning and control impulse tasks. However, chronic cannabis users do not show those impairments. Although demonstration of residual effects of cannabis in the executive functioning is controversial, persistent deficits seem to be present at least in a subgroup of chronic users after 28 days of abstinence. CONCLUSIONS: The neuropsychological studies found did not have as a main aim the evaluation of executive functioning. A criterial selection of standardized neuropsychological tests, more appropriate study designs as well as concomitant investigations with structural and functional neuroimaging techniques may improve the understanding of eventual neurotoxicity associated with cannabis use.

Tradução, adaptação e validação da versão brasileira da escala Marijuana Expectancy Questionnaire / Translation, adaptation, and validation of the Brazilian version of the Marijuana Expectancy Questionnaire

Este estudo apresenta a tradução e a validação do Marijuana Expectancy Questionnaire (MEQ adaptação brasileira), a qual avalia as expectativas de resultados em relação ao uso de maconha, podendo ser importante no tratamento e prognóstico dos dependentes químicos dessa substância. A amostra foi de 400 sujeitos, homens (n = 217) e mulheres (n = 183), usuários de maconha (n = 147) e não-usuários (n = 253). Dentre os usuários, 90 eram dependentes de maconha. A validação semântica utilizou um Comitê de Juízes Especialistas. Na amostra brasileira, aplicaram-se os 78 itens, porém a análise estatística foi a partir da escala reduzida com 55 itens, pois as propriedades psicométricas foram similares. Obteve-se alfa = 0, 89 para as duas escalas. A validade discriminante para a escala reduzida foi, estatisticamente, significativa (p = 0,001). A estabilidade temporal foi examinada numa amostra de 123 sujeitos, com o intervalo de uma semana entre o teste e o reteste, indicando um padrão consistente de resposta ao longo do tempo (r = 0,990). O MEQ - adaptação brasileira apresentou bons resultados psicométricos, podendo avaliar as expectativas de resultados relacionadas ao uso de maconha.

This study presents the translation and validation of the Marijuana Expectancy Questionnaire (MEQ - Brazilian Adaptation), which evaluates the expectancy of results in marijuana use, important for treatment and prognosis related to addiction to this substance. The sample consisted of 400 subjects, 217 males and 183 females, of whom 147 were marijuana users and 253 were non-users. In the user group, 90 subjects were marijuana-dependent. Semantic validation of the MEQ-Brazilian Adaptation was confirmed after evaluation and suggestions by an expert review panel. In the Brazilian sample, 78 items were applied; however, the decision was made for a statistical analysis using the reduced scale (55 items), with similar psychometric properties. For both scales, an alpha = 0.89 was obtained. Discriminant validation of the reduced scale was statistically significant (p = 0.001). Temporal stability was examined using a 123-subject sample with a one-week interval between test and retest, indicating that the instrument obtains a consistent response pattern over time (r = 0.990). MEQ - Brazilian Adaptation presented good psychometric results and can be used in studies that aim to evaluate expectancy of results related to marijuana use.

Consumo de sustancias y conductas de riesgo en consumidores de pasta base de cacaína no consultantes a servicios de rehabilitación / Substance use and risk behaviors of out-of-treatment cocaine base paste and cocaine hydrochloride users

Background: In Chile, cocaine base paste (CBP) is the illegal substance that produces the highest rate of addiction. Nonetheless, a marginal number of users receive treatment each year. Aim: To compare the consumption patterns and risk behavior of CBP and cocaine hydrochloride (CH) users who do not attend rehabilitation services. Material and Methods: In a prospective research design, through a study methodology called Privileged Access Interview of hidden populations, 28 surveyors recruited 231 CBP users (group 1) and 236 CH users (group 2). The Risk Behavior Questionnaire was applied in four communities of Metropolitan Santiago, that have the highest prevalence of PBC and CH use. Results: CBP users showed higher schools drop-out and unemployment rates. Subjects of both groups were predominantly polysubstance and polyaddicted users. The severity of addiction to CBP of group 1 was significantly higher than the severity of addiction to CH of group 2 (5.5 versus 5.1: p<0.001). CBP users showed significantly higher rates of sexual risk behaviors, antisocial behavior, self infliction of injuries, suicide attempt and child neglect. Conclusions: A higher vulnerability was shown for users of CBP than those of CH. Attention is drawn to the need for developing community interventions in order to alter substance abuse and the risk behavior of these vulnerable groups.

Physical and psychological complications of cannabis ; an update

The use of illegal drug such as cannabis is most common. Young people are more vulnerable for its use. Prevalence is increasing markedly over the past decade. Long term use of cannabis use is found to be associated with increased risk of physical and psychological complications. This a brief review of recent literature on the use of cannabis in European society. Government has successful in increasing public awareness about cannabis misuse through media. More surveys and epidemiology studies are required in future to detect this change and any reduction in its use and dependence

Profesor Armando Roa y su aporte al estudio clínico de la marihuana en la perspectiva actual / Professor Armando Roa and his contribution to the clinical study of the marijuana in the present perspective

Se revisan los aspectos fundamentales del uso de la marihuana, a la luz del conocimiento actual, junto a los aspectos clínicos descritos por el Profesor Armando Roa sistematizados en su libro La Marihuana; se comenta sobre la importancia de su aporte a la clínica de este fenómeno