Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 173
Filter
1.
J. bras. psiquiatr ; 71(1): 50-55, jan.-mar. 2022. tab
Article in English | LILACS | ID: biblio-1365057

ABSTRACT

OBJECTIVE: São Paulo's Crackland is the biggest and oldest open drug use scene in Brazil, yet little is known about the profile of crack cocaine treatment-seeking individuals living in this region. The aim of this crossectional study was to describe the demographics and clinical characteristics of treatment-seeking crack users living in the Crackland region. METHODS: A sample of nighty eight individuals were screened for DSM-V substance use disorders, including substance use, impulsiveness, and psychiatric symptoms. Recent crack cocaine use was also tested using biologic specimens. RESULTS: Results indicated severe social vulnerability, as participants experienced high rates of homelessness (46.9%), unstable housing (50%), unemployment (60.4%) and early school drop-out (27.5%). The average age of crack use onset was 20 years (SD = 6.9) and the mean duration of continuous crack use was 15 years (SD = 9.7). Most participants presented with concomitant mental health disorders, particularly alcohol use disorder (87.8%), as well high rates of psychiatric symptomatology and impulsiveness. More than half of the sample reported at least one previous inpatient (73.5%) and outpatient (65.3%) addiction treatment attempt. CONCLUSION: This population profile should inform mental healthcare services, promoting the provision of tailored assistance by targeting specific demands at all levels of treatment.


OBJETIVO: Localizada em São Paulo, a Cracolândia é o maior e mais antigo cenário aberto de uso de drogas do Brasil. Ainda assim, pouco se sabe sobre o perfil dos indivíduos que vivem nessa região e buscam tratamento para crack. O objetivo deste estudo transversal foi descrever características demográficas e clínicas de usuários de crack vivendo na região da Cracolândia que estão em busca de tratamento. MÉTODOS: Noventa e oito indivíduos foram avaliados para transtornos por uso de substâncias do DSM-V, padrão de uso de substâncias, impulsividade e sintomatologia psiquiátrica. O uso recente de crack também foi determinado por meio de coleta de amostras toxicológicas. RESULTADOS: Os resultados indicaram grave vulnerabilidade social, com significativas prevalências de falta de moradia (46,9%), moradia instável (50%), desemprego (60,4%) e abandono escolar precoce (27,5%). A idade média de início do uso de crack foi de 20 anos (DP = 6,9) e a duração média do uso contínuo do crack foi de 15 anos (DP = 9,7). A maioria dos participantes apresentou alguma comorbidade psiquiátrica, particularmente transtorno por uso de álcool (87,8%), bem como altas taxas de sintomatologia psiquiátrica e impulsividade. Mais da metade da amostra relatou pelo menos uma tentativa anterior de tratamento por internação (73,5%) e ambulatorial (65,3%). CONCLUSÃO: Os achados desse estudo permitem um maior entendimento do perfil e das necessidades de usuários de crack vivendo na região da Cracolândia e podem ajudar serviços de saúde especializados em dependência química a promoverem uma assistência mais direcionada às demandas específicas dessa população.


Subject(s)
Humans , Male , Adult , Patient Acceptance of Health Care/psychology , Crack Cocaine/adverse effects , Substance-Related Disorders/diagnosis , Cocaine-Related Disorders/therapy , Cocaine-Related Disorders/epidemiology , Drug Users/psychology , Socioeconomic Factors , Brazil , Homeless Persons/statistics & numerical data , Prevalence , Cross-Sectional Studies
2.
Rev. Méd. Clín. Condes ; 31(2): 174-182, mar.-abr. 2020. tab
Article in Spanish | LILACS | ID: biblio-1223625

ABSTRACT

La comorbilidad entre trastornos del ánimo (TA) y trastornos por uso de sustancias (TUS) es frecuente, empeora el pronóstico de ambos cuadros y dificulta su tratamiento. El reconocimiento y manejo de síntomas anímicos en usuarios de sustancias significa un desafío en la práctica clínica. Si bien existen los trastornos anímicos secundarios a la patología por consumo, la evidencia muestra que la mayor parte de las veces en que ambas patologías coexisten, el trastorno anímico es primario, por lo tanto, el uso de sustancias activo no debiese impedir un tratamiento oportuno del TA, sin descuidar el manejo específico del uso de sustancias, ya que el tratamiento del cuadro afectivo por sí sólo no resuelve el TUS. Existe acuerdo en la necesidad de realizar un tratamiento integrado de ambos trastornos, que incorpore intervenciones farmacológicas y psicoterapéuticas ya validadas para el tratamiento de ambos trastornos por separado, y especialmente aquellas que han mostrado efectividad en la comorbilidad. El tratamiento debe tener un enfoque en la recuperación, que promueva la adherencia y reinserción social. Se requiere mayor investigación sobre el pronóstico y el tratamiento de la comorbilidad entre Trastorno anímicos y por uso de sustancias, y el fortalecimiento de la red de salud general y salud mental en la pesquisa y manejo de estos cuadros.


Comorbidity between Mood Disorders (MD) and Substance Use Disorders (SUD) are common and it worsens the prognosis of both conditions. The recognition and management of mood symptoms in SUD patients is a usual challenge in clinical practice. As opposed to the usual belief, most mood disorders in TUS patients are primary disorders and therefore the use of active substances should not prevent timely treatment of MD, without neglecting the specific management of substance use, since that the treatment of the affective condition alone does not resolve your SUD. There is agreement on the need to perform an integrated treatment of both disorders, which incorporates pharmacological and psychotherapeutic interventions already validated for the treatment of both disorders, and especially those that have shown effectiveness in comorbidity. Treatment should have a focus on recovery, which promotes adherence and social reintegration. More research is required on the prognosis and treatment of comorbidity between mood and substance use disorders, and the strengthening of the general health and mental health network in the research and management of these conditions.


Subject(s)
Humans , Mood Disorders/epidemiology , Substance-Related Disorders/epidemiology , Diagnosis, Dual (Psychiatry) , Mood Disorders/diagnosis , Mood Disorders/therapy , Substance-Related Disorders/diagnosis , Substance-Related Disorders/therapy
3.
Medicina (B.Aires) ; 80(supl.2): 76-79, mar. 2020.
Article in Spanish | LILACS | ID: biblio-1125112

ABSTRACT

El trastorno por déficit de atención con hiperactividad (TDAH) es una alteración del neurodesarrollo de base biológica que iniciado en la infancia puede persistir durante la adolescencia-juventud y, a pesar de lo que se pensaba hasta hace no muchos años, también en la edad adulta hasta en un 50-60% de los afectados, produciendo un notable deterioro clínico y psicosocial. A pesar de tratarse de un síndrome fácilmente identificable por la triada: desatención, hiperactividad e impulsividad que le caracteriza, en la práctica clínica existen diferentes circunstancias que dificultan y complican su diagnóstico y tratamiento. Una de las más significativas es la presencia, tanto en la infancia como en la edad adulta, de otros trastornos mentales comórbidos. Es a partir de la adolescencia-juventud cuando junto al TDAH podemos detectar la presencia de trastornos de la personalidad, trastornos del estado de ánimo, trastornos de ansiedad y muy especialmente trastornos por uso de sustancias. Las evidencias existentes hasta el presente muestran como la comorbilidad del TDAH y el trastorno por uso de sustancias influyen en el curso evolutivo de ambos, complicando el abordaje, el tratamiento y consecuentemente agravando el pronóstico final. Las dificultades en su abordaje y la escasez de opciones de tratamiento nos hacen subrayar la importancia del tratamiento preventivo en la etapa infantil a partir de programas de psicoeducación centrados en la vulnerabilidad de estos pacientes a las sustancias y las consecuencias asociadas al consumo.


Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental alteration of biological basis that started in childhood may persist during adolescence-youth and, despite what was believed until not many years ago, also in adulthood up to 50-60% of those affected, producing a significant clinical and psychosocial deterioration. In spite of being a syndrome easily identifiable by the triad: inattention, hyperactivity and impulsivity that characterizes it, in clinical practice there are different circumstances that hinder and complicate its diagnosis and treatment. One of the most significant is the presence, both in childhood and adulthood, of other comorbid mental disorders. It is from adolescence-youth when together with ADHD we can detect the presence of personality, mood and anxiety disorders and especially the use of several substances. The evidences existing until now show how the comorbidity of ADHD and substance use disorder influence the evolutionary course of both, complicating the approach, the treatment and, therefore, aggravating the final prognosis. The difficulties in their approach and the scarcity of treatment options make us underline the importance of preventive treatment in the infantile stage, starting from psychoeducation programs focused on the vulnerability of these patients to substances and the consequences associated with consumption.


Subject(s)
Humans , Child , Adolescent , Adult , Young Adult , Attention Deficit Disorder with Hyperactivity/complications , Substance-Related Disorders/etiology , Attention Deficit Disorder with Hyperactivity/diagnosis , Attention Deficit Disorder with Hyperactivity/therapy , Risk Factors , Substance-Related Disorders/diagnosis , Substance-Related Disorders/therapy , Diagnostic and Statistical Manual of Mental Disorders
4.
Summa psicol. UST ; 17(1): 11-19, 2020. tab
Article in Spanish | LILACS | ID: biblio-1129383

ABSTRACT

El presente estudio tuvo como objetivo detectar el nivel de riesgo por consumo de sustancias psicoactivas (SPA) en una muestra de 324 universitarios ingresantes a Psicología en Arequipa ­ Perú, siendo el 73.15% de sexo femenino y 26.85% masculino, con edades que fluctúan entre los 18 y 25 años. Se empleó para ello la prueba ASSIST elaborada por la Organización Mundial de la Salud (OMS), hallando que el 33.02%, 22.53% y 10.49% alcanza un nivel de riesgo moderado en el consumo de tabaco, bebidas alcohólicas y marihuana correspondientemente. Además, el 2.78% presentó un nivel de riesgo alto en el consumo de bebidas alcohólicas. Se concluye que las SPA más consumidas por dichos universitarios son bebidas alcohólicas y tabaco, y que aproximadamente 1 de cada 4 tiene un riesgo moderado a alto de tener problemas por el consumo de alcohol y tabaco


The objective of this study was to detect the level of risk due to consumption of psychoactive substances in a sample of 324 undergraduates entering Psychology in Arequipa - Peru, with 73.15% female and 26.85% male, and ages between 18 and 25 years. The ASSIST test prepared by the World Health Organization (WHO) detected that 33.02%, 22.53% and 10.49% reach a moderate level of risk in the consumption of tobacco, alcoholic beverages and marijuana correspondingly. Besides, 2.78% of a high level of risk in the consumption of alcoholic beverages, concluding that the SPA most consumed by these university students are alcoholic beverages and tobacco; that approximately 1 in 4 has a moderate to high risk of having problems with alcohol and tobacco consumption.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Young Adult , Students/psychology , Universities , Risk Assessment/methods , Substance-Related Disorders/epidemiology , Peru , Cannabis , Cross-Sectional Studies , Risk Factors , Substance-Related Disorders/diagnosis , Tobacco Use , Alcohol Drinking in College
6.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 41(3): 238-244, May-June 2019. tab
Article in English | LILACS | ID: biblio-1011494

ABSTRACT

Objective: To estimate the 12-month prevalence of mental health services utilization (overall and by type of service sector), the adequacy of treatment provided, and sociodemographic correlates in the Argentinean Study of Mental Health Epidemiology (ASMHE). Methods: The ASMHE is a multistage probability household sample representative of adults in urban areas of Argentina. The World Health Organization World Mental Health Composite International Diagnostic Interview (WMH-CIDI) was used to evaluate psychiatric diagnosis and service utilization. Results: Among those with a disorder, 27.6% received any treatment in the prior 12 months. Of these, 78.3% received minimally adequate treatment using a broad definition and only 43.6% using a stringent definition. For individuals with a disorder, more services were provided by mental health professionals (17.7%) than by general medical professionals (11.5%) or non-healthcare sectors (2.6%). Younger individuals with low education and income were less likely to receive treatment; those never married and those with an anxiety or mood disorder were more likely to receive treatment. Among those in treatment, treatment was least adequate among younger individuals with low education and low income. Conclusions: Policies to increase access to services for mental health disorders in Argentina are needed, as is training for primary care practitioners in the early detection and treatment of psychiatric disorders.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Young Adult , Substance-Related Disorders/therapy , Substance-Related Disorders/epidemiology , Mental Disorders/therapy , Mental Disorders/epidemiology , Mental Health Services/statistics & numerical data , Argentina/epidemiology , Psychiatry/education , Socioeconomic Factors , Urban Population/statistics & numerical data , Patient Acceptance of Health Care/statistics & numerical data , Prevalence , Surveys and Questionnaires , Health Surveys , Substance-Related Disorders/diagnosis , General Practitioners/education , Health Services Accessibility/statistics & numerical data , Mental Disorders/diagnosis , Middle Aged
7.
Rev. medica electron ; 41(1): 180-188, ene.-feb. 2019.
Article in Spanish | LILACS, CUMED | ID: biblio-991336

ABSTRACT

RESUMEN El síndrome de deprivación glucocorticoidea es el cuadro clínico resultante de la suspensión de la administración exógena de esteroides, aplicados por tiempo prolongado, independientemente de la vía de administración. Provoca la frenación del eje hipotálamo-hipófisis-suprarrenal y por ende disminuye la producción y secreción de corticotropina. Paciente femenina de 54 años de edad, con esteroides como tratamiento prolongado. Al retirarlo comenzó con pérdida de peso y dificultad para caminar, además de hipotensión ortostática, sufrió caída brusca al piso con pérdida de conocimiento. Fue llevada al hospital y no se constató pulsos periféricos ni tensión arterial, que no resolvió totalmente con el uso enérgico de fluidos endovenosos. Se mantuvo sin regular parámetros normales, se reevaluó como un síndrome de depravación corticoidea y se le impuso tratamiento con prednisona, mejorando paulatinamente. Los síndromes asociados a la retirada de corticoidesaparecen por el empleo de dosis altas, o retirada brusca de la corticoterapia prolongada. Al conjunto de síntomas y signos que aparecen cuando no se consigue tolerar la retirada de glucocorticoides, ante la ausencia de enfermedad subyacente para la cual fueron indicados estos medicamentos, y con un eje hipotálamo-hipófisis-suprarenal (HHS) no suprimido se le considera un síndrome de retirada de corticoides. A pesar de la gravedad, la frecuencia e importancia de este efecto secundario, en ocasiones no se repara en él, por lo que es imprescindible valorar los tratamientos indicados y reevaluar periódicamente los tratamientos crónicos indicados.


ABSTRACT The glucocorticoide deprivation symptom is the clinical symptom resulting from stoping the exogenous administration of steroids that were used for a long time, in spite of the administration way. It restrains the hypothalamus-pituitary-adrenal axis and therefore reduces corticotropine production and secretion. This is the case of a female patient, aged 54 years, with a continued steroid treatment. When stoping it, she began to lose weight and presented difficulties for walking. Besides orthostatic hypotension, she abruptly fell to the ground losing conciousness. She was carried to the hospital and there were not found periferal pulses nor arterial tension, a problem that was not solved by the active use of endovenous fluids. She kept on without regulating normal parameters, and was re-evaluated as a corticoid deprivation symptom and treated with prenisone. She gradually got better. The syndromes asociated to corticod deprivation begin due to the usage of high doses, or due to the abrupt withdrawal of a long corticotherapy. The whole of the symptoms appearing when corticoid withdrawal is not tolerated, in the absence of the underlying disease against which these medicines were indicated, and with a non-suppressed hypothalamus-pituitary-adrenal axis, is considered as a syndrome of corticoide withdrawal. In spite of its seriousness, of the frequency and importance of this secundary effect, sometimes it is not noticed; therefore it is essential to evaluate the indicated treatments and periodically reevaluate the treatments ordered for chronic diseases.


Subject(s)
Humans , Female , Middle Aged , Steroids/adverse effects , Steroids/therapeutic use , Substance-Related Disorders/diagnosis , Substance-Related Disorders/drug therapy , Prednisone/therapeutic use
8.
Psiquiatr. salud ment ; 35(3/4): 244-252, jul.-dic. 2018.
Article in Spanish | LILACS | ID: biblio-1005048

ABSTRACT

Se presenta el caso de un paciente de 53 años que padece dos cuadros clínicos, un trastorno por consumo de sustancia (TUS) y un cuadro de depresión mayor con riesgo suicida lo cual en la actualidad se denomina patología dual. Se dedican dos sesiones a la evaluación diagnóstica y funcional y el tratamiento se desarrolla de manera individual y grupal. Se utilizan técnicas de corte cognitivo-conductual: psicoeducación, mindfulness, técnicas cognitivas y de detección del pensamiento o también llamadas de bloqueo. Tras las sesiones de tratamiento los niveles de craving disminuyen, implementa técnicas de bloqueo y cesa el consumo de alcohol y tabaco. Se mantienen sesiones de seguimiento mensual, que tiene por finalidad objetivar el mantenimiento de los logros terapéuticos. Se observa a lo largo de estas sesiones de seguimiento la remisión de total del consumo de alcohol, tabaco y depresión. Se sigue trabajando actualmente en la búsqueda de actividades placenteras que llenen su tiempo libre (uso adecuado de su tiempo libre).


We present the case of a 53-year-old patient who suffers two clinical disorders, a disorder for consumption of substance and a major depression with suicidal risk, which at present is named a dual pathology. We dedicate two sessions to the diagnostic and functional evaluation and the treatment develops in an individual way and grupal. We use cognitive - behavioral technologies: psychoeducation, mindfulness, cognitive technologies and of thought detection or blockade. After the treatment sessions the levels of craving diminish, we implement technologies of blockade, and patient stops the consumption of alcohol and tobacco. There are kept meetings of monthly follow-up, which has for purpose the maintenance of the therapeutic achievements. Is observed along these meetings of follow-up the total remission of the consumption of alcohol, tobacco, and of depression. We continue working nowadays at the search of pleasant activities that fill his free time (suitable use of his free time).


Subject(s)
Humans , Male , Middle Aged , Substance-Related Disorders/diagnosis , Substance-Related Disorders/therapy , Depression/diagnosis , Depression/therapy , Tobacco Use Disorder , Alcohol Drinking , Cognitive Behavioral Therapy , Diagnosis, Dual (Psychiatry) , Substance-Related Disorders/complications , Depression/complications , Mindfulness
9.
Psiquiatr. salud ment ; 35(3/4): 262-267, jul.-dic. 2018.
Article in Spanish | LILACS | ID: biblio-1005052

ABSTRACT

Caso Clínico: Mujer, 23 años. Discapacidad intelectual. Asiste a colegio especial (no lee ni escribe). Institucionalizada. Motivo de ingreso: Paciente ingresa en octubre del 2017 traída por carabineros por ser encontrada en la calle bajo el efecto de múltiples sustancias, con ideación suicida. Días antes fue expulsada del hogar por agresión a cuidadoras. Diagnósticos de ingreso: Discapacidad intelectual moderado. Síndrome suicidal, Trastorno por dependencia a drogas. ¿Esquizofrenia hebefrénica? Evolución: Mantiene desajustes conductuales severos fluctuantes, con serias dificultades para manejar la rabia, lo que la lleva a tener conductas hetero y autoagresivas. Plan de tratamiento: Farmacológico (clozapina), Psicológico (TCC), Social (dispositivo adecuado post-alta). Clozapina para trastornos psicóticos en adultos con discapacidad intelectual. El principal riesgo de atribuir alguno de estos comportamientos a una supuesta "psicosis", es el de "medicalizar" y tratar de forma poco acertada. Es importante descartar factores ambientales y del aprendizaje (hábitos y conductas aprendidas, institucionalización, reacciones ante el estrés agudo.) La prevalencia de abuso y dependencia de sustancias en población con DI va desde el 0,5% al 2,6%. Lo cual es menor que la población general. Pacientes con DI y dependencia a drogas se asocia a otras enfermedades psiquiátricas (42-54%). Se ha informado que las personas con discapacidad intelectual en América Latina a menudo están institucionalizadas y escondidas de la sociedad en instalaciones deficientes y superpobladas.


Clinical Case: Female, 23 years old. Intellectual disability. He attends a special school (she does not read or write). Institutionalized. Reason for admission: Patient enters in October 2017 brought by police officers to be found in the street under the effect of multiple substances, with suicidal ideation. Days before she was expelled from the home because of assaulting caregivers. Admission diagnoses: Moderate intellectual disability. Suicidal syndrome, Disorder due to drug dependence. Hebephrenic schizophrenia? Evolution: Maintains fluctuating severe behavioral imbalances, with serious difficulties in managing rage, which leads to hetero and self-aggressive behaviors. Treatment plan: pharmacological (clozapine), Psychological (CBT), Social (adequate post-hospitalization discharge device). Clozapine for psychotic disorders in adults with intellectual disabilities. The main risk of attributing some of these behaviors to a supposed "psychosis" is that of "medicalizing" and dealing inappropriately. It is important to rule out environmental and learning factors (habits and behaviors learned, institutionalization, reactions to acute stress. The prevalence of substance abuse and dependence in the population with ID ranges from 0.5% to 2.6%. Which is less than the general population. Patients with ID and drug dependence are associated with other psychiatric illnesses (42-54%). It is reported that people with intellectual disabilty in Latin America are often institutionalized and hidden from society in poor and overcrowded facilities.


Subject(s)
Humans , Female , Young Adult , Substance-Related Disorders/diagnosis , Intellectual Disability/diagnosis , Intellectual Disability/therapy , Psychotherapy , Psychotic Disorders , Antipsychotic Agents/therapeutic use , Clozapine/therapeutic use , Substance-Related Disorders/complications , Substance-Related Disorders/therapy , Suicidal Ideation , Intellectual Disability/classification , Intellectual Disability/complications , Intellectual Disability/etiology
10.
Rev. medica electron ; 40(2): 513-520, mar.-abr. 2018.
Article in Spanish | LILACS, CUMED | ID: biblio-1103325

ABSTRACT

En la actualidad se acepta como adicción, cualquier actividad que el individuo no sea capaz de controlar, que lo lleve a conductas compulsivas y perjudique su calidad de vida. La drogodependencia, también llamada drogadicción o farmacodependencia, es un problema de salud causado por el frecuente uso de sustancias adictivas llamadas drogas. No nos resulta nuevo que gran cantidad de estudiantes universitarios consuman drogas controladas para supuestamente potenciar su desempeño académico. Cuba no escapa a esta realidad a pesar de ser un baluarte mundial en la lucha antidroga. La imitación o aprendizaje de esta conducta es un elemento clave en adolescentes y estudiantes universitarios, la dificultad estriba en el acceso al fármaco lo cual para estudiantes de determinadas carreras, por ejemplo las carreras de Ciencias Médicas, no constituye un gran obstáculo. Exponemos de forma breve las consideraciones sobre el tema (AU).


Currently, any activity the individual is not able to control, that lead him to compulsive behavior damaging his life quality is accepted as addiction. Drug-dependence, also called drug addiction of pharmacodependence, is a health problem caused by the frequent use of addictive substances called drugs. It is not a news that a big quantity of university students consume controlled drugs to supposedly potentiate their academic competence. Cuba is not free of this reality in spite of being a world bulwark in the antidrug fight. This behavior imitation or learning is a key element among teenagers and university students, the difficulty rests in the drug access for the students of several specialties, what is not a trouble for the Medicine students. We briefly expose several considerations on the them (AU).


Subject(s)
Humans , Quality of Life , Students, Medical , Illicit Drugs/adverse effects , Substance-Related Disorders/diagnosis , Amphetamine-Related Disorders , Physiological Effects of Drugs , Universities , Drug Users , Performance-Enhancing Substances/administration & dosage , Performance Anxiety , Social Problems , Social Values , Student Health Services , Health Services Administration , Health Systems , Substance-Related Disorders/etiology , Cuba/epidemiology , Performance-Enhancing Substances/pharmacology , Academic Performance , Missed Diagnosis
11.
Trends psychiatry psychother. (Impr.) ; 40(1): 16-20, Jan.-Mar. 2018. tab, graf
Article in English | LILACS | ID: biblio-904606

ABSTRACT

Abstract Objective The current study presents the translation and adaptation of the 20-item Taiwan version of the Borderline Personality Inventory (BPI) into Brazilian Portuguese (BPI-P). Methods After translation and back-translation, the Brazilian Portuguese version was administered to three samples: patients with borderline personality disorder, psychiatric patients with comorbid substance use disorder and volunteers with no reported mental disorders. Results Significant differences between groups for borderline scores (analysis of variance [ANOVA], F = 52.923, p = 0.01) were found but there were no significant correlations between scores for borderline personality disorder and alcohol or nicotine dependence. The BPI-P had satisfactory validity for borderline personality disorder, even when anxiety and depression were present, with an area under the receiver operating characteristic curve of 0.931 at a cutoff point of 14. Conclusion This study provides support for the potential utility of the BPI-P as a screening instrument for clinical practice in Portuguese speaking countries, including outpatients with alcohol and nicotine use disorders in early or sustained remission.


Resumo Objetivo Este estudo apresenta a tradução e adaptação do Inventário de Taiwan para Transtorno de Personalidade Borderline (IPB) de 20 itens, para o português brasileiro (IPB-P). Métodos Após tradução e retrotradução, a versão em português brasileiro foi aplicada em três amostras: pacientes com transtorno de personalidade borderline, pacientes psiquiátricos com comorbidade de transtorno de uso de substâncias e voluntários sem transtornos mentais relatados. Resultados Diferenças significantes entre os grupos em relação aos graus para borderline (análise de variância [ANOVA], F = 52,923, p = 0,01) foram encontradas mas não houve correlações significantes entre as pontuações para transtorno de personalidade borderline e dependência de álcool ou nicotina. O IPB-P teve uma validade satisfatória para transtorno de personalidade borderline mesmo quando ansiedade e depressão estavam presentes, com uma área sob a ROC (receiver operating characteristic curve) de 0,931 no ponto de corte de 14. Conclusão Este estudo dá suporte para a utilidade potencial do IPB-P como um instrumento de rastreamento para a prática clínica em países de língua portuguesa, incluindo pacientes ambulatoriais com transtorno de uso de álcool e nicotina em remissão precoce ou sustentada.


Subject(s)
Humans , Male , Female , Psychiatric Status Rating Scales , Borderline Personality Disorder/diagnosis , Anxiety/complications , Anxiety/diagnosis , Translating , Borderline Personality Disorder/complications , Borderline Personality Disorder/psychology , Analysis of Variance , Sensitivity and Specificity , Substance-Related Disorders/complications , Substance-Related Disorders/diagnosis , Depression/complications , Depression/diagnosis
12.
Rev. bras. enferm ; 71(supl.5): 2258-2263, 2018. tab
Article in English | LILACS, BDENF | ID: biblio-977629

ABSTRACT

ABSTRACT Objective: to identify the lifetime use of alcohol and other drugs among users of the Family Health Strategy and apply Brief Intervention to problems related to the use of these substances. Method: a descriptive cross-sectional study where 1,031 users of the Family Health Strategy of the city of Rio de Janeiro answered a form with socio-demographic information and the Alcohol, Smoking and Substance Involvement Screening Test. Statistical analysis with simple frequency distribution was performed. Results: the most commonly used drugs in lifetime were alcohol and tobacco; among the illegal drugs, marijuana, hypnotics and cocaine/crack stood out. Those who received most Brief Intervention were users of tobacco, hypnotics, marijuana, cocaine/crack and alcohol. Conclusion: it is important to detect early problems associated with the use of alcohol and other drugs in Primary Care, since it has the promotion/protection of health and the prevention of diseases as priority health practices.


RESUMEN Objetivo: identificar el uso en la vida de alcohol y otras drogas entre usuarios de la Estrategia Salud de la Familia y aplicar una intervención breve para problemas relacionados al uso de esas sustancias. Método: el estudio descriptivo del tipo transversal donde 1031 usuarios de la Estrategia Salud de la Familia de la ciudad de Rio de Janeiro respondieron a un formulario con informaciones sociodemográficas y a el Alcohol, Smoking and Substance Involvement Screening Test. Se realizó un análisis estadístico con distribución de frecuencias simple. Resultados: las drogas más usadas en la vida fueron el alcohol y el tabaco; entre las drogas ilícitas, se destacaron marihuana, hipnóticos y cocaína/crack. Los que más recibieron intervención breve fueron los usuarios de tabaco, hipnóticos, marihuana, cocaína/crack y alcohol. Conclusión: es importante detectar precozmente problemas asociados al uso de alcohol y otras drogas en la atención básica, pues ella tiene la promoción/protección de la salud y la prevención de agravios como prácticas sanitarias prioritarias.


RESUMO Objetivo: identificar o uso, na vida, de álcool e outras drogas entre usuários da Estratégia Saúde da Família e aplicar Intervenção Breve para problemas relacionados ao uso dessas substâncias. Método: estudo descritivo do tipo transversal onde 1031 usuários da Estratégia Saúde da Família da cidade do Rio de Janeiro responderam um formulário com informações sociodemográficas e o Alcohol, Smoking and Substance Involvement Screening Test. Análise estatística com distribuição de frequências simples foi realizada. Resultados: as drogas mais usadas na vida foram álcool e tabaco; entre as drogas ilícitas, destacaram-se maconha, hipnóticos e cocaína/crack. Os que mais receberam Intervenção Breve foram os usuários de tabaco, hipnóticos, maconha, cocaína/crack e álcool. Conclusão: é importante detectar precocemente problemas associados ao uso de álcool e outras drogas na Atenção Básica, pois ela tem a promoção/proteção da saúde e a prevenção de agravos como práticas sanitárias prioritárias.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Mass Screening/methods , Substance-Related Disorders/diagnosis , Primary Health Care/methods , Primary Health Care/standards , Psychometrics/instrumentation , Psychometrics/methods , Social Class , Brazil , Mass Screening/standards , Mass Screening/psychology , Cross-Sectional Studies , Surveys and Questionnaires , Substance-Related Disorders/psychology , Middle Aged
14.
Rev. bras. psiquiatr ; 39(4): 286-292, Oct.-Dec. 2017. tab, graf
Article in English | LILACS | ID: biblio-899384

ABSTRACT

Objective: To identify symptom-based subgroups within a sample of patients with co-occurring disorders (CODs) and to analyze intersubgroup differences in mental health services utilization. Methods: Two hundred and fifteen patients with COD from an addiction clinic completed the Symptom Checklist 90-Revised. Subgroups were determined using latent class profile analysis. Services utilization data were collected from electronic records during a 3-year span. Results: The five-class model obtained the best fit (Bayesian information criteria [BIC] = 3,546.95; adjusted BIC = 3,363.14; bootstrapped likelihood ratio test p < 0.0001). Differences between classes were quantitative, and groups were labeled according to severity: mild (26%), mild-moderate (28.8%), moderate (18.6%), moderate-severe (17.2%), and severe (9.3%). A significant time by class interaction was obtained (chi-square [χ2[15]] = 30.05, p = 0.012); mild (χ2[1] = 243.90, p < 0.05), mild-moderate (χ2[1] = 198.03, p < 0.05), and moderate (χ2[1] = 526.77, p < 0.05) classes displayed significantly higher treatment utilization. Conclusion: The classes with more symptom severity (moderate-severe and severe) displayed lower utilization of services across time when compared to participants belonging to less severe groups. However, as pairwise differences in treatment utilization between classes were not significant between every subgroup, future studies should determine whether subgroup membership predicts other treatment outcomes.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Young Adult , Substance-Related Disorders/diagnosis , Substance-Related Disorders/therapy , Mental Disorders/diagnosis , Mental Disorders/therapy , Mental Health Services/statistics & numerical data , Socioeconomic Factors , Severity of Illness Index , Bayes Theorem , Substance-Related Disorders/classification , Diagnostic and Statistical Manual of Mental Disorders , Symptom Assessment , Mental Disorders/classification , Models, Psychological
15.
Rev. cuba. salud pública ; 43(4)oct.-dic. 2017.
Article in Spanish | LILACS, CUMED | ID: biblio-901546

ABSTRACT

Recientemente se publicó en la revista un artículo,1que proporciona información relevante acerca del consumo de drogas y su relación con el estilo de vida en estudiantes de una facultad de comunicación. No obstante, es necesario establecer una diferencia en la descripción de los participantes del estudio. En el artículo objeto de análisis en esta carta, se refiere en la parte de resultado, que se ha hecho uso de una muestra. Sin embargo, una muestra es entendida como un subconjunto de la población conformado por unidades de análisis.2 Pese a ello, en ningún momento en el artículo se describe a la población. La población es un conjunto de elementos que contienen ciertas características que se pretenden estudiar.3 Por esa razón, entre la población y la muestra existe un carácter inductivo (de lo particular a lo general), esperando que la parte observada (en este caso la muestra) sea representativa de la realidad (entiéndase aquí a la población); para de esa forma garantizar las conclusiones extraídas en el estudio.4 Existen dos niveles de población, el primero,la población diana, que generalmente es muy grande y el investigador no logra tener acceso a ella y el segundo, la población accesible, en donde el número de elementos es menor y está delimitado por criterios de inclusión y exclusión.3Es en la última población en la que se realiza el muestreo y tamaño muestral. No obstante, en el artículo que se analiza, no indica la población accesible, pese a referir que se usó una muestra. De ser realmente una muestra, los autores debieron indicar, el tipo de muestreo, si este fue probabilístico o no probabilístico.5 En caso de usar el primero, debió referir si fue: simple, sistemático, estratificado y conglomerado; en caso del segundo, si fue por cuota, conveniencia o intencional. Por lo antes mencionado, se recomienda que la utilización correcta del término muestra; y que, en caso de referirla en un artículo, esta deba ir acompañada de la descripción de la población y el tipo de muestreo(AU)


Subject(s)
Humans , Young Adult , Substance-Related Disorders/diagnosis , Substance-Related Disorders/etiology , Life Style/ethnology , Peru/ethnology , Students , Stratified Sampling
16.
Cad. Saúde Pública (Online) ; 33(11): e00143416, nov. 2017. tab
Article in English | LILACS | ID: biblio-889621

ABSTRACT

Abstract: Abortion is a very sensitive issue with relevance to public health; however few clinical or population-based studies have examined induced abortion among drug users. The study aims to evaluate the prevalence of induced abortion and sex-related conditions in an inpatient drug user sample. A cross-sectional design study was conducted in an inpatient addiction treatment unit in São Paulo, Brazil, with a sample of 616 patients, aged 18-75. Sociodemographic data, sexual behavior, and dependence severity were evaluated in relation to induced abortion. Approximately 27% of patients reported having a history of abortion (themselves in the case of women or partners in the case of men). The mean age was 34.6±10.9 years old, 34.9% diagnosed with severe alcohol dependence, 33% were diagnosed with severe levels of dependence on other drugs, 69.6% were diagnosed cocaine users (inhaled and smoked), and alcohol was the drug of choice for 30.4%. Chances of having a history of abortion is greater for women than for men with a odds ratio (OR = 2.9; 95%CI: 1.75-4.76), (OR = 1.7; 95%CI: 1.09-2.75) of no condom use; (OR = 2.0; 95%CI: 1.35-3.23) of history of STI and (OR = 3.2; 95%CI: 1.29-5.73) use of morning-after pill. Drug- and alcohol-dependent patients have high-risk behaviours of sporadic use or no-condom use which contribute to unplanned pregnancy and induced abortion, making this vulnerable population a group which deserves special attention in sexual health prevention programmes and health promotion efforts for the reduction of induced abortion.


Resumo: O aborto é uma questão altamente sensível e com relevância para a saúde pública. Entretanto, poucos estudos clínicos ou populacionais já examinaram o aborto provocado em usuárias de drogas. O estudo tem como objetivo avaliar a prevalência de aborto provocado e condições sexuais em uma amostra de usuárias hospitalizadas. Foi realizado um estudo transversal em uma unidade hospitalar para tratamento de dependência química em São Paulo, Brasil, com uma amostra de 616 pacientes entre 18 e 75 anos de idade. Foram avaliados dados sóciodemográficos, comportamento sexual e gravidade da dependência química e a associação com o aborto provocado. Entre as próprias usuárias e seus parceiros masculinos, 27% relataram história de aborto. A média de idade era 34,6±10.9 anos, 34,9% tinham diagnóstico de dependência alcoólica grave, 33% tinham diagnóstico de níveis graves de outras dependências química, 69,6% usavam cocaína (inalada e/ou fumada) e álcool era a droga de escolha para 30,4% da amostra. Quando comparadas aos parceiros masculinos, as mulheres relatavam chances mais elevadas nos seguintes itens: história de aborto (OR = 2,9; IC95%: 1,75-4,76), falta de uso de preservativo (OR = 1,7; IC95%: 1,09-2,75), história de DSTs (OR = 2,0; IC95%: 1,35-3,23) e uso da pílula do dia seguinte (OR = 3,2; IC95%: 1,29-5,73). Os pacientes com dependência de álcool e outras drogas apresentam comportamentos de alto risco para uso nulo ou esporádico de preservativos, contribuindo para a gravidez não planejada e o aborto provocado, fazendo com que essa população vulnerável seja um grupo que merece atenção especial nos programas de prevenção em saúde sexual e nos esforços de promoção da saúde para a redução do aborto provocado.


Resumen: El aborto es una cuestión altamente sensible y relevante para la salud pública. Pese a ello, pocos estudios clínicos o poblacionales han analizado el aborto provocado en consumidoras de drogas. El estudio tiene como objetivo evaluar la prevalencia de aborto provocado y las condiciones sexuales en una muestra de drogodependientes hospitalizadas. Se realizó un estudio trasversal en una unidad hospitalaria para el tratamiento de dependencia a drogas en Sao Paulo, Brasil, con una muestra de 616 pacientes entre 18 y 75 años de edad. Se evaluaron datos sociodemográficos, comportamiento sexual y gravedad de la drogodependencia y su asociación con el aborto provocado. Entre las propias drogodependientes y sus parejas masculinas, un 27% informaron de un historial de aborto. La media de edad era 34,6±10.9 años, un 34,9% tenían un diagnóstico de dependencia alcohólica grave, un 33% tenían un diagnóstico de niveles graves de otras dependencias a drogas, un 69,6% consumían cocaína (inhalada y/o fumada) y el alcohol era la droga de elección para un 30,4% de la muestra. Cuando se compara con las parejas masculinas, las mujeres presentaban oportunidades más elevadas en los siguientes ítems: historial de aborto (OR = 2,9; IC95%: 1,75-4,76), falta de uso de preservativo (OR = 1,7; IC95%: 1,09-2,75), historial de DSTs (OR = 2,0; IC95%: 1,35-3,23) y uso de la píldora del día siguiente (OR = 3,2; IC95%: 1,29-5,73). Los pacientes con dependencia del alcohol y otras drogas presentan comportamientos de alto riesgo, asociados a un uso nulo o esporádico de preservativos, contribuyendo al embarazo no planeado y al aborto provocado, ocasionando que esa población vulnerable sea un grupo que merece atención especial en los programas de prevención en salud sexual y en los esfuerzos de promoción de la salud para la reducción del aborto provocado.


Subject(s)
Humans , Male , Female , Pregnancy , Adolescent , Aged , Young Adult , Abortion, Induced/statistics & numerical data , Substance-Related Disorders/diagnosis , Drug Users , Sexual Behavior , Socioeconomic Factors , Severity of Illness Index , Brazil , Sexual Partners , Cross-Sectional Studies , Risk Factors , Pregnancy, Unplanned , Alcoholism/diagnosis , Middle Aged
20.
Rev. bras. ginecol. obstet ; 38(12): 609-614, Dec. 2016. tab
Article in English | LILACS | ID: biblio-843888

ABSTRACT

ABSTRACT Objective: To assess depression, domestic violence and the use of substances in women with recurrent miscarriages. Methods: The Abuse Assessment Screen (AAS), the Edinburgh Postnatal Depression Scale (EPDS) and the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) were used to assess violence, depression and the use of substances among women with recurrent miscarriages. The population corresponded to patients receiv-ing prenatal care from June to August 2014. Multiple logistic regression was used to assess the multivariable relationship between depression and sociodemographic, psychosocial and medical characteristics (p < 0,10). Results: The prevalence of depression was of 41.3% (95% confidence interval [CI] 1/4 28.3-55.7%). One third of the pregnant women (32.6%) reported emotional or physical violence, and 13% were classified as abusing or addicted to tobacco according to ASSIST. History of psychiatric diseases was associated with depression (p 1/4 0.005). Violence during life demonstrated a modest association (p 1/4 0.073) with depression, as well as the number of miscarriages (p 1/4 0.071). Conclusion: Depression is a frequent disease among pregnant women with recurrent miscarriages. The results of this investigation suggest that a systematic assessment of depression and its associated conditions, such as domestic violence and the use of substances, should be part of the prenatal follow-up visits for women with recurrent miscarriages.


RESUMO Objetivo: Avaliar a presença de depressão, violência doméstica e uso de substâncias em gestantes com história de perdas gestacionais de repetição. Métodos: Foram utilizados os instrumentos: Edinburgh Postnatal Depression Scale (EPDS), Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), Abuse Assessment Screen (AAS), além de um questionário com dados sociodemográficos e clínicos elaborado pelos investigadores. As variáveis que apresentaram associação com depressão na análise bivariada (p < 0,10), tais como número de abortos e violência durante a vida, entraram no modelo de regressão logística. Resultados: Foram entrevistadas 46 pacientes, sendo encontrada uma prevalência de depressão de 41,3% (intervalo de confiança [IC] de 95% 1/4 28,3-55,7%). Com relação à violência contra a mulher, um terço das gestantes (32,6%) foi vítima de violência emocional ou física pelo seu parceiro ou por alguém próximo a elas. O abuso e/ou dependência de tabaco estava presente em 13% das gestantes, segundo o ASSIST. Na análise bivariada, observou-se uma associação significativa entre histórico de doença psiquiátrica e depressão em mulheres com abortamento de repetição (p 1/4 0,005). Observamos também uma tendência de associação entre depressão, número de abortos (p 1/4 0,071) e histórico de violência durante a vida (p 1/4 0,073) . Conclusão: Depressão é uma doença frequente entre as gestantes com abortamento de repetição. A sobreposição entre depressão, violência doméstica e uso de substâncias aponta para a necessidade do rastreio sistemático dessas condições no pré-natal de gestantes com perdas gestacionais de repetição.


Subject(s)
Humans , Female , Pregnancy , Abortion, Habitual/psychology , Depression/diagnosis , Domestic Violence , Substance-Related Disorders/diagnosis , Depression/epidemiology , Domestic Violence/psychology , Domestic Violence/statistics & numerical data , Pregnancy Complications/diagnosis , Pregnancy Complications/epidemiology , Prenatal Care , Prevalence , Regression Analysis , Substance-Related Disorders/epidemiology
SELECTION OF CITATIONS
SEARCH DETAIL