Crime in Trinidad and Tobago: the effect of alcohol use and unemployment

OBJETIVO: Determinar si el desempleo y el consumo de alcohol se asociaban con distintos tipos de delincuencia en Trinidad y Tabago. MÉTODOS: El estudio se realizó con datos secundarios obtenidos de la Oficina Central de Estadísticas de Trinidad y Tabago para el período de 1990­1997. Se aplicaron correlaciones de Pearson del tipo producto-momento y análisis de regresión múltiple por eliminación progresiva (stepwise regression) para identificar los principales factores pronósticos relacionados con la delincuencia. RESULTADOS: El desempleo explicó 69,2% de la varianza en la frecuencia de delitos graves. La disponibilidad de cerveza para consumo en el hogar explicó 64% de la varianza en la frecuencia de infracciones menores, y el desempleo junto con la disponibilidad de cerveza para consumo en el hogar explicaron 92,2% de la varianza en la frecuencia de delitos menores. CONCLUSIONES: Este estudio proporciona información que puede ser útil para idear políticas contra el desempleo y la venta de cerveza destinada al consumo doméstico, factores que se asocian con la delincuencia en Trinidad y Tabago. Si se redujera la disponibilidad de cerveza para consumo en el hogar ùproblema de salud pública importanteù, la frecuencia de infracciones menores se reduciría notablemente en este país. Hacen falta más investigaciones que exploren la relación entre el desempleo y la delincuencia.

The prescribing of psychotropic drugs in mental health services in Trinidad

Objective. To describe, analyze, and interpret patterns of psychotropic drug prescribing in new psychiatric patients attending psychiatric outpatient clinics in the Caribbean island of Trinidad. Design and Methods. This was a cross-sectional study of psychotropic drug prescribing by psychiatrists for 132 new psychiatric outpatients who were seen at the outpatient clinics surveyed and who were entering the mental health system during the period of research, November 1998 through February 1999. Results. A single patient could be prescribed more than one psychotropic drug. Antidepressant drugs were the class of psychotropic drugs most prescribed (79 of 132 patients, 59.8 percent), followed by antipsychotic drugs (67 of 132 patients, 50.8 percent). Tricyclic antidepressants (TCAs) were the antidepressants most prescribed (58 of the 79 patients), mainly amitriptyline (53 of the 58). Fluoxetine was the only selective serotonin reuptake inhibitor (SSRI) prescribed (21 of the 79 patients prescribed antidepressants). Of the 67 patients receiving antipsychotic drugs, phenothiazines accounted for 41 of those 67, including trifluoperazine (14 of the 41) and thioridazine (13 of the 41). The individual antipsychotic most prescribed was sulpiride (21 of the 67 patients). Anticholinergic drugs were prescribed to 20 of the 132 patients (15.1 percent). Eighty-three of the patients were prescribed more than one drug concomitantly (either more than one psychotropic or a combination of psychotropic(s) and nonpsychotropic(s)). Prescription by ethnicity, age, and gender coincided with the morbidity rates encountered in these patients. The prescribing of SSRIs to persons of African or East Indian ethnicity was significantly lower than it was for persons of mixed heritage. Conclusions. The prescription patterns of psychotropic drugs in Trinidad revealed the psychiatrists' preferences for traditional psychotropic drugs, the moderate use of anticholinergic drugs, and polypharmacy in some cases, with probable predisposition to adverse drug reactions. Given our results and based on the evaluation of individual patients, consideration should be given to a broader use of the newer antidepressants (SSRIs) and antipsychotics. Unless justified, polypharmacy should be avoided