At-risk drinking and current cannabis use among medical students: a multivariable analysis of the role of personality traits

Objective: To explore the role of personality traits in at-risk drinking and current cannabis use among medical students. Methods: This cross-sectional study evaluated 707 medical students from two universities. Multiple logistic regression models for at-risk drinking and current cannabis use were constructed including sociodemographic, psychiatric, and personality variables. Results: At-risk drinking and current cannabis use were reported by 19.3% and 14.9% of participants, respectively. Models including Big Five measures showed associations of at-risk drinking with higher extraversion (p < 0.00001, adjusted odds ratio [AOR] = 1.9) and lower conscientiousness (p = 0.00001, AOR = 0.5); cannabis use was also associated with lower conscientiousness (p = 0.003, AOR = 0.6), besides higher openness to experience (p = 0.002, AOR = 1.9). Models including measures of the Behavioral Inhibition and Activation Systems scales (BIS/BAS) showed associations of at-risk drinking with lower BIS (p = 0.002, AOR = 0.9) and higher BAS fun-seeking (p = 0.0005, AOR = 1.2); cannabis use was also associated with higher BAS fun-seeking (p = 0.008, AOR = 1.2). Personality variables had modest effects on model fit. Conclusion: Specific personality traits were independently associated with at-risk drinking and current cannabis use, albeit with modest effect sizes.

Alcohol-related blackouts among college students: impact of low level of response to alcohol, ethnicity, sex, and environmental characteristics

Objective: To explore how a genetically-influenced characteristic (the level of response to alcohol [LR]), ethnicity, and sex relate to environmental and attitudinal characteristics (peer drinking [PEER], drinking to cope [COPE], and alcohol expectancies [EXPECT]) regarding future alcohol-related blackouts (ARBs). Methods: Structural equation models (SEMs) were used to evaluate how baseline variables related to ARB patterns in 462 college students over 55 weeks. Data were extracted from a longitudinal study of heavy drinking and its consequences at a U.S. university. Results: In the SEM analysis, female sex and Asian ethnicity directly predicted future ARBs (beta weights 0.10 and -0.11, respectively), while all other variables had indirect impacts on ARBs through alcohol quantities (beta weights ~ 0.23 for European American ethnicity and low LR, 0.21 for cannabis use and COPE, and 0.44 for PEER). Alcohol quantities then related to ARBs with beta = 0.44. The SEM explained 23% of the variance. Conclusion: These data may be useful in identifying college students who are more likely to experience future ARBs over a 1-year period. They enhance our understanding of whether the relationships of predictors to ARBs are direct or mediated through baseline drinking patterns, information that may be useful in prevention strategies for ARBs.

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.

Factores psicosociales asociados al consumo de sustancias en estudiantes de una universidad pública / Public university students' psychosocial factors associated with legal and illegal substance consumption

Objetivo Determinar prevalencia y factores psicosociales asociados al consumo de sustancias legales e ilegales en estudiantes de una universidad pública. Método Estudio de tipo transversal realizado con 1359 estudiantes, seleccionados aleatoriamente. El instrumento de recolección incluyó el VESPA, CAGE, y las escalas de WHO, Rosemberg, Francis y APGAR. Se realizó análisis univariado y bivariado a través de razones de disparidad, con intervalos de confianza del 95 por ciento y error del 5 por ciento; análisis multivariado por medio de regresión logística, utilizando el programa Statistical Package Socials Sciencies (SPSS). Resultados Se encontró asociación entre el consumo abusivo de alcohol con el consumo de cigarrillos (OR=4,6), marihuana (OR=4,6) y cocaína (OR=2,2). El tener familias disfuncionales se asoció con el consumo de cigarrillo (OR=1,2), cocaína (OR=1,95) y consumo abusivo de alcohol (OR=1,94). Conclusiones El consumo abusivo de alcohol y la disfuncionalidad familiar son factores influyentes para el consumo de sustancias psicoactivas, en estudiantes universitarios.

Objective Determining the prevalence and psychosocial factors associated with public university students' legal and illegal substance consumption. Method This was across-sectional study of 1,359 randomly selected students. The harvesting instrument included the CAGE questionnaire and VESPA,WHO, Rosenberg, Francis and APGAR scales. The Statistical Package for the Social Sciences (SPSS) was used for univariate and bivariate analysis using disparity ratios (95 percent confidence intervals and 5 percent error) whilst logistic regression was used for multivariate analysis. Results An association was found between abusive alcohol consumption and smoking cigarettes (OR=4.6), marijuana (OR=4.6) and using cocaine (OR=2.2); having a dysfunctional family was associated with smoking cigarettes (OR=1.2), using cocaine (OR=1.95) and abusive alcohol consumption (OR=1.94). Conclusions Abusive alcohol consumption and having a dysfunctional family were influential factors regarding psychoactive substance consumption in public university students.

Cannabis e humor / Cannabis and mood

OBJETIVO: Avaliar as relações entre o uso agudo e crônico de cannabis e alterações do humor. MÉTODO: Os artigos foram selecionados por meio de busca eletrônica no indexador PubMed. Capítulos de livros e as listas de referências dos artigos selecionados também foram revisados. RESULTADOS: Observam-se elevados índices de comorbidade entre abuso/dependência de cannabis e transtornos afetivos em estudos transversais e em amostras clínicas. Estudos longitudinais indicam que, em longo prazo, o uso mais intenso de cannabis está relacionado com um risco maior de desenvolvimento de doença bipolar e, talvez, depressão maior em indivíduos inicialmente sem quadros afetivos; porém, os mesmos não encontraram maior risco de uso de cannabis entre aqueles com mania ou depressão sem esta comorbidade. Outra importante observação é que o uso de substâncias psicoativas em bipolares pode estar associado a uma série de características negativas, como dificuldade na recuperação dos sintomas afetivos, maior número de internações, piora na adesão ao tratamento, risco aumentado de suicídio, agressividade e a uma pobre resposta ao lítio. Tratamentos psicossociais e farmacológicos são indicados para o manejo da comorbidade entre cannabis e transtornos afetivos. CONCLUSÃO: As relações entre o uso de cannabis e alterações do humor são observadas tanto epidemiologicamente quanto nos contextos clínicos.

OBJECTIVE: Evaluate the relationship between acute and chronic use of cannabis and mood changes. METHOD: Articles were selected by electronic search in PubMed. Chapters in books and reference lists of selected articles were also reviewed. As the research did not involve humans, there was no evaluation by a Research Ethics Committee. RESULTS: High rates of comorbidity between use/abuse/dependence of cannabis and affective disorders in longitudinal studies and in clinical samples were observed. Longitudinal studies indicate that, in long-term, the higher use of cannabis is associated with an increased risk of developing bipolar disorder, and probably, major depression in subjects initially without affective disorder, but was not found increased risk of cannabis use among those initially only with mania or depression. Another important observation is that substance abuse in bipolar patients may be associated with a number of negative characteristics, such as difficulty in recovering the affective symptoms, more hospitalizations, poor compliance with treatment, increased risk of suicide, aggression and a poor response to lithium. Psychosocial and pharmacological treatments are indicated for the management of comorbidity between cannabis and affective disorders. CONCLUSION: The relationship between cannabis use and mood changes are observed both in the epidemiological research and in the clinical settings.

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.

O consumo de maconha na adolescência e as conseqüências nas funções cognitivas / The use of cannabis in adolescence and it's effects in the cognitive functions

Este estudo objetiva comparar o desempenho nas funções cognitivas de 30 usuários de maconha e de 30 não usuários. Os instrumentos usados foram uma entrevista estruturada; Screening Cognitivo (WISC-III e WAIS-III); WCST e Figuras Complexas de Rey. A amostra foi de 60 adolescentes, idades entre 14 e 17 anos, e escolaridade mínima de 5¬ série do Ensino Fundamental. Observou-se que houve diferença estatisticamente significativa no desempenho dos dois grupos em todos os testes neuropsicológicos aplicados; no subteste Código e no WCST, o grupo de usuários denotou desempenho mais prejudicado. Concluiu-se que a maconha pode afetar funções cognitivas de adolescentes usuários.

The objective of the study was to compare the cognitive function performance between a group of 30 cannabis users and a group of 30 non-users. The instruments used were a structured interview; Cognitive Screening (WISC - III and WAIS-III); WCST and Rey Complex Figure Test. The sample was 60 adolescents, aged from 14 to 17 from 5th grade on. The results showed that was statistically significant difference in the performance of the two groups in every neuropsychological test applied, and, in the Digit Symbol and in the WCST subtests, the users' group showed more impaired performance. The findings in this study it can be concluded that cannabis may affect the cognitive functions of adolescents.

Este estudio tiene como objetivo el de comparar el desempeño en las funciones cognitivas de 30 usuarios de marihuana y de 30 no usuarios. Los instrumentos usados fueron una entrevista estructurada; Screening Cognitivo (WISC-III y WAIS-III); WCST y Figuras Complejas de Rey. La muestra fue de 60 adolescentes, con edad entre 14 y 17 años y escolaridad mínima de 5 º año de la educación primaria. Se observó que hubo diferencia estadísticamente significativa en el desempeño de los dos grupos en todos los testes neuropsicológicos aplicados; en el sub-test código y no WCST, el grupo de usuarios obtuvo desempeño más perjudicado. Se concluyó que la marihuana puede afectar funciones cognitivas de adolescentes usuarios.

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

Characteristics of Jamaicans who smoke marijuana before sex and their risk status for sexually transmitted diseases

Because of the high prevalence of marijuana smoking in Jamaica, it is important to know if this practice is associated with increased risk for STD infections. A national sample of 2,580 randomly selected Jamaicans, aged 15 to 49 years were administered a questionnaire to measure a number of health and behavioural variables. The results indicated that more persons who smoked marijuana before sex had a history of STD infections than non-marijuana smokers, the difference was significant among men (46 percent vs 26 percent, p < 0.001) but not among women (19 percent vs 8 percent, p = 0.09). There was no difference in age, however, more of the smokers were unmarried, poorly educated and unemployed than persons who did not smoke marijuana before sex. They were also more likely to engage in high risk sex behaviours and other risk taking behaviors than non-smokers. The results of multiple logistic analyses indicated that marijuana smoking before sex was an independent risk factor for STDs among men (Odd Ratio = 2.0, p = 0.04). Although it was not possible to determine if the association was causal, the increased risk for STDs among men who smoke marijuana before sex should be incorporated into the Jamaican STD/AIDS control programme by making special efforts to encourage condom use among marijuana smokers

Estudio psicosocial de un grupo de pacientes fumadores de marihuana / Psychosocial study of a group of marijana smoker patients

Se estudiaron 40 pacientes fumadores de marihuana que fueron tratados en las Salas o Clínicas de Psiquiatría del Hospital Público de Georgetown, Guyana en los meses de Febrero a Julio de 1987. Se les aplicó cuestionario confeccionado al efecto y entrevista psicológica. Se evidenció que el grupo más afectado correspondió a los hombres entre 21 y 25 años, que las alucinaciones contituyeron el motivo de consulta de mayor incidencia siendo la influencia social el móvil para iniciarse en el uso de la droga en la mayor parte de los casos estudiados. Se constató además que la desvinculación laboral y la insatisfacción con el medio familiar son aspectos significativos, observándose en el 32 % manifestaciones del Síndrome de Abstinencia y abuso de droga sin dependencia en el 20 % de los casos

Avaliaçäo dos efeitos da maconha por usuários de populaçäo estudantil / Evaluation of the effects of marihuana by student users

A maconha, droga bastante difundida no meio estudantil, foi estudada do ponto de vista do usuário, através da coleta de relatos sobre seus efeitos e o significado de seu uso. Foram realizadas entrevistas semidirigidas, com 26 estudantes de 16 a 23 anos de idade, de ambos os sexos, com os quais já se havia estabelecido rapport. Colheram-se informaçöes sobre: situaçäo familiar e individual; variáveis controladoras da primeira administraçäo e do uso atual; significado do uso no contexto de outras atividades; uso de outras drogas; efeitos nas esferas somática, cognitiva, percentual, emocional e sócio-sexual, e sua variaçäo intra-individual. Os resultados mais relevantes indicaram que: a) metade dos usuários nunca experimentou outra droga ilícita; b) a freqüência de uso tende a aumentar no início, atinge um pico e depois decresce; c) a maioria dos sujeitos pretende continuar a administraçäo da droga; d) os efeitos apontam para um aguçamento da sensibilidade perceptual, emocional e sexual, aumento no fluxo de idéias e perda da consolidaçäo de memória, modificaçäo na percepçäo de tempo e espaço; e) esses efeitos parecem interagir com a personalidade básica do sujeito e as circunstâncias em que a droga é consumida. Apesar de pequeno o número de sujeitos, os relatos säo consistentes com a literatura e justificam a exploraçäo mais pormenorizada das constataçöes a e b