Is drug use related to the choice of potentially more harmful methods in suicide attempts?

OBJECTIVE: To identify whether drug abuse is a risk factor for potentially more harmful methods of suicide attempts that could predict suicide completion in the future. METHODS: The study involved the assessment of 86 patients who attempted suicide and who were admitted to the emergency ward of a Southwestern Brazilian general hospital. RESULTS: Most patients were women (84.9%), young adults (30.53 ± 10.4 years), and single (61.6%). Recent drug use was reported by 53.5%, and 25.6% reported the use of drugs during the 24-hour period immediately before the suicide attempt. Most patients (75.6%) ingested pills when attempting suicide-a method considered potentially less harmful. Hanging, jumping, gas inhaling, and wrist cutting accounted for 22.2% of the attempts. Considering dual diagnoses, 54.7% presented with a depressive disorder, 8.1% with a disorder on the impulse control spectrum, and 26.7% reported an associated clinical condition. Recent drug use was predictive of the severity of the suicide attempt, as it was reported by 81% of those who engaged in more harmful attempts and by 46.2% of those who used less harmful methods (P < 0.01; odds ratio = 4.96; confidence interval: 1.5-16.4). CONCLUSION: The identified variables associated with the use of potentially more harmful methods in suicide attempts were gender (male), presence of an impulsive control disorder, and recent use of psychoactive drugs.

Internal validity, dimensionality and performance of the Body Shape Questionnaire in a group of brazilian college students / Validade interna, dimensionalidade e desempenho da escala Body Shape Questionnaire em uma população de estudantes universitários brasileiros

OBJECTIVE: To adapt the Body Shape Questionnaire for use in the Brazilian population; to study the internal validity and the dimensionality of the scale when used in a non- clinical Brazilian population. METHOD: A cross- sectional study was accomplished comprising 164 students in the first 3 years of the School of Medicine conveniently selected at the Universidade Federal de São Paulo. The 34- item Body Shape Questionnaire version and a questionnaire to assess demographic and anthropometric information were used. RESULTS: The internal consistency of the Body Shape Questionnaire measured by Cronbach's alpha was 0.97, indicating that the questions of the scale converge to the same construct. The factor analysis of the scale resulted in a four- dimension solution accounting for 66.4 percent of the total data variability. Regarding the final score of Body Shape Questionnaire, the mean score was 58.7 ± 25.1 for men and 89.7 ± 31.3 for women. DISCUSSION: We found statistically significant gender differences in the means of the Body Shape Questionnaire scores. Women showed higher dissatisfaction than did men as to their appearance as measured by the Body Shape Questionnaire. The adapted version of the scale seems to maintain the characteristics of the original scale.

OBJETIVO: Adaptar a escala Body Shape Questionnaire para uso no Brasil; estudar a validade interna e a dimensionalidade da escala quando usada em uma população não clínica brasileira. MÉTODO: Um estudo de corte transversal foi realizado envolvendo uma população selecionada por conveniência de 164 estudantes dos três primeiros anos do curso de Medicina da Universidade Federal de São Paulo. Foram usados a versão de 34 itens do Body Shape Questionnaire e um questionário adicional para informação demográfica e antropométrica. RESULTADOS: A consistência interna do Body Shape Questionnaire, medida através do alfa de Cronbach, foi de 0,97, o que indica que as questões da escala convergem para um mesmo construto. A análise fatorial da escala resultou em uma solução de quatro dimensões que responde por 66,4 por cento da variabilidade total dos dados. Em relação aos escores Body Shape Questionnaire, sua média foi de 58,7 ± 25,1 para os homens e 89,7 ± 31,3 para as mulheres. DISCUSSÃO: Encontramos uma diferença estatisticamente significante entre os gêneros na média dos escores do Body Shape Questionnaire. As alterações de imagem corporal, medidas pelo Body Shape Questionnaire, mostram uma grande insatisfação com a aparência em mulheres quando comparadas aos homens. A versão adaptada da escala parece manter as características da escala original.

Internal validity, dimensionality and performance of the Body Shape Questionnaire in a group of Brazilian college students.

OBJECTIVE: To adapt the Body Shape Questionnaire for use in the Brazilian population; to study the internal validity and the dimensionality of the scale when used in a non- clinical Brazilian population. METHOD: A cross- sectional study was accomplished comprising 164 students in the first 3 years of the School of Medicine conveniently selected at the Universidade Federal de São Paulo. The 34- item Body Shape Questionnaire version and a questionnaire to assess demographic and anthropometric information were used. RESULTS: The internal consistency of the Body Shape Questionnaire measured by Cronbach's alpha was 0.97, indicating that the questions of the scale converge to the same construct. The factor analysis of the scale resulted in a four- dimension solution accounting for 66.4% of the total data variability. Regarding the final score of Body Shape Questionnaire, the mean score was 58.7 +/- 25.1 for men and 89.7 +/- 31.3 for women. DISCUSSION: We found statistically significant gender differences in the means of the Body Shape Questionnaire scores. Women showed higher dissatisfaction than did men as to their appearance as measured by the Body Shape Questionnaire. The adapted version of the scale seems to maintain the characteristics of the original scale.

Evolutional pattern of drug use by medical students.

Recent use of psychoactive substances among 456 medical students throughout the six grades was surveyed by way of a self-report questionnaire using World Health Organisation criteria. Among male medical students, the most frequently used substances were alcohol (80.5%), cannabis (25.3%), solvents (25.2%), and tobacco (25.2%), whereas among female students the most frequently used drugs were alcohol (72.6%), tobacco (14.6%), solvents (10.5%), and tranquillizers (7.5%). Switch from illegal to legal drugs were observed only among female medical students. Male students tend to alternate cannabis and solvents throughout college years. Interventions aiming to influence patterns of drug consumption among medical students must consider both gender differences and evolutional patterns of substance use throughout medical course.

Factors associated with the use of solvents and cannabis by medical students.

INTRODUCTION: The use of alcohol and other drugs among medical students has been a theme of growing interest and concern on the part of researchers, teaching institutions and medical associations since the decade of the 1960's. OBJECTIVE: Recent use of alcohol, tobacco, tranquillisers, amphetamines, cannabis, organic solvents, and cocaine among 456 medical students was surveyed. METHOD: Assessment was done by means of a self-report questionnaire according to World Health Organisation guidelines. RESULTS: Among medical students, after alcohol and tobacco, cannabis and solvents are the most frequently used psychoactive substances. As such, they were the most deeply analysed drugs in this study. Factors associated with the recent use of cannabis and solvents were established by logistic regression. Living with parents or a companion appeared as a protective factor for the use of cannabis. However, being male and regularly participating in the activities at the campus Sports Association showed as risk factors for the use of both cannabis and solvents. DISCUSSION: Concepts and misconceptions concerning protective and risk factors must be discussed in the light of cultural and circumstantial interferences. Harm reduction strategies should be seriously considered.

Effectiveness of time-limited psychotherapy for minor psychiatric disorders: randomised controlled trial evaluating immediate v. long-term effects.

BACKGROUND: Psychotherapy research rarely has studied outcome in the longer term. AIMS: To evaluate the effectiveness of brief group dynamic psychotherapy (BGDP) intervention in patients with minor psychiatric disorders compared with the usual clinical management shortly after treatment termination and to investigate whether intervention would show a differential effect at 2-year follow-up. METHOD: Patients were allocated randomly to an experimental or control group. The General Health Questionnaire (GHQ) was used as a primary outcome measure. RESULTS: Based on improvement in the GHQ, at termination of treatment the BGDP group showed a significant improvement in 23 out of 42 (54.8%) compared with 11 out of 41 (26.8%) in the clinical management group. The difference in the total improvement rate is 28% (95% C18-48) (chi(2)=6.7; d.f.=1; P=0.009). In contrast, no differential follow-up effects were found between the BGDP and clinical management groups. CONCLUSIONS: Psychotherapy appears to have beneficial effects at termination of treatment but the changes attained were not stable.