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1.
Int Rev Psychiatry ; 35(5-6): 434-449, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38299652

RESUMEN

Currently, few treatments are available for craving in general, and none of them have received approval for cannabis craving. The objective of this review is to evaluate existing studies analysing treatments for cannabis craving and explore novel treatment possibilities for these patients. The study followed PRISMA guidelines and conducted an extensive database search. Inclusion criteria included human randomised controlled trials examining drug effects on craving symptoms. Exclusion criteria involved studies unrelated to craving, non-pharmacological treatments, duplicates, and non-English/Spanish/Portuguese articles. Our included 22 studies that investigated a wide range of compounds used for cravings related to other drugs, as well as interventions based on healthcare professionals' empirical knowledge. The current pharmacological treatments largely involve off-label drug use and the utilisation of cannabinoid-based medications, such as combinations of THC and lofexidine, oxytocin, progesterone, and N-acetylcysteine. These emerging treatments show promise and have the potential to revolutionise current clinical practices, but further investigation is needed to establish their efficacy. In this context, it is essential to consider non-pharmacological interventions, such as psychotherapy and behavioural treatments. These approaches play a crucial role in complementing pharmacological interventions and addressing the complex nature of the disorder.


Asunto(s)
Cannabis , Alucinógenos , Abuso de Marihuana , Humanos , Agonistas de Receptores de Cannabinoides/uso terapéutico , Ansia , Dronabinol/efectos adversos , Alucinógenos/farmacología , Abuso de Marihuana/tratamiento farmacológico , Uso Fuera de lo Indicado
2.
Int Rev Psychiatry ; 35(5-6): 468-474, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38299649

RESUMEN

Smoking rates among individuals with mental disorders are higher compared to general population. We aimed to investigate the effectiveness of a smoking cessation treatment among individuals with and without mental disorders. Self-report 7-day point prevalence was used to assess abstinence status among 'intention to treat' (n = 1,213) and 'completers-only' (n = 578) samples. Participants were distributed in (1) ND-only; (2) ND and other substance use disorder (ND-SUD); (3) ND associated with mental disorder but no other SUD (ND-MD); and (4) co-morbid ND, SUD and MD (ND-SUMD). The treatment program was composed by six weeks of group Cognitive Behavioral Therapy (CBT) and medical consultations. Multivariate logistic regression models were applied. Rates of abstinence between ND-only and both ND-MD and ND-SUMD differed in the 'intention-to-treat' sample, with the former group showing the best rate (62.5%, 48% and 45.4% respectively). ND-SUD had the second-best rate of abstinence (56.1%). Differences between groups were not observed among 'completers-only'. Self-report 7-day point prevalence abstinence is economical and reliable to be used in low to middle-income countries. In this study, it showed that the 6-week smoking cessation treatment had a positive effect among completers, which supports the importance of investing in treatment to decrease smoking prevalence in this population.


Asunto(s)
Trastornos Mentales , Cese del Hábito de Fumar , Trastornos Relacionados con Sustancias , Humanos , Cese del Hábito de Fumar/psicología , Autoinforme , Prevalencia , Fumar/psicología , Trastornos Mentales/epidemiología , Trastornos Mentales/terapia , Trastornos Relacionados con Sustancias/complicaciones
3.
Int Rev Psychiatry ; 34(1): 59-77, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-35584015

RESUMEN

Immigration typically occurs from low- to high-income countries and regions. Unfortunately, these wealthier areas also have higher rates of cannabis use (e.g. European Union and the US). This systematic review aimed to summarize available studies on cannabis use among immigrants, refugees, and asylum seekers. In addition, evidence on the association between immigration and cannabis use was reviewed. The rates of cannabis use were lower among immigrants than natives. The risk and protective factors to cannabis use were quite similar to those of the native populations. The population at greatest risk for cannabis use were refugees, males, singles, non-religious, those with lower educational level, living in urban areas, with friends that use cannabis and/or other drugs. Cannabis use tend to increase over generations, and acculturation seems to play a pivotal role. First generation migrants report equal or lower consumption of cannabis when compared with the majority population with a subsequent increase in following generations, with a clear association with acculturation factors. A higher cannabis use was found among migrants with lower cultural congruity as well as a higher level of culture assimilation. This use seems to be unrelated to alcohol or illicit drugs consumption, but possibly associated with tobacco smoking.


Asunto(s)
Cannabis , Emigrantes e Inmigrantes , Refugiados , Migrantes , Cannabis/efectos adversos , Emigración e Inmigración , Humanos , Masculino
4.
Int Rev Psychiatry ; 34(1): 26-33, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-35584022

RESUMEN

Social exclusion and poverty are associated with increased mental health issues. In addition, the current political and civil conflicts worldwide are also considered as leading factors to mental disorders and substance use disorders. The Compassion, Assertive action, Pragmatism and Evidence (CAPE) index comprises nine country-level measures and highlights the need for assistance in countries with a high degree of vulnerability. Several findings from previous studies reported a broad relationship between CAPE indices and increased levels of mental disorders and substance use. In this paper, we identified the prevalence of mental disorders and substance use disorders among those countries reporting higher (i.e., highest CAPE Index scores) as well as lower (i.e., highest Quality of Life Index scores) vulnerability. We extracted prevalence data from the Institute for Health Metrics and Evaluation global database in 2019. There was a lower prevalence of mental (12.5%) and substance use (1.7%) disorders in highly vulnerable countries than less vulnerable ones (15.1% and 3.5%, respectively). These findings suggest an urgent need for early detection of mental and substance use disorders in vulnerable countries: increasing mental health literacy among non-specialized health professionals in these regions may greatly improve the level of detection and treatment.


Asunto(s)
Trastornos Mentales , Trastornos Relacionados con Sustancias , Humanos , Trastornos Mentales/epidemiología , Trastornos Mentales/terapia , Salud Mental , Pobreza , Prevalencia , Calidad de Vida , Trastornos Relacionados con Sustancias/epidemiología , Trastornos Relacionados con Sustancias/terapia
5.
Subst Use Misuse ; 56(12): 1910-1914, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34347562

RESUMEN

Background: Hookah is a device commonly employed for the use of tobacco, which is becoming popular in Western countries, especially among young people. In fact, its use has become a public health problem worldwide. Few Brazilian studies have researched its use, in this way, hookah culture has not been adequately examined in the country. Objective: This study aimed to investigate in depth the culture of hookah use in the city of São Paulo, Brazil. Methods: To do so, a cross-sectional, observational qualitative study was conducted. An intentional sample made by 29 subjects was selected through key informants and the snowball sampling technique. Participants were asked to engage in a semi-structured individual interview, which was recorded with the participant's prior consent. The interviews were analyzed according to Bardin's content analysis method. Results: Most of the participants were young, single men. The use of hookah is predominantly done in groups and during festive situations. Public places such as lounges, snack bars, and on the street were most often reported locations for hookah use. Interviewees have reported using hookah for long periods of time, for instance, from 1 to 10 hours continuously. Physical and psychological effects were reported, especially unpleasant ones. Engagement in polydrug use was reported for coping with the hookah effects. Participating in games was the main reason to use hookah. Conclusions: It is worrisome that a health risk behavior such as hookah use is conducted as an entertainment activity among young people, and thus it deserves a different approach and evaluation from the appropriate authorities.


Asunto(s)
Pipas de Agua , Productos de Tabaco , Adolescente , Brasil/epidemiología , Estudios Transversales , Humanos , Masculino , Investigación Cualitativa
6.
Subst Use Misuse ; 52(14): 1809-1822, 2017 Dec 06.
Artículo en Inglés | MEDLINE | ID: mdl-28742414

RESUMEN

This review aims to summarize neuroimaging studies in order to better understand the neural correlates of depressive symptoms in tobacco smokers. Using the keywords "depressive OR depression" AND "tobacco OR nicotine OR smok* OR cigarette" AND "neuroimage OR magnetic resonance OR smri OR structural magnetic resonance OR fmri OR functional magnetic resonance OR pet OR positron emission tomography", literature search was conducted in PubMed, Web of Science and PsycINFO databases. The first and the last author read the abstracts of all the studies found in the search (n = 179). The inclusion and exclusion criteria were applied and 150 articles were excluded. Then, both authors assessed the remaining 29 studies for eligibility and 16 studies were included in the present review. In the phase of active/chronic smoking, depressive symptoms are characterized as comorbidity related to an enhancement of dopamine release, and smokers have decreased Monoamine oxidase A (MAO-A). Stimuli-related functional magnetic resonance imaging (Stimuli-fMRI) studies also show that there is a positive correlation between the level of depressive symptoms and a greater response to general negative stimuli in active/chronic smokers. In the withdrawal phase, depressive symptoms are related to the withdrawal syndrome and increased MAO-A. Stimuli-fMRI studies show that there is a negative correlation between level of depressive symptoms and reactivity to negative stimuli in recent abstinent smokers. Major areas of the reward system such as the striatum and areas related to impulse control are activated to a greater extent in depressive smokers compared to non-depressed smokers.


Asunto(s)
Encéfalo/fisiopatología , Trastorno Depresivo/fisiopatología , Imagen por Resonancia Magnética , Fumadores/psicología , Fumar/efectos adversos , Correlación de Datos , Trastorno Depresivo/psicología , Dopamina/metabolismo , Humanos , Monoaminooxidasa/metabolismo , Nicotina/efectos adversos , Fumar/fisiopatología , Cese del Hábito de Fumar , Síndrome de Abstinencia a Sustancias
7.
J Dual Diagn ; 13(4): 238-246, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28489501

RESUMEN

OBJECTIVES: The aim of this study was to investigate smoking treatment effectiveness and retention in a population with and without mental disorders (MD). Participants received cognitive behavioral therapy (CBT) plus nicotine patch alone or in combination with other medications (i.e., gum, bupropion, or nortriptyline) for smoking cessation treatment in a Brazilian Psychosocial Care Center unit (CAPS), taking into account sociodemographics and smoking profile covariates. METHODS: The study involved comparison of treatment success (seven-day point prevalence abstinence at the end of the treatment) and retention (presence of the individual in all of the four medical consultations and six group sessions) in two subsamples of patients with MD (n = 267) and without MD (n = 397) who were included in a six-week treatment provided by a CAPS from 2007 to 2013. The treatment protocol comprised group CBT and pharmacotherapy (nicotine patches, nicotine gums, and bupropion and nortriptyline available, prescribed by psychiatrists). RESULTS: Within patients with MD, CBT plus nicotine patch plus bupropion (aOR = 2.00, 95% CI [1.14, 3.50], p = .015) and CBT plus nicotine patch plus gum (aOR = 2.10, 95% CI [1.04, 4.23], p = .036) were associated with treatment success. Within patients without MD, female gender (aOR = 0.60, 95% CI [0.37, 0.95], p = .031) and lower Heaviness of Smoking Index score (aOR = 0.80, 95% CI [0.65, 0.99], p = .048) were associated with treatment success. No variable was associated with dropout or retention within patients with or without MD. CONCLUSION: Our findings support the use of CBT plus nicotine patch plus bupropion as well as CBT plus nicotine patch plus gum in samples with high rates of medical, psychiatric, and addiction disorders. These findings support those of previous studies in the general population. Pharmacological treatment associated with group CBT based on cognitive-behavioral concepts and combined with ongoing MD treatment seems to be the best option for smoking cessation treatment among patients with MD. Units that deal with patients with MD, such as CAPS in Brazil, should be encouraged to treat smoking addiction in this population. Future studies should investigate retention rates in other samples of patients with MD.


Asunto(s)
Colinérgicos/uso terapéutico , Terapia Cognitivo-Conductual , Trastornos Mentales/complicaciones , Cese del Hábito de Fumar/métodos , Fumar/terapia , Adulto , Bupropión/uso terapéutico , Terapia Cognitivo-Conductual/métodos , Terapia Combinada , Diagnóstico Dual (Psiquiatría) , Femenino , Humanos , Masculino , Trastornos Mentales/terapia , Persona de Mediana Edad , Nortriptilina/uso terapéutico , Cooperación del Paciente , Modelos de Riesgos Proporcionales , Psicotrópicos/uso terapéutico , Factores Sexuales , Dispositivos para Dejar de Fumar Tabaco , Resultado del Tratamiento , Adulto Joven
8.
Am J Addict ; 25(7): 518-28, 2016 10.
Artículo en Inglés | MEDLINE | ID: mdl-27629700

RESUMEN

BACKGROUND AND OBJECTIVES: Despite scientific evidence that marijuana impairs performance and mental health, there is evidence that some athletes are at higher risk for use. This review aims to identify possible risk factors associated with marijuana use in athletes. METHODS: A search was conducted in the PubMed database with the keywords: (marijuana OR cannabis OR tetrahydrocannabinol OR delta-9-tetrahydrocannabinol OR THC) AND (sports OR sport OR athlete OR athletes). We retrieved 186 studies. After applying the inclusion/exclusion criteria, 15 studies remained for review. RESULTS: The review revealed a number of potential risk factors for marijuana use among adult athletes, including being male, Caucasian, using sport performance-enhancing drugs, using marijuana to enhance recreation or non-sport performance, and practicing specific types of sports including skeleton, bobsleding, and ice hockey. Contrary to use patterns in the general population, among athletes marijuana appears to take the place of tobacco as the second most widely used drug, after alcohol. Many elite athletes denied the use of marijuana, which suggests that toxicological testing is an important tool for identifying users, because it is more accurate than self-report. Geography appears important, as in areas of high consumption, prevalence among athletes appears to be greater as well. CONCLUSION AND SCIENTIFIC SIGNIFICANCE: Contrary to the image that athletes do not use psychoactive drugs, this review suggests that a number of athletic subgroups are at increased risk for marijuana use. Surprisingly, a common rationale for use appears to be to enhance sports performance. As in the general population, experimentation starts early-in pre-adolescence-at an age that prevention and guidance programs could have positive influences. (Am J Addict 2016;25:518-528).


Asunto(s)
Atletas/psicología , Uso de la Marihuana/epidemiología , Atletas/estadística & datos numéricos , Salud Global , Conocimientos, Actitudes y Práctica en Salud , Humanos , Uso de la Marihuana/psicología , Prevalencia , Factores de Riesgo
9.
Int Rev Psychiatry ; 28(6): 572-578, 2016 12.
Artículo en Inglés | MEDLINE | ID: mdl-27534440

RESUMEN

The consumption of alcohol, tobacco, and other drugs has become a concern in high-performance athletes. Professional athletes are more exposed to drugs than the general population. Although some drugs are unquestionably detrimental to performance, several studies have nevertheless shown evidence of increased consumption of these substances within this sub-population. This review aimed to elucidate alcohol, tobacco, cocaine, cannabis, and opioid use among high-performance athletes, discussing the prevalence of substance use, its impacts, and alternatives to treatment in this special population. Unfortunately, no clinical trials for the treatment of substance use disorders were carried out with this specific sub-population. Therefore, the strategies adopted for the general population should be adapted to high-performance athletes. Psychological, psychosocial, psychoeducational, cognitive-behavioural, motivational interviewing approaches can be implemented. As regards pharmacological treatment, medications used in the treatment of alcohol and tobacco dependence, such as naltrexone, disulfiram, acamprosate, varenicline, bupropion, and nicotine replacement treatment can be used without problems. However, some medications used in cocaine and opioid dependence treatment, such as moldafinil and methadone, are prohibited by doping enforcement agencies. Professionals involved with athletes should be aware of the signs and symptoms of the acute effects of substances so as to enable an early identification of substance abuse problems, especially during training periods.


Asunto(s)
Atletas/estadística & datos numéricos , Trastornos Relacionados con Sustancias/epidemiología , Trastornos Relacionados con Sustancias/terapia , Humanos , Trastornos Relacionados con Sustancias/tratamiento farmacológico
10.
Int Q Community Health Educ ; 36(3): 199-205, 2016 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-27166357

RESUMEN

Quantitative structured assessment of 193 scenes depicting substance use from a convenience sample of 50 Brazilian movies was performed. Logistic regression and analysis of variance or multivariate analysis of variance models were employed to test for two different types of outcome regarding alcohol appearance: The mean length of alcohol scenes in seconds and the prevalence of alcohol use scenes. The presence of adolescent characters was associated with a higher prevalence of alcohol use scenes compared to nonalcohol use scenes. The presence of adolescents was also associated with a higher than average length of alcohol use scenes compared to the nonalcohol use scenes. Alcohol use was negatively associated with cannabis, cocaine, and other drugs use. However, when the use of cannabis, cocaine, or other drugs was present in the alcohol use scenes, a higher average length was found. This may mean that most vulnerable group may see drinking as a more attractive option leading to higher alcohol use.


Asunto(s)
Conducta del Adolescente , Películas Cinematográficas , Consumo de Alcohol en Menores , Adolescente , Brasil , Femenino , Humanos , Drogas Ilícitas , Modelos Logísticos , Masculino
11.
J Ment Health ; 24(1): 9-14, 2015 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-25188583

RESUMEN

BACKGROUND: There has been considerable debate regarding what typically occurs after experimentation with drugs throughout the life of young people who used various drugs. AIMS: To evaluate the clinical importance of the most common sequence for the first use of a drug by two models (the "gateway model" and the "alternative model", which is the most popular sequence for Brazilian university students according to a previous study) regarding the problematic use of alcohol, tobacco, cannabis and other illegal drugs, assessed by ASSIST. METHOD: People who had already experimented with three or more drugs across different stages of the two models were selected from a representative sample of university students from 27 Brazilian capitals (n = 12 711). FINDINGS: There were no differences regarding the problematic use of the most consumed drugs in Brazil (alcohol, tobacco and cannabis) between the models. Multiple drug seekers and violators had more problematic use of illegal drugs other than cannabis than individuals in the model sequence. However, in the case of violators, this was only evident in the alternative model. CONCLUSIONS: Multiple drug seekers and violators deserve special attention due to their increased risk of problematic use of other illegal drugs.


Asunto(s)
Consumidores de Drogas/psicología , Trastornos Relacionados con Sustancias/epidemiología , Adulto , Alcoholismo/epidemiología , Femenino , Humanos , Masculino , Abuso de Marihuana/epidemiología , Análisis de Regresión , Tabaquismo/epidemiología , Adulto Joven
12.
BMC Microbiol ; 14: 250, 2014 Oct 03.
Artículo en Inglés | MEDLINE | ID: mdl-25278091

RESUMEN

BACKGROUND: Today there are more than 2 billion alcohol users and about 1.3 billion tobacco users worldwide. The chronic and heavy use of these two substances is at the heart of numerous diseases and may wreak havoc on the human oral microbiome. This study delves into the changes that alcohol and tobacco may cause on biofilms of the human oral microbiome. To do so, we used swabs to sample the oral biofilm of 22 subjects; including 9 control-individuals with no or very low consumption of alcohol and no consumption of tobacco, 7 who were chronic and heavy users of both substances and 6 active smokers that reported no significant alcohol consumption. DNA was extracted from swabs and the V1 region of the 16S rRNA gene was PCR amplified and sequenced using the Ion Torrent PGM platform, generating 3.7 million high quality reads. DNA sequences were clustered and OTUs were assigned using the ARB SILVA database and Qiime. RESULTS: We found no differences in species diversity and evenness among the groups. However, we found a significant decrease in species richness in only smokers and in smokers/drinkers when compared to controls. We found that Neisseria abundance was significantly decreased in both groups when compared to controls. Smokers had significant increases in Prevotella and Capnocytophaga and reductions in Granulicatella, Staphylococcus, Peptostreptococcus and Gemella when compared to the two other groups. Controls showed higher abundance of Aggregibacter, whilst smokers/drinkers had lower abundances of Fusobacteria. Samples from only smokers clustered closer together than to controls and smokers/drinkers, and also had a significant reduction in inter-group dissimilarity distances, indicating a more homogenous group than controls. CONCLUSIONS: Our results indicate that the continued use of tobacco or alcohol plus tobacco significantly reduces bacterial richness, which apparently leads to a reduction in inter-group variability, turning the respective biofilms into a more homogenous microenvironment in terms of bacterial community composition, with possible consequences for human oral diseases.


Asunto(s)
Consumo de Bebidas Alcohólicas , Bacterias/clasificación , Biopelículas/crecimiento & desarrollo , Biota/efectos de los fármacos , Mucosa Bucal/microbiología , Uso de Tabaco , Anciano , Bacterias/genética , Bacterias/aislamiento & purificación , Análisis por Conglomerados , ADN Bacteriano/química , ADN Bacteriano/genética , ADN Ribosómico/química , ADN Ribosómico/genética , Femenino , Humanos , Masculino , Persona de Mediana Edad , Datos de Secuencia Molecular , Filogenia , Reacción en Cadena de la Polimerasa , ARN Ribosómico 16S/genética , Análisis de Secuencia de ADN
13.
Int Rev Psychiatry ; 26(4): 515-23, 2014 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-25137119

RESUMEN

Psychosocial units in Brazil (CAPS) provide access to mental health and addiction patients, who are not routinely treated for nicotine dependence. The present study analysed predictors of retention of a 6-week treatment provided by a CAPS unit to 367 smokers with a high rate of psychiatric disorders and addictions for the period 2007-2010. Several baseline variables were collected. Retention was defined as the presence of the individual in all four medical consultations and six group sessions. Multivariate discrete time Cox survival regression models were used to test for the outcome of interest. Timetables were used to explore in which moment of the treatment each predictor was important. Time to smoking the first cigarette (TTFC) 5 min or later after waking and nicotine patch use (nicotine replacement therapy, NRT) were associated with retention. The present study supports the importance of the variables TTFC and NRT when used in treatment retention for a sample with a high rate of psychiatric and alcohol disorders. NRT seems to be very important in the beginning of the treatment, probably because of withdrawal symptoms. Individuals currently undergoing psychiatric treatment and with alcohol problems had good retention rates comparable to the other individuals.


Asunto(s)
Servicios de Salud Mental/estadística & datos numéricos , Cooperación del Paciente/estadística & datos numéricos , Cese del Hábito de Fumar/estadística & datos numéricos , Adulto , Brasil/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pacientes Desistentes del Tratamiento/estadística & datos numéricos , Modelos de Riesgos Proporcionales , Fumar/epidemiología , Cese del Hábito de Fumar/métodos , Dispositivos para Dejar de Fumar Tabaco/estadística & datos numéricos , Adulto Joven
14.
Int Rev Psychiatry ; 26(4): 508-14, 2014 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-25137118

RESUMEN

The present study investigated the predictors of an increased number of visits from individuals with some of the diagnoses noted in chapter F14 of ICD-10, from calls to the emergency psychiatric unit of a general hospital in São Paulo state, Brazil, in the period 2011-2012. Poisson regression models were carried out for the outcome variable, accounting for number of subsequent visits to the psychiatric emergency unit. For the analysis of this outcome we took into account the exposure time of each individual in the study. Our findings point to a population at risk for frequent psychiatric emergency service visits: individuals over 25 years. This population should be targeted for interventions on entry into public healthcare due to increased psychiatric morbidity and greater clinical morbidity already confirmed by previous studies. We discussed the need of these individuals for special attention during the clinical or psychiatric emergency consultation which, unfortunately, may be the access point for the public health system. None of the other variables were related to the outcome of interest, such as those related to the level of individual entry into the care network before and after treatment, and other variables related to medical acts during the visit.


Asunto(s)
Trastornos Relacionados con Cocaína/complicaciones , Cocaína/efectos adversos , Cocaína Crack/efectos adversos , Servicios Médicos de Urgencia/estadística & datos numéricos , Trastornos Mentales/inducido químicamente , Adulto , Brasil/epidemiología , Trastornos Relacionados con Cocaína/psicología , Trastornos Relacionados con Cocaína/terapia , Femenino , Humanos , Clasificación Internacional de Enfermedades , Masculino , Trastornos Mentales/terapia , Estudios Prospectivos , Servicio de Psiquiatría en Hospital/estadística & datos numéricos , Adulto Joven
15.
Soc Psychiatry Psychiatr Epidemiol ; 49(3): 385-94, 2014 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-23918195

RESUMEN

PURPOSE: The aim of the present study was to test whether the first use of an illicit drug increases the chance of first use of other illicit drugs. METHOD: The transitions from the first use of a drug to the first use of another drug were analyzed. Comparisons were made between first drug users and non-users. Survival analysis methods were used to compare the cumulative probability of second drug use after adjusting for socio-demographic covariates and the intermediate use of alcohol and/or tobacco. A total of 12,721 Brazilian university students participated in this study. RESULTS: Inhalants and marijuana were used prior to the use of several other drugs, whereas the opposite pattern was not found. Ecstasy was used before other drugs in several instances. Other well-examined drugs, such as amphetamines, cocaine and hallucinogens, were used both before and after other illicit drugs without any marked predominance for either of the two roles. CONCLUSIONS: This study supports the role of the use of marijuana and inhalants almost exclusively before the use of other illicit drugs, whereas the use of ecstasy has an opposite role. These roles could be linked to the prevalence of lifetime use and whether individuals were at an earlier or later age during experimentation.


Asunto(s)
Consumidores de Drogas/estadística & datos numéricos , Drogas Ilícitas , Estudiantes/estadística & datos numéricos , Universidades/estadística & datos numéricos , Adolescente , Brasil/epidemiología , Femenino , Humanos , Masculino , Prevalencia , Estudiantes/psicología , Adulto Joven
16.
Acad Psychiatry ; 38(1): 90-5, 2014 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-24442788

RESUMEN

OBJECTIVE: The movie Crazy Heart (2009) draws our attention to alcohol disorders as it has a large number of scenes which portray alcohol consumption and fulfill the new DSM-5 Alcohol Use Disorder (DSM-5-AUD) criteria. In view of the recent launch of DSM-5, this is an appropriate opportunity to explore alcohol consumption in a large number of scenes employing the DSM-5-AUD criteria to study this. METHODS: We use media content analysis to identify DSM-5 AUD criteria as portrayed by the main protagonist of the movie Bad Blake in a structured manner. We studied his behavior and attitudes in the context of the film structure and storyline. RESULTS: The severity continuum of DSM-5 AUD can be demonstrated through the trajectory of the character Bad Blake. In the course of the movie, there is some reference to all the DSM-5-AUD criteria, which can be applied to this character within the 21 scenes selected for this study. CONCLUSION: This film can therefore be helpful and used to introduce students and trainees to the DSM-5-AUD criteria. It also allows teachers to discuss with their students and trainees the options of treatment including decision to quit drinking (total abstinence) and the recovery and relapse of this chronic condition.


Asunto(s)
Alcoholismo/diagnóstico , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Educación Médica/métodos , Películas Cinematográficas , Psiquiatría/educación , Humanos
17.
Arq Gastroenterol ; 61: e23175, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39046002

RESUMEN

BACKGROUND: Chronic excessive use of alcohol is an important risk factor for several health and social conditions. METHODS: A cross-sectional survey, in a sample representative of the Brazilian population,was conducted to evaluate the frequency of consumption of alcoholic beverages and behaviors concerning liver diseases. Participants were prospectively interviewed using a questionnaire regarding alcohol consumption and actions toward liver health. The study accepted at most one sampling error of ±2 percentage points and considered a 95% confidence interval. RESULTS: One thousand nine hundred ninety-five subjects (1.048 women, mean age 44 years) from all Brazilian regions were interviewed. Most of the Brazilian subjects believe that alcohol abuse (63-87%) is the leading cause of cirrhosis and liver cancer, however, most responders (56%) had never been screened to assess liver damage related to alcohol consumption. A total of 55% of Brazilians drink alcoholic beverages. Among Brazilians who drink alcoholic beverages, 44% consume three or more drinks at a time, 11% consume more than 10 doses a day. Among those who consume 1 to 2 drinks a day, women (42%) consume more than men (32%) and more than the national average (37%). CONCLUSION: There is a high frequency of alcohol consumption, especially among young people, and individuals from lower social classes, with frequent consumption among women. Despite the knowledge of its adverse impact on liver health, less than half of the Brazilians have been evaluated at least once for liver disease. Education and prevention strategies need to be implemented to reduce theharmful use of alcohol.


Asunto(s)
Consumo de Bebidas Alcohólicas , Factores Socioeconómicos , Humanos , Femenino , Masculino , Brasil/epidemiología , Adulto , Consumo de Bebidas Alcohólicas/epidemiología , Consumo de Bebidas Alcohólicas/efectos adversos , Estudios Transversales , Persona de Mediana Edad , Adulto Joven , Factores de Riesgo , Hepatopatías Alcohólicas/epidemiología , Hepatopatías Alcohólicas/etiología , Estudios Prospectivos , Encuestas y Cuestionarios , Anciano , Adolescente
18.
Subst Use Misuse ; 48(3): 248-57, 2013 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-23302060

RESUMEN

Considering the absence of data on the appearance of drugs other than alcohol and tobacco in movie scenes, we decided to study the prevalence of portrayal of illicit drug use in a convenience sample of 50 Brazilian Movies. A total of 192 scenes (12h49'03(″)) meeting the inclusion criteria were identified and assessed in a structured manner. Despite several limitations regarding the nature of this comparison, we found that scenes show substance use and misuse almost similar to that in the general population, mainly alcohol (especially among people of low socioeconomic status), cannabis and inhalants. Main differences were found in cocaine and tranquilizers (over- and underexposure in movies, respectively).


Asunto(s)
Películas Cinematográficas/estadística & datos numéricos , Trastornos Relacionados con Sustancias/epidemiología , Bebidas Alcohólicas/estadística & datos numéricos , Conducta Adictiva/epidemiología , Brasil/epidemiología , Humanos , Fumar Marihuana/epidemiología , Proyectos Piloto , Prevalencia
19.
Int J Ment Health Addict ; : 1-14, 2023 May 22.
Artículo en Inglés | MEDLINE | ID: mdl-37363763

RESUMEN

The use of electronic cigarettes (e-cigarettes) persists in Brazil, despite restrictions on sales, imports, and advertising. This study aimed to identify the prevalence of e-cigarette use and user profiles among university students. This cross-sectional study used a convenience sample of 3083 university students (female = 2253, male = 830; M=26.1; SD =8.43) who completed an online survey. We employed logistic regression models and network analysis to determine the profile of e-cigarette users. The prevalence of e-cigarette use in the past year was 12.2% (n =377). Men, single individuals, Caucasians, secular individuals, and non-heterosexual individuals were more likely to engage in e-cigarette use. Intense use of alcohol, tobacco products, and illicit drugs increased the likelihood of e-cigarette use. Brazilian college students continue to use electronic cigarettes despite the prohibition. The pattern of alcohol abuse and tobacco product use among e-cigarette users is concerning. These risky behaviors render young and highly educated individuals targets for public policies to control and regulate electronic cigarettes in the country.

20.
J Affect Disord ; 329: 324-334, 2023 05 15.
Artículo en Inglés | MEDLINE | ID: mdl-36849006

RESUMEN

BACKGROUND: Suicide is one of the leading causes of death among youth and its occurrence among college students is a matter of great concern. Challenges of transitional adulting and mental illness increase the likelihood of suicidal cognition in students. The objective of present study was to investigate the prevalence of suicide ideation and associated factors in a representative sample of Brazilian college students (n = 12,245). METHODS: Data were drawn from a nationwide survey and further subjected to estimate the prevalence of suicide ideation and its association with socio-demographic and academic characteristics. We performed logistic regression analyses upon a conceptual framework, considering individual and academic factors. RESULTS: The point-prevalence of suicide ideation among college students was 5.9 % (SE = 0.37). In the final regression model, variables associated with the likelihood of suicide ideation were psychopathology, sexual abuse, and academic variables, such as dissatisfaction with the chosen undergraduate course (OR = 1.86; IC95 % 1.43-2.41) and low academic performance (OR = 3.56; IC95 % 1.69-7.48). Having children and religious affiliation were inversely associated with the likelihood of suicide ideation. LIMITATIONS: Participants were recruited from state capitals, which limited data generalizability to non-urban college students. CONCLUSIONS: The impact of academic life on the mental health of students should be carefully monitored in in-campus pedagogical and health services. Early identification of poor-performance students with social disadvantages could indicate vulnerable ones who are much in need of psycho-social support.


Asunto(s)
Delitos Sexuales , Ideación Suicida , Adolescente , Niño , Humanos , Salud Mental , Intento de Suicidio/psicología , Brasil/epidemiología , Estudiantes/psicología , Factores de Riesgo
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