Predictors of drug-drug interactions of medications prescribed to patients admitted due to suicidal behavior.

INTRODUCTION: Drug-drug interactions among people with suicidal behavior is a challenging topic, considering the harm it poses for patients already vulnerable and the lack of literature on the thematic. This aspect must not be neglected in research and clinical practice, and thus requires thorough investigation. OBJECTIVE: to investigate predictors of drug-drug interaction of prescribed drugs and the prescription of two or more drugs for people admitted due to suicidal behavior in a psychiatric emergency department (short-stay hospital ward). METHOD: A cross-sectional study with retrospective approach, carried out in a Brazilian psychiatric emergency unit in 2015. Data about first and last medical prescriptions were collected from 127 patients' files. Descriptive statistics and the Zero Adjusted Logarithmic Distribution (ZALG) model were adopted, with the significance level α = 0.05. RESULTS: Potential drug-drug interactions were found in most of the first and last prescriptions. The sample majority were female, with previous suicide attempts, being discharged from the hospital with three drugs (or more) prescribed, and without referral to any health service. Age and comorbidities were predictors of more drug prescriptions and the amount of prescribed drugs was the most important predictor of drug-drug interactions (quantity and severity). CONCLUSIONS: the variables associated with drug-drug interactions and prescription of two or more drugs among people with suicidal behavior needs to be investigated in different contexts and addressed in interventions with the aim to promote patient safety.

Factors associated with alcohol use and abuse in Brazilian primary health care settings.

The main goal of this study was to identify the prevalence of alcohol use and associations with selected variables among clients in a primary healthcare setting. A quantitative, cross-sectional study was carried out using structured questionnaires to measure the pattern of alcohol consumption, quality of life and common mental disorders. The results showed that men, people between 18 and 40 years old, with income between $300.00 and 1200.00 and smokers were at a higher risk of problematic alcohol use. Healthcare professionals should include alcohol screening questions to identify the hazardous consumption of alcohol at an early stage and prevent negative consequences.

An Integrative Review of Non-Pharmacological Therapeutic Interventions in Children with Mental Health Problems.

We provide an integrative review of non-pharmacological interventions for children with mental health problems. A total of 262 studies were found in three databases, of which 12 met the inclusion criteria, indicating a shortage of research on the subject. The most frequently used type of intervention was cognitive-behavioural therapy-based interventions, and attention deficit hyperactivity disorder was the most frequent problem. Non-pharmacological interventions help to improve the symptoms of childhood mental health problems, so there is a need to carry out further research on this issue in Brazil and the rest of Latin America.

Factors associated with common mental disorders and use of psychiatric drugs in cancer outpatients.

BACKGROUND: Considering the high incidence of cancer in Brazil and worldwide, the high prevalence and relevance of Common Mental Disorders (CMD) in the treatment of cancer patients, and the use of psychiatric drugs without reliably proven effectiveness, studies that contemplate this topic are needed to understand and provide rationale for the treatment of CMD in these individuals. OBJECTIVES: This study identified prevalence and factors associated with Common Mental Disorders (CMD) and psychotropic use in cancer outpatients. METHOD: This is a cross-sectional study with descriptive correlational design. It was developed in the chemotherapy sector of a hospital specialized in cancer. The tools used were: Self Reporting Questionnaire (SRQ-20) and structured questionnaires. FINDINGS: Among 403 respondents, CMD prevalence was 31.5% and psychotropic use was 25.8%. CMD were associated with gender, education, family income, psychotropic use and cancer surgery. Psychotropic use was associated with gender, employment status, cancer surgery, treatment period and other physical health conditions. Logistic regressions showed CMD were associated with gender and other physical health conditions; psychotropic use was associated with gender, employment status and other conditions.

Assistance related to suicidal behavior at a mobile emergency service: Sociodemographic and clinical associated factors.

It is important to investigate the care given to people with suicidal behavior, as it is an important predictor of future death by suicide and there is a lack of studies on this issue in Brazil. This study had the objective of investigating assistance related to suicidal behavior at a mobile emergency service and sociodemographic and clinical associated factors. This was a quantitative, cross-sectional study based on documental information. The data were collected through manual consultation of nursing records in which call-outs for suicidal behavior in the year 2014 were documented. The data were analyzed using descriptive statistics, Chi-squared test, Fisher's exact test, correlation tests, and comparison of means tests. In the 313 records analyzed there was a predominance of adult women with self-inflicted drug poisoning, attended to in their own residence and referred to pre-hospital emergency medical services. There was a lack of documentation on signs, symptoms, and grievances in most cases. The interventions most carried out by the nurses were related to monitoring of clinical parameters. There were differences related to the victim's sex and lethality, suicide attempt method, referral to emergency services, and semester of occurrence (January-June, July-December). Suicide attempts through self-poisoning or self-inflicted injuries differed in relation to time of call-out, waiting time, lethality, documentation on clinical assessment and interventions, and referral to emergency services. This study enabled the charting of factors linked with suicidal behavior and associated factors; it offers reflections on limitations and nursing care potential in the prevention of reoccurrence of suicidal behavior.

Physical and mechanical restraint in psychiatric units: Perceptions and experiences of nursing staff.

BACKGROUND: Physical restraint in psychiatric units is a common practice but extremely controversial and poorly evaluated by methodologically appropriate investigations. The cultural issues and professionals' perceptions and attitudes are substantial contributors to the frequency of restraint that tend to be elevated. Aim In this qualitative study, we aimed to understand the experiences and perceptions of nursing staff regarding physical restraint in psychiatric units. METHOD: Through theoretical sampling, 29 nurses from two Brazilian psychiatric units participated in the study. Data were collected from 2014 to 2016 from individual interviews and analyzed through thematic analysis, employing theoretical presuppositions of symbolic interactionism. RESULTS: Physical restraint was considered unpleasant, challenging, risky, and associated with dilemmas and conflicts. The nursing staff was often exposed to the risks and injuries related to restraint. Professionals sought strategies to reduce restraint-related damages, but still considered it necessary due to the lack of effective options to control aggressive behavior. CONCLUSIONS: This study provides additional perspectives about physical restraint and reveals the need for safer, humanized and appropriate methods for the care of aggressive patients that consider the real needs and rights of these patients.

Factors Associated with Potential Drug-Drug Interactions in Patients Attended in Primary Health Care: A Focus on Mental Health.

There were no Brazilian studies regarding potential drug-drug interactions (DDIs) in primary health care (PHC) analysing common mental disorders (CMDs) and psychotropic medication. OBJECTIVES: To identify DDI prevalence in that setting; to classify DDI; to verify correlations with demographics, pharmacotherapeutics, psychotropic medication and CMDs. Among 430 patients interviewed 190 had more than two medications prescribed, 58.4% had DDI. Factors associated were age and number of medications. Nine types of severe DDI composed 28% patients' prescriptions, 71.9% involving psychotropic medication. Only the number of types of drugs contributed to the regression model. Results raise important aspects regarding patient safety in PHC units in Brazil are where patients with psychological complaints have to seek for health care firstly.

The Meaning of Stigma for People with Mental Disorders in Brazil.

OBJECTIVE: To understand the meaning of stigma for people with mental disorders. METHOD: A qualitative study with 46 Brazilian adults with mental disorders. Data were collected through semistructured interviews and nonparticipant observation and submitted for a thematic analysis with symbolic interactionism. RESULTS: Stigma was considered as an experience of incomprehension and suffering. The society has difficulty in empathizing, respecting differences and understanding the extent of the suffering of people with mental disorders. Participants recommended anti-stigma strategies that included promoting knowledge and respecting differences. CONCLUSIONS: The present study contributes new insights to be addressed in interventions to reduce the suffering and impact of stigma.

Emergency Nursing Experiences in Assisting People With Suicidal Behavior: A Grounded Theory Study.

AIM: To understand emergency nursing experiences in assisting people with suicidal behavior. METHOD: Grounded theory study with symbolic interactionism conducted in 2015 to 2016 in Brazil with 19 nurses. RESULTS: Assistance for people with suicidal behavior is critical, challenging, evokes different feelings and requires knowledge, skills and emotional control. Nurses did not feel prepared or supported, and identified recurrent gaps and problems. Nurses occupied a limited role, restricted to attending to physical needs. They predominantly manifested opposition, judgments and incomprehension about patients. CONCLUSION: This study presents key elements to be addressed in interventions and investigations regarding nursing support, training and supervision.

Factors Associated With Psychotropic Medication Use in Individuals in Brazilian Primary Health Care Units: A Descriptive, Cross-Sectional Study.

The current descriptive, cross-sectional study aimed to investigate the rate of psychotropic medication use and its association with sociodemographic factors, pharmacotherapy, health history, and presence of common mental disorders in individuals in Brazilian primary health care (PHC) units. A sample of 442 individuals was interviewed in 10 PHC units. Tools used included a structured questionnaire and the Self Reporting Questionnaire-20. The rate of psychotropic medication use was 38.7%. Demographic characteristics associated with psychotropic medication use were age 60 or older with common mental disorders and physical illness, a primary-level education or less, no occupation, and family income greater than three times the minimum wage. The strongest predictor of psychotropic medication use was monthly family income. The results highlight the need for interventions to improve patient outcomes. [Journal of Psychosocial Nursing and Mental Health Services, 55(3), 38-45.].

Quality of Life in Brazil's Family Health Strategy: Common Mental Disorders, Use of Psychotropic Drugs and Sociodemographic Factors.

The aim of the study was to evaluate the patients' quality of life in Brazil's Family Health Strategy and its association with sociodemographic factors, presence of common mental disorders, and use of psychotropic drugs. Were interviewed 442 patients. Tools were: World Health Organization Quality of Life Assessment-Bref and Self Reporting Questionnaire. Male and low education were strongly associated with higher quality of life. Use of psychotropic drugs and the presence of CMD were strongly associated with poor quality of life. There is a pressing need for primary health care professionals to invest in tracking, and in holistic interventions that are able to cover the healthcare needs of these vulnerable groups.

Adherence to Psychotropic Medications and Associated Factors in Primary Health Care.

The study aims were to analyze patients' adherence to psychotropic medications and its association with sociodemographic factors, therapeutic regimen, presence of common mental disorders, and illness factors. A descriptive cross-sectional study was carried out in ten Primary Health Care units in Brazil. The tools were the Measurement of Treatment Adherence Test and the Self Reporting Questionnaire. Nonadherence to psychotropic drugs was 88.9%. There was association between adherence and age and among patients positive for Common Mental Disorders (97.8%). In the multivariate analysis this association was not maintained. Findings indicate strategies are needed to improve medication adherence in the Primary Health Care services. However, no strategy will be effective if patients and their families are not involved in the process.

Common Mental Disorders in Primary Health Care Units: Associated Factors and Impact on Quality of Life.

BACKGROUND: Considering the high worldwide prevalence of common mental disorders (CMDs), characterizing the association between CMD and quality of life (QoL) constitute a valuable measure to gauge patient's functional impairment due to CMD symptoms. OBJECTIVE: To investigate factors associated with the incidence of CMD and its impact on the QoL in primary health care (PHC) patients. DESIGN: Cross-sectional study completed in a municipality in Brazil. Standardized tools included the Self-Reporting Questionnaire-20 to detect CMDs and the WHOQOL-brief to assess QoL, in addition to a sociodemographic and treatment-related questionnaire. RESULTS: A total of 41.4% of the patients met cutoff scores for a CMD, and the presence of a CMD was associated with female gender and marital status. Patients with CMDs had lower QoL scores than patients who were negative for a CMD. CONCLUSIONS: CMDs are highly prevalent in PHC settings and affect patients' QoL. The high frequency of CMD in those that seek care through PHC necessitate incorporating mental health services into the range of available services.

Meaning of Pharmacological Treatment for Families of People With Depression.

Medication adherence is related to patient satisfaction with family support. This research aimed to understand the meaning of pharmacotherapy to families of people with major depressive disorder. This qualitative study employed Grounded Theory and Symbolic Interactionism. Seventeen families of people with depression from a Brazilian clinic were included. Data was collected from 2013 to 2014, using open interviews, which were analyzed by open, axial, and selective coding. Medication represented "Tranquility and worry" because it re-established tranquility in family routine, but generated concerns. Thus, families were conflicted and ambivalent about medications, and they interfered with the promotion or impairment of adherence.

Transtornos mentais comuns e uso de psicofármacos em mulheres atendidas em unidades básicas de saúde em um centro urbano brasileiro / Common mental disorders and use of psychotropic medications in women consulting at primary care units in a Brazilian urban area

Objetivo. Investigar a prevalência de transtornos mentais comuns (TMC) em mulheres atendidas em unidades de atenção básica em um centro urbano brasileiro, assim como o impacto desses transtornos sobre a qualidade de vida (QV), a associação de fatores sociodemográficos a TMC e QV e a prevalência de uso e padrão de utilização de psicofármacos na amostra estudada. Métodos. Nesta pesquisa quantitativa, transversal e correlacional-descritiva, uma amostra estratificada de 365 mulheres foi entrevistada entre maio de 2012 e janeiro de 2013 em cinco unidades básicas de saúde brasileiras. Foram utilizados questionários sociodemográfico e far¬macoterapêutico; questionário de autorrelato SRQ-20 para estimar a prevalência de transtornos mentais comuns; e escala de qualidade de vida WHOQOL-bref. Para avaliar o impacto dos TMD na QV, foram utilizados o teste t e modelos de regressão linear. Utilizou-se o teste do qui-quadrado para verificar associações entre TMC e variáveis sociodemográficas. A análise do consumo de psicofármacos foi descritiva. Resultados. A prevalência de TMC foi de 44,1% e a de consumo de psicofármacos de 27,1%. Apenas 5,6% das participantes do estudo tinham registro de diagnóstico psiquiátrico no prontuário. Os psicofármacos eram usados por 41,6% das entrevistadas positivas para TMC e 15,7% das negativas para TMC. Não houve associação entre TMC e variáveis sociodemográficas. Houve associação estatisticamente significativa entre TMC e QV. As mulheres positivas para TMC apresentaram pior QV. Não houve influência de fatores sociodemográficos sobre esse resultado. Conclusões. Mais atenção é necessária ao padrão de uso e prescrição de psicofármacos na atenção básica. As pacientes com TMC apresentaram prejuízo funcional, evidenciado por escores de QV significativamente menores. A ausência de influência dos fatores sociodemográficos sobre os resultados parece corroborar a proposição de uma origem distinta para TMC em mulheres.

Objective. To investigate the prevalence of common mental disorders (CMD) in women consulting at primary health care units in a Brazilian urban area, as well as to determine the impact of CMD on quality of life (QoL), the association of sociodemographic factors with CMD and QoL, and the prevalence and pattern of psychotropic medication use in the study sample. Methods. In this quantitative, cross-sectional, correlational-descriptive study, a stratified sample of 365 women was interviewed between May 2012 and January 2013 in five primary health care units in Brazil. Data were collected using sociodemographic and drug use questionnaires. The self-reporting questionnaire (SRQ-20) was used to estimate the prevalence of CMD; and the World Health Organization Quality of Life (WHOQOL)-bref instrument was used to assess quality of life. To evaluate the impact of CMD on QoL, the t test and linear regression models were employed. The chi-square test was used to verify associations between CMD and sociodemographic variables. Descriptive analysis was used for psychotropic drug use. Results. The prevalence of CMD was 44.1%. The prevalence of psychotropic medi¬cation use was 27.1%. Only 5.6% of participants had a psychiatric diagnosis recorded in their medical chart. Psychotropic drugs were used by 41.6% of participants with CMD according to the SRQ-20 and by 15.7% of those without CMD. There was no association between CMD and sociodemographic variables, but CMD and QoL were significantly associated. Women with CMD had the worst QoL, without impact of sociodemographic variables. Conclusions. Further attention should be given to the pattern of psychotropic medication use and prescription in primary care settings. Women with CMD had functional impairment, as shown by significantly lower QoL scores. The fact that sociodemographic factors did not impact the present results seems to support the notion of a different basis for CMD in women.

Transtornos mentais comuns e uso de psicofármacos em mulheres atendidas em unidades básicas de saúde em um centro urbano brasileiro / Common mental disorders and use of psychotropic medications in women consulting at primary care units in a Brazilian urban area

OBJETIVO: Investigar a prevalência de transtornos mentais comuns (TMC) em mulheres atendidas em unidades de atenção básica em um centro urbano brasileiro, assim como o impacto desses transtornos sobre a qualidade de vida (QV), a associação de fatores sociodemográficos a TMC e QV e a prevalência de uso e padrão de utilização de psicofármacos na amostra estudada. MÉTODOS: Nesta pesquisa quantitativa, transversal e correlacional-descritiva, uma amostra estratificada de 365 mulheres foi entrevistada entre maio de 2012 e janeiro de 2013 em cinco unidades básicas de saúde brasileiras. Foram utilizados questionários sociodemográfico e farmacoterapêutico; questionário de autorrelato SRQ-20 para estimar a prevalência de transtornos mentais comuns; e escala de qualidade de vida WHOQOL-bref. Para avaliar o impacto dos TMD na QV, foram utilizados o teste t e modelos de regressão linear. Utilizou-se o teste do qui-quadrado para verificar associações entre TMC e variáveis ​​sociodemográficas. A análise do consumo de psicofármacos foi descritiva. RESULTADOS: A prevalência de TMC foi de 44,1% e a de consumo de psicofármacos de 27,1%. Apenas 5,6% das participantes do estudo tinham registro de diagnóstico psiquiátrico no prontuário. Os psicofármacos eram usados por 41,6% das entrevistadas positivas para TMC e 15,7% das negativas para TMC. Não houve associação entre TMC e variáveis sociodemográficas. Houve associação estatisticamente significativa entre TMC e QV. As mulheres positivas para TMC apresentaram pior QV. Não houve influência de fatores sociodemográficos sobre esse resultado. CONCLUSÕES: Mais atenção é necessária ao padrão de uso e prescrição de psicofármacos na atenção básica. As pacientes com TMC apresentaram prejuízo funcional, evidenciado por escores de QV significativamente menores. A ausência de influência dos fatores sociodemográficos sobre os resultados parece corroborar a proposição de uma origem distinta para TMC em mulheres.

OBJECTIVE:To investigate the prevalence of common mental disorders (CMD) in women consulting at primary health care units in a Brazilian urban area, as well as to determine the impact of CMD on quality of life (QoL), the association of sociodemographic factors with CMD and QoL, and the prevalence and pattern of psychotropic medication use in the study sample. METHODS: In this quantitative, cross-sectional, correlational-descriptive study, a stratified sample of 365 women was interviewed between May 2012 and January 2013 in five primary health care units in Brazil. Data were collected using sociodemographic and drug use questionnaires. The self-reporting questionnaire (SRQ-20) was used to estimate the prevalence of CMD; and the World Health Organization Quality of Life (WHOQOL)-bref instrument was used to assess quality of life. To evaluate the impact of CMD on QoL, the t test and linear regression models were employed. The chi-square test was used to verify associations between CMD and sociodemographic variables. Descriptive analysis was used for psychotropic drug use. RESULTS: The prevalence of CMD was 44.1%. The prevalence of psychotropic medication use was 27.1%. Only 5.6% of participants had a psychiatric diagnosis recorded in their medical chart. Psychotropic drugs were used by 41.6% of participants with CMD according to the SRQ-20 and by 15.7% of those without CMD. There was no association between CMD and sociodemographic variables, but CMD and QoL were significantly associated. Women with CMD had the worst QoL, without impact of sociodemographic variables. CONCLUSIONS: Further attention should be given to the pattern of psychotropic medication use and prescription in primary care settings. Women with CMD had functional impairment, as shown by significantly lower QoL scores. The fact that sociodemographic factors did not impact the present results seems to support the notion of a different basis for CMD in women.

Prevalência do uso de psicotrópicos e fatores associados na atenção primária à saúde / Prevalence in the use of psychotropics and associated factors in primary health care

Objetivo Investigar a prevalência de uso de psicotrópicos e fatores associados na atenção primária à saúde com fatores sociodemográficos, farmacoterapêuticos, histórico de saúde e Transtornos Mentais Comuns.Método Estudo transversal que incluiu 430 pacientes de atenção primária à saúde. O instrumento de pesquisa foi o Self-reporting Questionnaire e prontuários. Para análise, utilizou-se teste qui-quadrado na análise univariada e regressão logística na multivariada.Resultados A prevalência de uso de psicotrópicos foi de 25,8%. Houve associação entre uso de psicofármacos e transtornos mentais comuns, uso de medicamentos não psicofármacos, número de medicamentos prescritos, número de comprimidos/dia, patologias clínicas, idade e escolaridade. Na análise multivariada os preditores para uso de psicofármacos foram: transtornos mentais comuns, patologias clínicas e escolaridade.Conclusão A prevalência de uso de psicofármacos e os fatores associados variaram conforme a análise uni ou multivariada.

Objective Investigating the prevalence in the use of psychotropics and associated factors in primary health care withsocio-demographic and pharmacotherapeutic factors, medical history, and Common Mental Disorders.Methods A cross-section study which includes 430 primary health care patients. The research instruments were Self-reporting Questionnaires and medical records. A chi-squared test was used in the univariate analysis, and a logistic regression was used in the multivariate analysis.Results The prevalence in the use of psychotropics was 25.8%. There was an association among the use of psychiatric drugs and common mental disorders, use of non-psychiatric drugs, number of medications prescribed,number of pills a day, clinical pathologies, age, and schooling. In the multivariate analysis, the predictors for the use of psychiatric drugs were: common mental disorders, clinical pathologies, and schooling.Conclusion The prevalence in the use of psychiatric drugs and the associated factors varied according to the univariate or the multivariate analyses.

[Common mental disorders and use of psychotropic medications in women consulting at primary care units in a Brazilian urban area]. / Transtornos mentais comuns e uso de psicofármacos em mulheres atendidas em unidades básicas de saúde em um centro urbano brasileiro.

OBJECTIVE: To investigate the prevalence of common mental disorders (CMD) in women consulting at primary health care units in a Brazilian urban area, as well as to determine the impact of CMD on quality of life (QoL), the association of sociodemographic factors with CMD and QoL, and the prevalence and pattern of psychotropic medication use in the study sample. METHODS: In this quantitative, cross-sectional, correlational-descriptive study, a stratified sample of 365 women was interviewed between May 2012 and January 2013 in five primary health care units in Brazil. Data were collected using sociodemographic and drug use questionnaires. The self-reporting questionnaire (SRQ-20) was used to estimate the prevalence of CMD; and the World Health Organization Quality of Life (WHOQOL)-bref instrument was used to assess quality of life. To evaluate the impact of CMD on QoL, the t test and linear regression models were employed. The chi-square test was used to verify associations between CMD and sociodemographic variables. Descriptive analysis was used for psychotropic drug use. RESULTS: The prevalence of CMD was 44.1%. The prevalence of psychotropic medication use was 27.1%. Only 5.6% of participants had a psychiatric diagnosis recorded in their medical chart. Psychotropic drugs were used by 41.6% of participants with CMD according to the SRQ-20 and by 15.7% of those without CMD. There was no association between CMD and sociodemographic variables, but CMD and QoL were significantly associated. Women with CMD had the worst QoL, without impact of sociodemographic variables. CONCLUSIONS: Further attention should be given to the pattern of psychotropic medication use and prescription in primary care settings. Women with CMD had functional impairment, as shown by significantly lower QoL scores. The fact that sociodemographic factors did not impact the present results seems to support the notion of a different basis for CMD in women.