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1.
An Acad Bras Cienc ; 95(1): e20220100, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37194913

RESUMEN

This study aimed to assess the mental health of a University community in South Brazil during the COVID-19 pandemic. A cross-sectional web-based survey was conducted between July-August 2020 through a self-administered questionnaire. All University staff and students were eligible. Depression was measured using the Patient Health Questionnaire-9 and anxiety by the Generalized Anxiety Disorder-7. To evaluate the effect of social distancing and mental health factors on outcomes, Poisson regression models with robust variance were performed, estimating Prevalence Ratios (PR) and 95% Confidence Intervals (95%CI). 2,785 individuals participated in the study. Prevalence of depression and anxiety were 39.2% (95%CI 37.3-41.1) and 52.5% (95% CI 50.6-54.4), respectively. Undergraduate students showed a higher prevalence of the outcomes. Not leaving the house routinely, mental health care, and previous diagnosis of mental illness were associated with both outcomes. Those with a previous medical diagnosis of depression had a 58% (PR 1.58; 95%CI 1.44; 1.74) and anxiety a 72% (PR 1.72; 95%CI 1.56; 1.91) greater prevalence of depression than their peers. An alarming prevalence of psychopathologies was observed. Despite the well-known benefits of social distancing to public health, it requires a surveillance on the population's mental health, especially students and those with previous mental illness diagnosis.


Asunto(s)
COVID-19 , Humanos , COVID-19/epidemiología , Depresión/epidemiología , Depresión/diagnóstico , Depresión/psicología , Brasil/epidemiología , Universidades , Estudios Transversales , Pandemias , Ansiedad/epidemiología , Trastornos de Ansiedad/epidemiología
2.
J Psychiatr Res ; 101: 80-103, 2018 06.
Artículo en Inglés | MEDLINE | ID: mdl-29567510

RESUMEN

Early life stress (ELS), in the form of childhood maltreatment, abuse, or neglect, increases the risk for psychiatric sequelae later in life. The neurobiology of response to early stress and of reward processing overlap substantially, leading to the prediction that reward processing may be a primary mediator of the effects of early life stress. We describe a growing body of literature investigating the effects of early life stressors on reward processing in animals and humans. Despite variation in the reviewed studies, an emerging pattern of results indicates that ELS results in deficits of ventral striatum-related functions of reward responsiveness and approach motivation, especially when the stressor is experienced in early in development. For stressors experienced later in the juvenile period and adolescence, the animal literature suggests an opposite effect, in which ELS results in increased hedonic drive. Future research in this area will help elucidate the transdiagnostic impact of early life stress, and therefore potentially identify and intervene with at-risk youth, prior to the emergence of clinical psychopathology.


Asunto(s)
Experiencias Adversas de la Infancia , Anhedonia , Recompensa , Estrés Psicológico , Anhedonia/fisiología , Animales , Niño , Humanos , Estrés Psicológico/complicaciones , Estrés Psicológico/fisiopatología
3.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 39(2): 90-94, Apr.-June 2017. tab, graf
Artículo en Inglés | LILACS | ID: biblio-844184

RESUMEN

Objective: Memory impairment is an important contributor to the reduction in quality of life experienced by older adults, and genetic risk factors seem to contribute to variance in age-related cognitive decline. Brain-derived neurotrophic factor (BDNF) is an important nerve growth factor linked with development and neural plasticity. The Val66Met polymorphism in the BDNF gene has been associated with impaired episodic memory in adults, but whether this functional variant plays a role in cognitive aging remains unclear. The purpose of this study was to investigate the effects of the BDNF Val66Met polymorphism on memory performance in a sample of elderly adults. Methods: Eighty-seven subjects aged > 55 years were recruited using a community-based convenience sampling strategy in Porto Alegre, Brazil. The logical memory subset of the Wechsler Memory Scale-Revised was used to assess immediate verbal recall (IVR), delayed verbal recall (DVR), and memory retention rate. Results: BDNF Met allele carriers had lower DVR scores (p = 0.004) and a decline in memory retention (p = 0.017) when compared to Val/Val homozygotes. However, we found no significant differences in IVR between the two groups (p = 0.088). Conclusion: These results support the hypothesis of the BDNF Val66Met polymorphism as a risk factor associated with cognitive impairment, corroborating previous findings in young and older adults.


Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Valina/genética , Factor Neurotrófico Derivado del Encéfalo/genética , Polimorfismo de Nucleótido Simple , Trastornos de la Memoria/genética , Metionina/genética , Análisis y Desempeño de Tareas , Escalas de Wechsler , Análisis Multivariante , Factores de Riesgo , Factores de Edad , Estadísticas no Paramétricas , Predisposición Genética a la Enfermedad , Alelos , Pruebas Neuropsicológicas
4.
Braz J Psychiatry ; 39(2): 90-94, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28099630

RESUMEN

OBJECTIVE:: Memory impairment is an important contributor to the reduction in quality of life experienced by older adults, and genetic risk factors seem to contribute to variance in age-related cognitive decline. Brain-derived neurotrophic factor (BDNF) is an important nerve growth factor linked with development and neural plasticity. The Val66Met polymorphism in the BDNF gene has been associated with impaired episodic memory in adults, but whether this functional variant plays a role in cognitive aging remains unclear. The purpose of this study was to investigate the effects of the BDNF Val66Met polymorphism on memory performance in a sample of elderly adults. METHODS:: Eighty-seven subjects aged > 55 years were recruited using a community-based convenience sampling strategy in Porto Alegre, Brazil. The logical memory subset of the Wechsler Memory Scale-Revised was used to assess immediate verbal recall (IVR), delayed verbal recall (DVR), and memory retention rate. RESULTS:: BDNF Met allele carriers had lower DVR scores (p = 0.004) and a decline in memory retention (p = 0.017) when compared to Val/Val homozygotes. However, we found no significant differences in IVR between the two groups (p = 0.088). CONCLUSION:: These results support the hypothesis of the BDNF Val66Met polymorphism as a risk factor associated with cognitive impairment, corroborating previous findings in young and older adults.


Asunto(s)
Factor Neurotrófico Derivado del Encéfalo/genética , Trastornos de la Memoria/genética , Metionina/genética , Polimorfismo de Nucleótido Simple , Valina/genética , Factores de Edad , Anciano , Anciano de 80 o más Años , Alelos , Femenino , Predisposición Genética a la Enfermedad , Humanos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Pruebas Neuropsicológicas , Factores de Riesgo , Estadísticas no Paramétricas , Análisis y Desempeño de Tareas , Escalas de Wechsler
5.
Eur Child Adolesc Psychiatry ; 26(5): 521-529, 2017 May.
Artículo en Inglés | MEDLINE | ID: mdl-27785581

RESUMEN

Replicated evidence indicates that perinatal complications are associated with increased markers of oxidative stress and with mental health problems in children. However, there are fewer reports on the impact of perinatal complications in later phases of development. We aimed to investigate the estimated effects of perinatal complications on levels of lipid peroxidation and on psychopathology in children and adolescents. The study is part of the High Risk Cohort Study for Psychiatric Disorders; the population was composed by 554 students, 6-14 years of age. Serum levels of malondialdehyde, a product of lipid peroxidation, were measured by the TBARS method. A household interview with parents and caregivers was conducted and included inquiries about perinatal history, the Child Behavior Checklist (CBCL), and parent's evaluation, using the Mini International Psychiatric Interview (MINI). We created a cumulative risk index, conceptualized as each individual's cumulative exposure to perinatal complications. Results indicate that perinatal complications were associated with higher levels of TBARS. After adjusting for age, gender, socio-economic status, CBCL total problems score, parental psychopathology, and childhood maltreatment, children exposed to 3 or more perinatal complications had an 26.9% (95% CI 9.9%, 46.6%) increase in TBARS levels, relative to the unexposed group. Exploratory mediation analysis indicated that TBARS levels partially mediated the association between perinatal complications and externalizing problems. In conclusion, an adverse intrauterine and/or early life environment, as proxied by the cumulative exposure to perinatal complications, was independently associated with higher levels of lipid peroxidation in children and adolescents.


Asunto(s)
Discapacidades del Desarrollo/complicaciones , Peroxidación de Lípido/fisiología , Malondialdehído/metabolismo , Sustancias Reactivas al Ácido Tiobarbitúrico/metabolismo , Adolescente , Brasil/epidemiología , Lista de Verificación , Niño , Trastornos de la Conducta Infantil/sangre , Trastornos de la Conducta Infantil/epidemiología , Trastornos de la Conducta Infantil/psicología , Estudios de Cohortes , Discapacidades del Desarrollo/epidemiología , Discapacidades del Desarrollo/psicología , Femenino , Humanos , Efectos Adversos a Largo Plazo , Masculino , Malondialdehído/sangre , Trastornos Mentales/sangre , Trastornos Mentales/epidemiología , Trastornos Mentales/psicología , Salud Mental , Estrés Oxidativo , Embarazo , Psicopatología , Factores Socioeconómicos
6.
PLoS One ; 11(8): e0160455, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27489945

RESUMEN

BACKGROUND: Socioeconomic disadvantage (SED) has been consistently associated with early life mental health problems. SED has been shown to impact multiple biological systems, including the regulation of neurotrophic proteins, immune-inflammatory and oxidative stress markers, which, conversely, have been reported to be relevant to physiological and pathological neurodevelopment This study investigated the relationship between SED, different domains of psychopathology, serum levels of interleukin-6 (IL6), thiobarbituric acid-reactive substance (TBARS) and brain-derived neurotrophic factor (BDNF). We hypothesized that a composite of socioeconomic risk would be associated with psychopathology and altered levels of peripheral biomarkers. In addition, we hypothesized that SED would moderate the associations between mental health problems, IL6, TBARS and BDNF. METHODS AND FINDINGS: Using a cross-sectional design, we measured the serum levels of IL6, TBARS and BDNF in 495 children aged 6 to 12. We also investigated socio-demographic characteristics and mental health problems using the Child Behaviour Checklist (CBCL) DSM-oriented scales. SED was evaluated using a cumulative risk model. Generalized linear models were used to assess associations between SED, biomarkers levels and psychopathology. SED was significantly associated with serum levels of IL6 (RR = 1.026, 95% CI 1.004; 1.049, p = 0.020) and TBARS (RR = 1.077, 95% CI 1.028; 1.127, p = 0.002). The association between SED and BDNF was not statistically significant (RR = 1.031, 95% CI 0.997; 1.066, p = 0.077). SED was also significantly associated with all CBCL DSM-oriented scales (all p < 0.05), whereas serum biomarkers (i.e. IL6, TBARS, BDNF) were associated with specific subscales. Moreover, the associations between serum biomarkers and domains of psychopathology were moderated by SED, with stronger correlations between mental health problems, IL6, TBARS, and BDNF being observed in children with high SED. CONCLUSIONS: In children, SED is highly associated with mental health problems. Our findings suggest that this association may be moderated via effects on multiple interacting neurobiological systems.


Asunto(s)
Factor Neurotrófico Derivado del Encéfalo/sangre , Interleucina-6/sangre , Trastornos Mentales/sangre , Salud Mental , Estrés Psicológico/sangre , Sustancias Reactivas al Ácido Tiobarbitúrico/metabolismo , Biomarcadores/sangre , Niño , Estudios Transversales , Femenino , Humanos , Masculino , Factores Socioeconómicos
7.
Eur Neuropsychopharmacol ; 26(9): 1438-1447, 2016 09.
Artículo en Inglés | MEDLINE | ID: mdl-27397864

RESUMEN

Crack cocaine addicted inpatients that present more severe withdrawal symptoms also exhibit higher rates of depressive symptoms. There is strong evidence that the identification of genetic variants in depression is potentialized when reducing phenotypic heterogeneity by studying selected groups. Since depression has been associated to dysregulation of the hypothalamic-pituitary-adrenal axis, this study evaluated the effects of SNPs in stress-related genes on depressive symptoms of crack cocaine addicts at early abstinence and over the detoxification treatment (4th, 11th and 18th day post admission). Also, the role of these SNPs on the re-hospitalization rates after 2.5 years of follow-up was studied. One hundred eight-two women were enrolled and eight SNPs in four genes (NR3C2, NR3C1, FKBP5 and CRHR1) were genotyped. A significant main effect of NR3C1-rs41423247 was found, where the C minor allele increased depressive symptoms at early abstinence. This effect remained significant after 10,000 permutations to account for multiple SNPs tested (P=0.0077). There was no effect of rs41423247 on the course of detoxification treatment, but a slight effect of rs41423247 at late abstinence was detected (P=0.0463). This analysis suggests that the presence of at least one C allele is worse at early abstinence, while only CC genotype appears to increase depressive symptoms at late abstinence. Also, a slight effect of rs41423247 C minor allele increasing the number of re-hospitalizations after 2.5 years was found (P=0.0413). These findings are in agreement with previous studies reporting an influence of rs41423247 on sensitivity to glucocorticoids and further elucidate its resulting effects on depressive-related traits.


Asunto(s)
Trastornos Relacionados con Cocaína/genética , Trastornos Relacionados con Cocaína/psicología , Cocaína Crack , Depresión/genética , Polimorfismo de Nucleótido Simple , Receptores de Glucocorticoides/genética , Adulto , Trastornos Relacionados con Cocaína/terapia , Depresión/terapia , Femenino , Estudios de Seguimiento , Técnicas de Genotipaje , Hospitalización , Humanos , Estudios Longitudinales , Receptores de Hormona Liberadora de Corticotropina/genética , Receptores de Mineralocorticoides/genética , Análisis de Regresión , Síndrome de Abstinencia a Sustancias/genética , Síndrome de Abstinencia a Sustancias/psicología , Proteínas de Unión a Tacrolimus/genética , Adulto Joven
8.
Psychiatry Clin Neurosci ; 70(10): 434-441, 2016 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-27278269

RESUMEN

AIM: Childhood maltreatment (CM) has been related to a persistent reprograming of stress-response. Copeptin is a marker of hypothalamic-pituitary-adrenal axis activation; however, few studies have examined copeptin levels in children exposed to CM. The aim of this study was to compare serum copeptin levels in children reporting child abuse and/or neglect and children with no history of CM. METHODS: This study included 65 children with a positive history of moderate to severe CM, as reported by themselves and their parent(s) during a clinical interview, and 71 children with no history of CM as a comparison group. CM was considered moderate to severe based on the child-reported frequency of being exposed to events related to sexual abuse, physical abuse, emotional abuse, emotional neglect, and/or physical neglect. Child psychopathology symptoms were assessed using the Child Behavior Checklist (CBCL). We measured serum copeptin concentration using enzyme-linked immunosorbent assay. RESULTS: Children exposed to CM exhibited higher levels of serum copeptin compared to children without CM when controlling for sex, age, and psychiatric morbidity. The CBCL total score, including internalizing and externalizing symptoms, was higher in children with CM. We found no correlation between copeptin and CBCL scores for internalizing symptoms and externalizing symptoms. CONCLUSION: CM is associated with copeptin serum levels independently of age, sex, and symptom severity. Copeptin is a promising new biomarker for children with a history of abuse and/or neglect.


Asunto(s)
Maltrato a los Niños , Glicopéptidos/sangre , Trastornos Mentales/sangre , Adolescente , Brasil , Niño , Femenino , Humanos , Masculino
9.
Psychoneuroendocrinology ; 71: 94-101, 2016 09.
Artículo en Inglés | MEDLINE | ID: mdl-27258821

RESUMEN

There is consistent evidence that inflammation is involved in mental disorders pathogenesis. Herein, using data from the High Risk Cohort Study for Psychiatric Disorders, we investigated the relationship between parental mood disorders (PMD), environmental factors, serum interleukin-6 (IL6) and mental health problems in children aged 6-12. We measured the serum levels of IL6 in 567 children. Information related to socio-demographic characteristics, mental health problems and multiple risk factors, as well as parent's psychiatric diagnosis, was captured. We evaluated two groups of environmental risk factors (i.e. perinatal complications and social disadvantage) using a cumulative risk model. Results showed that higher serum levels of IL6 were associated with PMD (RR=1.072, p=0.001), perinatal complications (RR=1.022, p=0.013) and social disadvantage (RR=1.024, p=0.021). There was an interaction between PMD and social disadvantage (RR=1.141, p=0.021), as the effect of PMD on IL6 was significantly higher in children exposed to higher levels of social disadvantage. Moreover, there was a positive correlation between IL6 and mental health problems (RR=1.099, p=0.026), which was moderated by exposure to perinatal complications or social disadvantage (RR=1.273, p=0.015 and RR=1.179, p=0.048, respectively). In conclusions, there is evidence of a differential inflammatory activation in children with PMD and exposure to environmental risk factors, when compared to matched peers. Systemic inflammation may be involved in the pathway linking familial risk and mental health problems.


Asunto(s)
Interleucina-6/análisis , Trastornos Mentales/etiología , Niño , Estudios de Cohortes , Composición Familiar , Femenino , Humanos , Interleucina-6/sangre , Masculino , Trastornos Mentales/psicología , Salud Mental , Atención Perinatal , Factores de Riesgo , Factores Socioeconómicos , Encuestas y Cuestionarios
10.
Neurosci Biobehav Rev ; 68: 489-503, 2016 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-27328784

RESUMEN

Early life stress (ELS) developmental effects have been widely studied by preclinical researchers. Despite the growing body of evidence from ELS models, such as the maternal separation paradigm, the reported results have marked inconsistencies. The maternal separation model has several methodological pitfalls that could influence the reliability of its results. Here, we critically review 94 mice studies that addressed the effects of maternal separation on behavioural outcomes. We also discuss methodological issues related to the heterogeneity of separation protocols and the quality of reporting methods. Our findings indicate a lack of consistency in maternal separation effects: major studies of behavioural and biological phenotypes failed to find significant deleterious effects. Furthermore, we identified several specific variations in separation methodological procedures. These methodological variations could contribute to the inconsistency of maternal separation effects by producing different degrees of stress exposure in maternal separation-reared pups. These methodological problems, together with insufficient reporting, might lead to inaccurate and unreliable effect estimates in maternal separation studies.


Asunto(s)
Privación Materna , Animales , Animales Recién Nacidos , Conducta Animal , Ratones , Reproducibilidad de los Resultados , Estrés Psicológico
11.
Trends psychiatry psychother. (Impr.) ; 36(2): 119-122, Apr-Jun/2014. tab
Artículo en Inglés | LILACS | ID: biblio-833136

RESUMEN

Introduction: Recurrent exposure to childhood sexual abuse (CSA) seems to be higher among victims of sexual abuse. In this sense, experiences related to sexual violence can perpetuate within the family context itself in various ways. Here, we investigate the association between being exposed to CSA and having a child victim of sexual abuse. Method: We used a sample with 123 mothers, who were divided into 2 groups: one consisting of 41 mothers of sexually abused children and another consisting of 82 mothers of non-sexually abused children. History of exposure to CSA was evaluated by means of the Childhood Trauma Questionnaire - Short Form (CTQ) and we used a logistic regression model to estimate the prediction values regarding having or not a child exposed to sexual violence. Results: Mothers of sexually abused children had significantly higher scores on CTQ, especially on the sexual abuse subscale (SA). According to our logistic regression model, higher scores on the CTQ significantly predicted the status of being a mother of children exposed to sexual violence in our sample (Wald = 7.074; p = 0.008; Exp(B) = 1.681). Years of formal education reduced the likelihood of having a child victim of sexual violence (Wald = 18.994; p = 0.001; Exp(B) = 0.497). Conclusion: Our findings highlight the importance of a possible intergenerational effect of sexual abuse. Family intervention and prevention against childhood maltreatment should take this issue in account (AU)


Introdução: A recorrência da exposição ao abuso sexual na infância (ASI) parece ser maior entre vítimas de abuso sexual. Nesse sentido, experiências relacionadas à violência sexual podem perpetuar-se dentro do próprio contexto familiar por diversas maneiras. Aqui, investigamos a associação entre ser exposto a ASI e ter um filho vítima de abuso sexual. Método: Usamos uma amostra com 123 mães, que foram divididas em 2 grupos: um composto por 41 mães de filhos abusados sexualmente e outro composto por 82 mães de filhos não abusados. O histórico da exposição à ASI foi avaliado por meio do Childhood Trauma Questionnaire - Short Form (CTQ) e usamos um modelo de regressão logística para estimar os valores preditivos em relação a ter ou não um filho exposto a violência sexual. Resultados: Mães de crianças vítimas de abuso sexual obtiveram maiores escores no CTQ, especialmente na subescala de abuso sexual (SA). Segundo nosso modelo de regressão logística, escores maiores no CTQ foram capazes de predizer significativamente a categoria de ser ou não mãe de uma criança vítima de violência sexual em nossa amostra (Wald = 7,074; p = 0,008; Exp(B) = 1,681). O número de anos de escolaridade reduziu a chance de ter um filho vítima de violência sexual (Wald = 18,994; p = 0,001; Exp(B) = 0,497). Conclusão: Nossos achados ressaltam a importância de um possível efeito intergeracional do abuso sexual. Intervenções familiares e preventivas contra maus-tratos na infância deveriam levar em consideração essa problemática (AU)


Asunto(s)
Humanos , Femenino , Adulto , Persona de Mediana Edad , Adultos Sobrevivientes del Maltrato a los Niños/psicología , Abuso Sexual Infantil/psicología , Relaciones Madre-Hijo , Relaciones Intergeneracionales , Relaciones Interpersonales , Estudios Retrospectivos , Encuestas y Cuestionarios
12.
Trends Psychiatry Psychother ; 36(2): 119-22, 2014 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-27000712

RESUMEN

INTRODUCTION: Recurrent exposure to childhood sexual abuse (CSA) seems to be higher among victims of sexual abuse. In this sense, experiences related to sexual violence can perpetuate within the family context itself in various ways. Here, we investigate the association between being exposed to CSA and having a child victim of sexual abuse. METHOD: We used a sample with 123 mothers, who were divided into 2 groups: one consisting of 41 mothers of sexually abused children and another consisting of 82 mothers of non-sexually abused children. History of exposure to CSA was evaluated by means of the Childhood Trauma Questionnaire - Short Form (CTQ) and we used a logistic regression model to estimate the prediction values regarding having or not a child exposed to sexual violence. RESULTS: Mothers of sexually abused children had significantly higher scores on CTQ, especially on the sexual abuse subscale (SA). According to our logistic regression model, higher scores on the CTQ significantly predicted the status of being a mother of children exposed to sexual violence in our sample (Wald = 7.074; p = 0.008; Exp(B) = 1.681). Years of formal education reduced the likelihood of having a child victim of sexual violence (Wald = 18.994; p = 0.001; Exp(B) = 0.497). CONCLUSION: Our findings highlight the importance of a possible intergenerational effect of sexual abuse. Family intervention and prevention against childhood maltreatment should take this issue in account.

13.
Psychiatry Res ; 210(2): 536-40, 2013 Dec 15.
Artículo en Inglés | MEDLINE | ID: mdl-23896356

RESUMEN

Childhood maltreatment has been associated with addiction and immune dysregulation, although neurobiological substrates underlying this association remain largely unknown. The aim of the study was to compare plasma levels of adipokines during early abstinence in crack cocaine dependent women with (CM+) and without history of childhood maltreatment (CM-). One hundred four crack cocaine female users were followed for 20 days in a detoxification inpatient treatment unit. Plasma levels of adiponectin, resistin and leptin were assessed every 7 days during 3 weeks of follow-up. The Childhood Trauma Questionnaire (CTQ) retrospectively assessed childhood maltreatment history. A healthy control group was included to provide adipokines reference values (HC). All crack users increased leptin plasma levels during early abstinence despite concentrations remained lower in comparison with non-users group. Crack users reporting childhood maltreatment exhibited a significant reduction in plasma levels of adiponectin and resistin when compared to CM- group. In addition, only CM- participants increased plasma levels of adiponectin during detoxification. This is the first study evaluating adipokines during crack cocaine abstinence. Our results suggest a modulator effect of childhood maltreatment on inflammatory status in treatment-seeking crack cocaine dependents during early abstinence.


Asunto(s)
Adipoquinas/sangre , Adultos Sobrevivientes del Maltrato a los Niños , Cocaína Crack/efectos adversos , Leptina/sangre , Resistina/sangre , Adulto , Biomarcadores/sangre , Estudios de Casos y Controles , Trastornos Relacionados con Cocaína/sangre , Trastornos Relacionados con Cocaína/psicología , Trastornos Relacionados con Cocaína/terapia , Femenino , Estudios de Seguimiento , Humanos , Inflamación/sangre , Masculino , Estudios Retrospectivos , Encuestas y Cuestionarios
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