Female crack cocaine users under treatment at therapeutic communities in southern Brazil: characteristics, pattern of consumption, and psychiatric comorbidities.

OBJECTIVE: To explore and describe sociodemographic characteristics, crack consumption patterns, and psychiatric comorbidities of female crack users receiving treatment at therapeutic communities. METHODS: This was a cross-sectional, descriptive, quantitative study. Forty-six women who abstained from crack use were assessed using a sociodemographic questionnaire, the Mini-Mental State Examination (MMSE), the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), and a profile of crack use questionnaire. Descriptive statistical analyses were conducted. RESULTS: Participants had a mean age of 31.02 years (standard deviation [SD] = 7.73), most were single (76.1%), white (67.4%) and had complete or incomplete elementary education (43.5%). Before treatment, 65.2% of the women reported using crack every day; 46.3% smoked between 10 to 30 crack rocks per week. Mean treatment time was 63.56 days (SD = 75.85), with a mean of 80.41 days of abstinence (SD = 74.52) and 3.37 previous treatments (SD = 5.49). Mean age upon crack use initiation was 22.61 years (SD = 8.06), and the most frequent motivation to start using crack was curiosity (78.3%). The mean lifetime duration of crack use was 82.26 months (SD = 74.76), and the physical complications most frequently reported were weight loss (93.5%), followed by sleep problems (87%). In this study, the most prevalent psychiatric diagnoses were major depressive episode (60.87%), followed by post-traumatic stress disorder (52.17%) and generalized anxiety disorder (13.07%). CONCLUSIONS: Overall, a pattern of high consumption of crack was observed. The results show a high frequency of mood and anxiety disorders, with the highest frequencies found for major depressive episode and post-traumatic stress disorder.

Female crack cocaine users under treatment at therapeutic communities in southern Brazil: characteristics, pattern of consumption, and psychiatric comorbidities / Mulheres usuárias de crack-cocaína em tratamento em comunidades terapêuticas no sul do Brasil: características, padrão de consumo e comorbidades psiquiátricas

Abstract Objective To explore and describe sociodemographic characteristics, crack consumption patterns, and psychiatric comorbidities of female crack users receiving treatment at therapeutic communities. Methods This was a cross-sectional, descriptive, quantitative study. Forty-six women who abstained from crack use were assessed using a sociodemographic questionnaire, the Mini-Mental State Examination (MMSE), the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), and a profile of crack use questionnaire. Descriptive statistical analyses were conducted. Results Participants had a mean age of 31.02 years (standard deviation [SD] = 7.73), most were single (76.1%), white (67.4%) and had complete or incomplete elementary education (43.5%). Before treatment, 65.2% of the women reported using crack every day; 46.3% smoked between 10 to 30 crack rocks per week. Mean treatment time was 63.56 days (SD = 75.85), with a mean of 80.41 days of abstinence (SD = 74.52) and 3.37 previous treatments (SD = 5.49). Mean age upon crack use initiation was 22.61 years (SD = 8.06), and the most frequent motivation to start using crack was curiosity (78.3%). The mean lifetime duration of crack use was 82.26 months (SD = 74.76), and the physical complications most frequently reported were weight loss (93.5%), followed by sleep problems (87%). In this study, the most prevalent psychiatric diagnoses were major depressive episode (60.87%), followed by post-traumatic stress disorder (52.17%) and generalized anxiety disorder (13.07%). Conclusions Overall, a pattern of high consumption of crack was observed. The results show a high frequency of mood and anxiety disorders, with the highest frequencies found for major depressive episode and post-traumatic stress disorder.

Resumo Objetivo Explorar e descrever características sociodemográficas, padrão de consumo e comorbidades psiquiátricas em mulheres usuárias de crack recebendo tratamento em comunidades terapêuticas. Método Estudo transversal, descritivo e quantitativo. Quarenta e seis mulheres abstinentes de crack responderam a um questionário sociodemográfico, ao Mini-Exame do Estado Mental (MEEM), à Entrevista Estruturada do DSM-IV para Transtornos do Eixo I (SCID-I) e a um questionário sobre padrão de consumo de crack. Foram realizadas análises estatísticas descritivas dos dados. Resultados As participantes tinham média de 31,02 anos [desvio padrão (DP) = 7,73], eram na maioria solteiras (76,1%), brancas (67,4%) e tinham ensino fundamental completo ou incompleto (43,5%). Antes do tratamento, 65,2% das mulheres relataram usar crack todos os dias; 46,3% fumavam entre 10 e 30 pedras de crack por semana. O tempo médio de tratamento foi de 63,56 dias (DP = 75,85), com média de 80,41 dias em abstinência (DP = 74,52) e 3,37 (DP = 5,49) tratamentos anteriores. A idade média de início do uso de crack foi de 22,61 anos (DP = 8,06), e a motivação mais frequente para iniciar o uso de crack foi a curiosidade (78,3%). A duração média de uso de crack na vida foi de 82,26 meses (DP = 74,76), e as complicações físicas mais frequentemente relatadas foram perda de peso (93,5%), seguida por problemas de sono (87%). Neste estudo, os diagnósticos mais prevalentes foram episódio depressivo maior (60,87%), seguido por transtorno de estresse pós-traumático (52,17%) e transtorno de ansiedade generalizada (13,07%). Conclusões Em geral, observamos um padrão de alto consumo de crack. Os resultados mostram alta frequência de transtornos de humor e ansiedade, com maiores frequências para episódio depressivo maior e transtorno de estresse pós-traumático.

Inhibitory Control and Impulsivity Levels in Women Crack Users.

OBJECTIVE: investigate impulsivity levels and inhibitory control in women crack users and explore the relationships between impulsivity and inhibitory control. METHOD AND DESIGN: 52 healthy women (M = 32.83 years; SD = 9.54) and 46 crack cocaine users (M = 31.02 years; SD = 7.73), in abstinence, performed the assessment protocol included a Sociodemographic Data Questionnaire, Mini-Mental State Examination (MMSE), a GO/No-Go Task and the Barratt Impulsiveness Scale-11 (BIS-11). It was a quantitative research with cross-sectional design and control group. RESULTS: crack group showed higher levels of impulsivity in all domains when compared to the control group (crack group M = 76.39, SD = 11.39, control group M = 58.53, SD = 10.76, p <.01). Participants from the crack group presented a significantly higher total reaction time in the Go-NoGo task (F(1,93) = 9.93, p =.002; effect size =.09, observed power =.87) and significantly more commission (F(1,93) = 7.20, p =.009; effect size =.07, observed power =.75) and omission errors (F(1,93) = 6.04, p =.01; effect size =.06, observed power =.68), in Go/NoGo Task. Groups did also significantly differ on total standard deviations suggesting that variability in total reaction time was significantly greater in the crack group. Results showed that only in the crack group there were significant correlations between Go-NoGo parameters and Barratt Impulsiveness Scale. CONCLUSIONS: Our findings are consistent that impulsivity and inhibitory control are closely linked to crack use in women. Future studies should consider to evaluate crack users in different withdrawal times, controlling the impact of abstinence time in the variables studied.

Relação entre atenção e desempenho em leitura, escrita e aritmética em crianças / Relationship between attention and performance in reading, writing and arithmetic in children / Relación entre atención y desempeño en lectura, escritura y aritmética en niños

Este estudo buscou verificar se há relação entre atenção (seletiva e sustentada visual) e o desempenho escolar (leitura, escrita e aritmética). Foram avaliados 258 estudantes do 1º a 9º ano do ensino fundamental de escolas brasileiras públicas e privadas, com idade média de 10,33 anos (DP=2,52). Os estudantes foram avaliados pelo Teste de Cancelamento do Sinos ­ Versão Infantil (TCS) e pelo Teste de Desempenho Escolar ­ Segunda Edição (TDE-II). Os escores dos testes foram correlacionados pelo coeficiente de correlação de Pearson, considerando o nível de significância de p≤0,05. Houve correlações significativas positivas de intensidade fraca entre os escores totais do TCS e TDE-II e correlação negativas significativas de intensidade fraca entre os escores de erros e omissões do TCS e escores totais do TDE-II. Foi possível observar relação entre os construtos estudados, porém sugere-se que investigações futuras utilizem diferentes métodos para avaliar outras habilidades relacionadas ao desempenho escolar e processos atencionais. (AU)

This study sought to verify the relationship between attention (selective and sustained visual) and school performance (reading, writing and arithmetic). We evaluated 258 students from the 1st to the 9th year of elementary school in Brazilian public and private schools, with a mean age of 10.33 years (SD=2.52). The students were evaluated by the Bells Test ­ children's version (BT) and by the School Performance Test - second edition (SPT-II). Test scores were correlated by the Pearson correlation coefficient, considering the level of significance of p<0.05. There were significant positive correlations of weak intensity between BT and SPT-II total scores and significant negative correlation of weak intensity between BT errors and omission scores and total SPT-II scores. An observable relationship between the constructs studied exists; however, it is suggested that future investigations use different methods to evaluate other skills related to school performance and attentional processes. (AU)

Este estudio trata de determinar si existe relación entre atención (selectiva y sostenida visual) y desempeño escolar (lectura, escritura y aritmética). Fueron evaluados 258 estudiantes del 1 al 9 año de Enseñanza Primaria de escuelas públicas y privadas de Brasil, con edad media de 10,33 años (DP=2,52). Los estudiantes fueron evaluados utilizando el Test de Cancelamento do Sinos-Versão Infantil (TCS) Test de Cancelamiento de las Campanas Versión Infantil y por el Test de Desempeño Escolar ­ Segunda Edición (TDE-II). Las puntuaciones de los tests fueron correlacionados por el coeficiente de correlación de Pearson, considerando el nivel de significación de p<0,05. Hubo correlaciones positivas significativas de baja intensidad entre los puntajes totales del TCS y TDE-II y correlaciones negativas significativas de baja intensidad entre los puntajes de errores y omisiones del TCS y puntajes totales de TDE-II. Fue posible observar relación entre los constructos estudiados, sin embargo se sugiere que investigaciones futuras utilizen diferentes métodos para evaluar otras habilidades relacionadas con el desempeño escolar y los procesos de atención. (AU)

Plasma interleukin-6 and executive function in crack cocaine-dependent women.

AIM: The aim of this study was to investigate the association between plasma interleukin 6 (IL-6) levels and executive function (EF) in crack cocaine-dependent women. METHODS: 42 crack cocaine-dependent women (CRACK) and 52 healthy women (CONTROL) were evaluated with respect to EF using the Wisconsin Card Sorting Test (WCST). Plasma IL-6 levels were quantitatively determined using the multiplexed cytometric bead assay. RESULTS: The CRACK group had poor performance on WSCT scores (Non-perseverative Errors and Percent Conceptual Level Responses) and higher plasma IL-6 levels when compared with the CONTROL group. Furthermore, IL-6 was correlated with worsening of several WCST sub-scores and a linear regression model showed that IL-6 levels predicted worse cognitive flexibility within the CRACK group independently of intelligence quotient and education. CONCLUSIONS: The results of this study indicated that low performances in EF task are associated with higher IL-6 levels in crack cocaine-dependent women. These data bolster previous works that link the cognitive decline observed in drug addicts with mechanisms of inflammation.

Family relations, stressful events and internalizing symptoms in adolescence: a longitudinal study.

This study aimed to examine how emotional and behavioral problems of parents and children and the characteristics of family relationships can be predictors of internalizing symptoms manifested by children after one year. This was a quantitative research study, of the longitudinal type, with a one year interval between the first and second evaluation. Participants were 139 adolescents, and their parents, with ages ranged from 11 to 16 years (M age = 12.90, SD = 1.07). The instruments used were: a Socio-Demographic Data Sheet, Youth Self-Report of 11 to 18 years old (YSR), Adult Self-Report of 18 to 59 years old (ASR), Familiogram (FG), the Family Climate Inventory (FCI) and Inventory of Stressful Events in Adolescence (ISEA). Results indicated that family relationships did not have a significant explanatory power in relation to internalizing symptoms of the adolescent after a year. Based on this study, it is possible to think that during adolescence, the power of the family to influence becomes more restricted in comparison with social and peer influence.

Sintomas internalizantes na adolescência e as relações familiares: uma revisão sistemática da literatura / Internalizing symptoms in adolescence and family relationships: a systematic literature review

Este artigo teve como objetivo realizar uma revisão sistemática de literatura, nacional e internacional, no período de 2005 a 2010, sobre os sintomas internalizantes na adolescência e as relações familiares. Inicialmente, foi realizado um levantamento dos artigos indexados nas bases de dados Academic Search Premier, Education Resources Information Center (ERIC), ISI Web of Knowledge, Lilacs, MEDLINE with Full Text e SciELO (Scientific Electronic Library Online), utilizando-se os descritores, em português, “problemas internalizantes” ou “sintomas internalizantes” e “adolescência ou adolescente ou jovem” e “família”; e, em inglês, “internalizing problems or internalizing symptoms” and “adolescence or adolescent or teenager” and “family”. Os artigos foram classificados de acordo com o ano de publicação, o país, a metodologia, o instrumento de mensuração para comportamentos internalizantes e, ainda, quanto à temática principal. Na literatura internacional, constatou-se um predomínio de estudos empíricos e de caráter quantitativo, realizados preponderantemente pelos Estados Unidos. No Brasil, observou-se uma grande escassez de estudos integrando as temáticas da sintomatologia internalizante na adolescência e as relações familiares. Foram encontrados somente dois artigos, o que indica a necessidade de realização de mais pesquisas nesta área em nosso país.(AU)

This article aims to perform a systematic literature review, national and international, in the period between 2005 to 2010, on internalizing symptoms in adolescence and family relationships. Initially, a survey was conducted in indexed articles in the Academic Search Premier, Education Resources Information Center (ERIC), ISI Web of Knowledge, Lilacs, MEDLINE databases with Full Text, and SciELO (Scientific Electronic Library Online), using the descriptors in Portuguese, “problemas internalizantes” or “sintomas internalizantes” and “adolescência ou adolescente ou jovem” and “família” and in English, “internalizing problems or internalizing symptoms” and “adolescence or adolescent or teenager” and “family”. The articles were classified according to the publication year, country, the methodology, the measurement instrument for internalizing behaviors, and also about the main issue related. In the international literature, we found a predominance of empirical studies and quantitative character, performed mainly in the United States. In Brazil, there was a paucity of studies integrating the themes of internalizing symptoms in adolescence and family relationships. We found only two articles, which indicates the need for more research in this area in our country.(AU)

Este artículo tiene como objetivo realizar una revisión sistemática de la literatura nacional e internacional, en el período 2005-2010, a cerca de los síntomas de internalización en la adolescencia y las relaciones familiares. Al principio, se realizó un levantamiento de artículos indexados en las bases de datos Academic Search Premier, Education Resources Information Center (ERIC), ISI Web of Knowledge, Lilacs, MEDLINE with Full Text y SciELO (Scientific Electronic Library Online), utilizando los descriptores en portugués, “problemas internalizantes” o “sintomas internalizantes” y “adolescência o adolescente o jovem” y “família”, y, en inglés, “internalizing problems o internalizing symptoms” y “adolescence o adolescent o teenager” y “family”. Los artículos fueron clasificados de acuerdo con el año de publicación, el país, la metodología, el instrumento de medición y también cuanto a la temática principal. En la literatura internacional, se observó un predominio de estudios empíricos y de carácter cuantitativo, realizados principalmente por los Estados Unidos. En Brasil, se observó una escasez de estudios que integren las temáticas de la sintomatología de internalización de los adolescentes y las relaciones familiares. Fueron encontrados sólo dos artículos, lo que indica la necesidad de realización de más investigaciones en esta área en nuestro país.(AU)

Sintomas internalizantes na adolescência e as relações familiares: uma revisão sistemática da literatura / Internalizing symptoms in adolescence and family relationships: a systematic literature review / Síntomas de internalización en la adolescencia y las relaciones familiares: una revisión sistemática de la literatura

Este artigo teve como objetivo realizar uma revisão sistemática de literatura, nacional e internacional, no período de 2005 a 2010, sobre os sintomas internalizantes na adolescência e as relações familiares. Inicialmente, foi realizado um levantamento dos artigos indexados nas bases de dados Academic Search Premier, Education Resources Information Center (ERIC), ISI Web of Knowledge, Lilacs, MEDLINE with Full Text e SciELO (Scientific Electronic Library Online), utilizando-se os descritores, em português, “problemas internalizantes” ou “sintomas internalizantes” e “adolescência ou adolescente ou jovem” e “família”; e, em inglês, “internalizing problems or internalizing symptoms” and “adolescence or adolescent or teenager” and “family”. Os artigos foram classificados de acordo com o ano de publicação, o país, a metodologia, o instrumento de mensuração para comportamentos internalizantes e, ainda, quanto à temática principal. Na literatura internacional, constatou-se um predomínio de estudos empíricos e de caráter quantitativo, realizados preponderantemente pelos Estados Unidos. No Brasil, observou-se uma grande escassez de estudos integrando as temáticas da sintomatologia internalizante na adolescência e as relações familiares. Foram encontrados somente dois artigos, o que indica a necessidade de realização de mais pesquisas nesta área em nosso país.

This article aims to perform a systematic literature review, national and international, in the period between 2005 to 2010, on internalizing symptoms in adolescence and family relationships. Initially, a survey was conducted in indexed articles in the Academic Search Premier, Education Resources Information Center (ERIC), ISI Web of Knowledge, Lilacs, MEDLINE databases with Full Text, and SciELO (Scientific Electronic Library Online), using the descriptors in Portuguese, “problemas internalizantes” or “sintomas internalizantes” and “adolescência ou adolescente ou jovem” and “família” and in English, “internalizing problems or internalizing symptoms” and “adolescence or adolescent or teenager” and “family”. The articles were classified according to the publication year, country, the methodology, the measurement instrument for internalizing behaviors, and also about the main issue related. In the international literature, we found a predominance of empirical studies and quantitative character, performed mainly in the United States. In Brazil, there was a paucity of studies integrating the themes of internalizing symptoms in adolescence and family relationships. We found only two articles, which indicates the need for more research in this area in our country.

Este artículo tiene como objetivo realizar una revisión sistemática de la literatura nacional e internacional, en el período 2005-2010, a cerca de los síntomas de internalización en la adolescencia y las relaciones familiares. Al principio, se realizó un levantamiento de artículos indexados en las bases de datos Academic Search Premier, Education Resources Information Center (ERIC), ISI Web of Knowledge, Lilacs, MEDLINE with Full Text y SciELO (Scientific Electronic Library Online), utilizando los descriptores en portugués, “problemas internalizantes” o “sintomas internalizantes” y “adolescência o adolescente o jovem” y “família”, y, en inglés, “internalizing problems o internalizing symptoms” y “adolescence o adolescent o teenager” y “family”. Los artículos fueron clasificados de acuerdo con el año de publicación, el país, la metodología, el instrumento de medición y también cuanto a la temática principal. En la literatura internacional, se observó un predominio de estudios empíricos y de carácter cuantitativo, realizados principalmente por los Estados Unidos. En Brasil, se observó una escasez de estudios que integren las temáticas de la sintomatología de internalización de los adolescentes y las relaciones familiares. Fueron encontrados sólo dos artículos, lo que indica la necesidad de realización de más investigaciones en esta área en nuestro país.

Comorbidades psiquiátricas em dependentes químicos em abstinência em ambiente protegido / Psychiatric comorbidities in abstinent drug addict in a protected environment

O objetivo desta pesquisa foi verificar a frequência de comorbidades psiquiátricas, utilizando Mini International Neuropsychiatric Interview, em diferentes grupos de dependentes químicos em abstinência, em ambiente protegido, classificados de acordo com o tipo de droga utilizada: (1) grupo controle (n = 37); (2) dependentes em abstinência de álcool (n = 8); (3) dependentes em abstinência de álcool, maconha e crack/cocaína (n = 24); e (4) dependentes em abstinência de múltiplas substâncias psicoativas (n=25), ou seja, indivíduos que faziam uso de vários tipos de drogas sem apresentar uma droga de escolha. Participaram 94 homens, com idade média de 30,41 anos (DP = 9,88). O período de abstinência variou entre 30 e 240 dias. A maioria dos participantes tinha baixa escolaridade e era solteira. Os resultados apontaram maior ocorrência de psicopatologias e risco de suicídio nos grupos formados por pacientes com histórico de consumo múltiplo de substâncias, sugerindo a importância da avaliação de outros transtornos associados à dependência química.(AU)

The objective of this research was to determine the frequency of psychiatric comorbidity, using Mini International Neuropsychiatric Interview, in different groups of former drug addicts, classified according to the type of drug used: (1) control group (n = 37), (2) ex-users of alcohol only (n = 8), (3) former users of alcohol, marijuana and crack /cocaine (n = 24), and (4) ex-poly drug users (n = 25), in other words, individuals who use various types of drugs without a clear drug of choice. Participants comprised 94 men, mean age 30.41 years (SD = 9.88). The withdrawal period varied between 30 and 240 days. Most participants had little schooling and were single. The results showed a higher incidence of psychopathology and suicide risk in the groups formed by patients with a history of multiple substance use, suggesting the importance of evaluation of other disorders associated with addiction.(AU)

Comorbidades psiquiátricas em dependentes químicos em abstinência em ambiente protegido / Psychiatric comorbidities in abstinent drug addict in a protected environment

O objetivo desta pesquisa foi verificar a frequência de comorbidades psiquiátricas, utilizando Mini International Neuropsychiatric Interview, em diferentes grupos de dependentes químicos em abstinência, em ambiente protegido, classificados de acordo com o tipo de droga utilizada: (1) grupo controle (n = 37); (2) dependentes em abstinência de álcool (n = 8); (3) dependentes em abstinência de álcool, maconha e crack/cocaína (n = 24); e (4) dependentes em abstinência de múltiplas substâncias psicoativas (n=25), ou seja, indivíduos que faziam uso de vários tipos de drogas sem apresentar uma droga de escolha. Participaram 94 homens, com idade média de 30,41 anos (DP = 9,88). O período de abstinência variou entre 30 e 240 dias. A maioria dos participantes tinha baixa escolaridade e era solteira. Os resultados apontaram maior ocorrência de psicopatologias e risco de suicídio nos grupos formados por pacientes com histórico de consumo múltiplo de substâncias, sugerindo a importância da avaliação de outros transtornos associados à dependência química.

The objective of this research was to determine the frequency of psychiatric comorbidity, using Mini International Neuropsychiatric Interview, in different groups of former drug addicts, classified according to the type of drug used: (1) control group (n = 37), (2) ex-users of alcohol only (n = 8), (3) former users of alcohol, marijuana and crack /cocaine (n = 24), and (4) ex-poly drug users (n = 25), in other words, individuals who use various types of drugs without a clear drug of choice. Participants comprised 94 men, mean age 30.41 years (SD = 9.88). The withdrawal period varied between 30 and 240 days. Most participants had little schooling and were single. The results showed a higher incidence of psychopathology and suicide risk in the groups formed by patients with a history of multiple substance use, suggesting the importance of evaluation of other disorders associated with addiction.