Psychoactive substance abuse and dependence and its association with anxiety disorders: a population-based study of young adults in Brazil

Objective: To evaluate the association between abuse of and dependence on different psychoactive substances and the presence of anxiety disorders in a sample of young adults from a city in southern Brazil. Methods: Between 2007 and 2009, we carried out a cross-sectional, population-based study of individuals aged 18-24 years who lived in Pelotas, a city in southern Brazil. We evaluated anxiety disorders using the Mini International Neuropsychiatric Interview 5.0 (MINI), and use of psychoactive substances with the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST 2.0/0MS). We used Fisher's exact test for univariate analysis, and Poisson regression models with robust variance for multivariable analysis. Results: The sample consisted of 1,560 young adults. The overall prevalence of abuse/dependence was 26.9% for alcohol, 24.9% for tobacco, and 7.3% for illicit substances. Individuals with agoraphobia had a 32% higher prevalence of tobacco abuse/dependence (prevalence ratio [PR] = 1.32 [95%CI 1.01-1.74]). Individuals with posttraumatic stress disorder (PTSD) or generalized anxiety disorder (GAD) had a 2.41-fold (95%CI 1.22-4.77) and 1.76-fold (95%CI 1.00-3.11) higher prevalence of illicit substance abuse/dependence, respectively. Conclusion: In this population-based sample, we found associations between GAD, PTSD, and increased prevalence of illicit substance abuse/dependence. In addition, individuals with agoraphobia seem to have increased tobacco abuse/dependence.

Psychoactive substance abuse and dependence and its association with anxiety disorders: a population-based study of young adults in Brazil.

OBJECTIVE: To evaluate the association between abuse of and dependence on different psychoactive substances and the presence of anxiety disorders in a sample of young adults from a city in southern Brazil. METHODS: Between 2007 and 2009, we carried out a cross-sectional, population-based study of individuals aged 18-24 years who lived in Pelotas, a city in southern Brazil. We evaluated anxiety disorders using the Mini International Neuropsychiatric Interview 5.0 (MINI), and use of psychoactive substances with the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST 2.0/0MS). We used Fisher's exact test for univariate analysis, and Poisson regression models with robust variance for multivariable analysis. RESULTS: The sample consisted of 1,560 young adults. The overall prevalence of abuse/dependence was 26.9% for alcohol, 24.9% for tobacco, and 7.3% for illicit substances. Individuals with agoraphobia had a 32% higher prevalence of tobacco abuse/dependence (prevalence ratio [PR] = 1.32 [95%CI 1.01-1.74]). Individuals with posttraumatic stress disorder (PTSD) or generalized anxiety disorder (GAD) had a 2.41-fold (95%CI 1.22-4.77) and 1.76-fold (95%CI 1.00-3.11) higher prevalence of illicit substance abuse/dependence, respectively. CONCLUSION: In this population-based sample, we found associations between GAD, PTSD, and increased prevalence of illicit substance abuse/dependence. In addition, individuals with agoraphobia seem to have increased tobacco abuse/dependence.

Risco de suicídio em jovens com transtornos de ansiedade: estudo de base populacional / Suicide risk in young adults with anxiety disorders: population-based study / Riesgo de suicidio en jóvenes con trastornos de ansiedad: estudio de base poblacional

Este estudo teve por objetivo verificar a relação entre a presença de transtornos de ansiedade e risco de suicídio em jovens. Em delineamento transversal de base populacional, os jovens respondiam a um questionário sobre questões sociodemográficas, comportamentais e de saúde. Avaliou-se o bem-estar psicológico através da Escala de Faces de Andrews e consumo de substâncias foi efetuado pelo Teste de Triagem do Envolvimento com Álcool, Cigarro e Outras Substâncias, (Alcohol, Smoking and Substance Involviment Screening Test - ASSIST). A Mini Internacional Neuropsychiatric Interview 5.0 avaliou transtornos de ansiedade e o risco de suicídio. Dos 1.621 jovens entrevistados, 20,9% apresentaram algum transtorno de ansiedade e 8,6% risco de suicídio. A presença de algum transtorno de ansiedade esteve significativamente associada ao risco de suicídio (RP 6,10 IC95% 3,95 a 9,43). Dessa forma, salienta-se a importância de maior atenção ao risco de suicídio também em pacientes com transtornos de ansiedade.(AU)

This study aimed at investigating the relationship between the presence of anxiety disorders and suicide risk in young adults. In a cross-sectional population-based design young adults answered a questionnaire about sociodemographic, behavioral and health characteristics. The measure of psychological well-being was made by Faces Scale of Andrews while the substances use evaluation was performed according to the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). The Mini International Neuropsychiatric Interview 5.0 evaluated anxiety disorders and suicide risk. Among the 1.621 young adults interviewed, 20.9% had some anxiety disorders and 8.6% suicide risk. After multivariate analysis, the presence of any anxiety disorder was significantly associated with suicide risk (PR 6.10 95% CI 3.95 to 9.43). Thus, it is highlighted the importance of greater attention to suicide risk in those patients with anxiety disorders.(AU)

Este estudio tubo por objetivo verificar la relación entre la presencia de trastornos de ansiedad y riesgo de suicidio en jóvenes. En delineamiento transversal de base poblacional, los jóvenes respondían a un cuestionario sobre cuestiones sociodemográficas, comportamentales y de salud. Se evaluó el bienestar psicológico por medio de la escala de fases de Andrews y consumo de sustancias efectuada por la prueba de detección del envolvimiento con alcohol, cigarrillo y otras sustancias, (Alcohol, Smoking and Substance Involviment Screening Test - ASSIST). La Mini Internacional Neuropsychiatric Interview 5.0 evaluó trastornos de ansiedad y el riesgo de suicidio. De los 1.621 jóvenes entrevistados, 20,9% presentaron algún trastorno de ansiedad y 8,6% riesgo de suicidio. La presencia de algún trastorno de ansiedad estuvo significativamente asociada al riesgo de suicidio (RP 6,10 IC95% 3,95 a 9,43). De esa forma, se resalta la importancia de mayor atención al riesgo de suicidio también en pacientes con trastornos de ansiedad.(AU)

[Suicide risk and health risk behavior among youth between the ages of 18 and 24 years: a descriptive study]. / Risco de suicídio e comportamentos de risco à saúde em jovens de 18 a 24 anos: um estudo descritivo.

The aim of this study was to assess suicide risk and risk behavior in young people. A cross-sectional study in the urban area of Pelotas, Rio Grande do Sul State, Brazil was performed using systematic sampling with young people between the ages of 18 to 24 years. We measured the risk of suicide (MINI), behavior (YRBSS), abuse/substance dependence (ASSIST) and socioeconomic status (ABEP). Data was analyzed using SPSS software. The sample consisted of 1,560 young people and the prevalence of suicide risk was 8.6%. Suicide risk was associated with: having suffered an accident that required a visit to the emergency room (p = 0.011), fighting (p = 0.016), carrying a weapon (p = 0.001) and carrying a firearm (p ≤ 0.001), substance abuse/dependence (p ≤ 0.001), not having used a condom during the last sexual relationship (p = 0.025), not having a steady partner (p ≤ 0.001) and having sex with five or more people (p = 0.018). Young people that present risk behavior also represent a suicide risk.

Risco de suicídio e comportamentos de risco à saúde em jovens de 18 a 24 anos: um estudo descritivo / Suicide risk and health risk behavior among youth between the ages of 18 and 24 years: a descriptive study

O objetivo foi avaliar risco de suicídio e comportamentos de risco em jovens. Estudo transversal na zona urbana de Pelotas, Rio Grande do Sul, Brasil, realizado por amostragem sistemática. Foram incluídos jovens de 18 a 24 anos, com capacidade cognitiva e que assinaram termo de consentimento. Foram aferidos risco de suicídio (MINI); comportamentos de risco (YRBSS); abuso/dependência de substâncias (ASSIST); e nível socioeconômico (ABEP). Os dados foram analisados no programa SPSS. A amostra constituiu-se de 1560 jovens e a prevalência de risco de suicídio foi de 8,6 por cento. O risco de suicídio foi associado com: ter sofrido acidente com necessidade de ir ao pronto-socorro (p = 0,011), ter entrado em briga com agressão física (p = 0,016), ter carregado arma branca (p = 0,001) e arma de fogo (p < 0,001), ter abuso/dependência de substâncias (p < 0,001), não ter utilizado preservativo na última relação sexual (p = 0,025), não ter parceiro fixo (p < 0,001) e ter relação sexual com cinco ou mais pessoas (p = 0,018). Jovens com comportamentos de risco também demonstram indícios de risco de suicídio.

The aim of this study was to assess suicide risk and risk behavior in young people. A cross-sectional study in the urban area of Pelotas, Rio Grande do Sul State, Brazil was performed using systematic sampling with young people between the ages of 18 to 24 years. We measured the risk of suicide (MINI), behavior (YRBSS), abuse/substance dependence (ASSIST) and socioeconomic status (ABEP). Data was analyzed using SPSS software. The sample consisted of 1,560 young people and the prevalence of suicide risk was 8.6 percent. Suicide risk was associated with: having suffered an accident that required a visit to the emergency room (p = 0.011), fighting (p = 0.016), carrying a weapon (p = 0.001) and carrying a firearm (p < 0.001), substance abuse/dependence (p < 0.001), not having used a condom during the last sexual relationship (p = 0.025), not having a steady partner (p < 0.001) and having sex with five or more people (p = 0.018). Young people that present risk behavior also represent a suicide risk.

[Factors associated with age at first intercourse: a population-based study]. / Fatores associados à idade da primeira relação sexual em jovens: estudo de base populacional.

First sexual intercourse is considered an important event in young people's lives and has occurred at an increasingly early age. The aim of this study was to identify factors associated with early age at first intercourse in individuals 18 to 24 years of age in Pelotas, Rio Grande do Sul State, Brazil. This was a population-based cross-sectional study in a representative sample of 1,621 young people from August 2007 to December 2008. Subjects answered a questionnaire on health behaviors, including items related to their sexual lives. Cox regression was used to assess the association between early age at sexual initiation. After multivariate analysis, variables that are directly related to early sexual initiation were: male gender, low socioeconomic status, low schooling, divorced parents, living with a partner, not practicing a religion, smoking, drug use in the previous three months, and non-use of condoms during last intercourse. Considering the current social context, the study highlights the need for adequate sexual orientation with a preventive approach.

Fatores associados à idade da primeira relação sexual em jovens: estudo de base populacional / Factors associated with age at first intercourse: a population-based study

A primeira relação sexual é considerada um evento importante na vida dos jovens e tem iniciado cada vez mais cedo. O objetivo do presente estudo foi descrever os fatores relacionados à idade precoce da primeira relação sexual, de jovens de 18 a 24 anos na cidade de Pelotas, Rio Grande do Sul, Brasil. Este é um estudo transversal de base populacional, em uma amostra representativa de 1.621 jovens que ocorreu entre agosto de 2007 e dezembro de 2008. Foram aplicados questionários sobre comportamentos de saúde que continham itens relativos à sexualidade. A regressão de Cox foi utilizada para aferir a associação com a idade precoce de início da vida sexual. Após a análise multivariada, as variáveis diretamente relacionadas com a iniciação sexual precoce foram: sexo masculino, baixo nível socioeconômico, baixa escolaridade, ter pais separados, morar com companheiro(a), não praticar uma religião, uso de tabaco e drogas, e o não uso da camisinha na última relação. Considerando o contexto social atual, evidencia-se a necessidade de uma adequada orientação sexual com aspecto preventivo.

First sexual intercourse is considered an important event in young people's lives and has occurred at an increasingly early age. The aim of this study was to identify factors associated with early age at first intercourse in individuals 18 to 24 years of age in Pelotas, Rio Grande do Sul State, Brazil. This was a population-based cross-sectional study in a representative sample of 1,621 young people from August 2007 to December 2008. Subjects answered a questionnaire on health behaviors, including items related to their sexual lives. Cox regression was used to assess the association between early age at sexual initiation. After multivariate analysis, variables that are directly related to early sexual initiation were: male gender, low socioeconomic status, low schooling, divorced parents, living with a partner, not practicing a religion, smoking, drug use in the previous three months, and non-use of condoms during last intercourse. Considering the current social context, the study highlights the need for adequate sexual orientation with a preventive approach.

[Mental common disorders and quality of life in young adulthoods: a population-based sample in Pelotas, Rio Grande do Sul State, Brazil]. / Transtornos mentais comuns e qualidade de vida em jovens: uma amostra populacional de Pelotas, Rio Grande do Sul, Brasil.

This study aimed to assess the prevalence of common mental disorders (CMD) and their association with quality of life among young adults in Pelotas, Rio Grande do Sul State, Brazil. This was a cross-sectional population-based study of young people 18 to 24 years of age. Sampling used simple cluster selection. Investigation of CMD used the Self-Report Questionnaire (SRQ-20), while quality of life was measured with the Medical Outcomes Survey Short-Form General Health Survey (SF-36). Prevalence of CMD in the study sample was 24.5% (N = 382), and was positively associated with: female gender, lower socioeconomic status (classes D or E), not studying, not working, alcohol consumption, smoking, and substance abuse. Young adults with CMD had lower mean scores on the SF-36 in all the assessed quality of life domains. Measures to prevent CMD are necessary to provide better quality of life for this age group.

Transtornos mentais comuns e qualidade de vida em jovens: uma amostra populacional de Pelotas, Rio Grande do Sul, Brasil / Mental common disorders and quality of life in young adulthoods: a population-based sample in Pelotas, Rio Grande do Sul State, Brazil

This study aimed to assess the prevalence of common mental disorders (CMD) and their association with quality of life among young adults in Pelotas, Rio Grande do Sul State, Brazil. This was a cross-sectional population-based study of young people 18 to 24 years of age. Sampling used simple cluster selection. Investigation of CMD used the Self-Report Questionnaire (SRQ-20), while quality of life was measured with the Medical Outcomes Survey Short-Form General Health Survey (SF-36). Prevalence of CMD in the study sample was 24.5 percent (N = 382), and was positively associated with: female gender, lower socioeconomic status (classes D or E), not studying, not working, alcohol consumption, smoking, and substance abuse. Young adults with CMD had lower mean scores on the SF-36 in all the assessed quality of life domains. Measures to prevent CMD are necessary to provide better quality of life for this age group.

O objetivo foi verificar a prevalência de transtornos mentais comuns (TMC) e sua associação com qualidade de vida em jovens da cidade de Pelotas, Rio Grande do Sul, Brasil. Estudo transversal de base populacional com jovens de 18 a 24 anos. A seleção amostral foi realizada por conglomerados. Para a investigação dos transtornos mentais comuns foi aplicado o Self Report Questionnaire (SRQ-20), enquanto os níveis de qualidade de vida foram mensurados por intermédio da Medical Outcomes Survey Short-form General Health Survey (SF-36). A prevalência de TMC na amostra estudada foi de 24,5 por cento (N = 382), apresentando-se mais evidente entre as mulheres, entre aqueles que pertenciam à menor classe socioeconômica (D ou E), não estavam estudando, não estavam trabalhando, consumiram álcool e usaram tabaco pelo menos uma vez na última semana e que fizeram uso de alguma substância ilícita nos últimos três meses. Os jovens com TMC obtiveram uma menor média nos escores da SF-36 em todos os domínios de qualidade de vida avaliados. Deve-se investir em medidas preventivas de TMC no intuito de proporcionar uma melhor qualidade de vida à população.

Prevalence of episodes of mania and hypomania and associated comorbidities among young adults.

OBJECTIVE: To evaluate the prevalence of episodes of mania and hypomania, as well as associated factors and comorbidities among adults 18 to 24 years old in the city of Pelotas, Brazil. METHOD: This is a cross-sectional population-based study. The sample was selected through conglomerates, and episodes of mania and hypomania were assessed using the Mini International Neuropsychiatric. RESULTS: The sample consisted of 1560 subjects. The lifetime prevalence of manic and hypomanic episodes was 7.5% and 5.3%, respectively. Subjects with (hypo)manic episodes had a higher prevalence of anxiety disorders, substance abuse and suicidality. LIMITATION: The high rate of (hypo)mania may to some extent reflect diagnostic error. CONCLUSION: Such high prevalence of (hypo)mania may nonetheless be valid as it was associated with corresponding rates of comorbidity and suicidality.

Depressão e qualidade de vida em jovens de 18 a 24 anos no sul do Brasil / Depression and quality of life in young adults aged 18 to 24 years in southern Brazil

OBJETIVO: Investigar a associação entre depressão e qualidade de vida em jovens de 18 a 24 anos de idade. MÉTODO: Estudo transversal de base populacional, composto por 1.560 jovens de 18 a 24 anos residentes na zona urbana de Pelotas (RS). A seleção amostral foi realizada por conglomerados: da divisão censitária de 448 setores, 97 foram sorteados aleatoriamente. A avaliação da depressão foi realizada através do Mini-International Neuropsychiatric Interview (MINI), e a qualidade de vida foi mensurada pela Medical Outcomes Study Short-Form General Health Survey (SF-36), ambos validados para uso em língua portuguesa. RESULTADOS: A prevalência de depressão foi de 12,6 por cento. A média dos escores de qualidade de vida entre os oito domínios do SF-36 foi menor entre os jovens com depressão, apresentando associação significativa no teste t para todos os domínios (p = 0,000). CONCLUSÃO: Jovens com indicativo de depressão apresentaram menores níveis de qualidade de vida nos domínios explorados.

OBJECTIVE: To investigate the association between depression and quality of life in young adults aged 18 to 24 years. METHOD: This cross-sectional, population-based study included 1,560 young adults aged 18 to 24 years living in the urban area of Pelotas, southern Brazil. Sample selection was based on cluster sampling: of a total of 448 sectors, 97 were randomly selected. Depression was assessed using the Mini-International Neuropsychiatric Interview (MINI), and quality of life was measured using the Medical Outcomes Study Short-Form General Health Survey (SF-36), both validated for use in Brazilian Portuguese. RESULTS: The prevalence of depression was 12.6 percent. Mean scores obtained for quality of life in the eight domains assessed by SF-36 were lower in depressive young adults, reaching statistical significance in all domains when assessed using the t test (p = 0.000). CONCLUSION: Young adults with signs and symptoms suggestive of depression presented lower levels of quality of life based on the domains assessed.

[Common mental disorders and self-esteem in pregnancy: prevalence and associated factors]. / Transtornos mentais comuns e auto-estima na gestação: prevalência e fatores associados.

The aim of this study was to assess the prevalence of common mental disorders and the association with self-esteem and other factors in pregnant women. A nested cross-sectional study was performed in a cohort of pregnant women treated in the public health system in Pelotas, Rio Grande do Sul State, Brazil. The Self-Reporting Questionnaire (SRQ-20) was used to screen for common mental disorders and the Rosenberg's Self-Esteem Scale for self-esteem. The sample consisted of 1,267 pregnant women with a mean age of 25 years (SD = 6.53). Mean self-esteem was 9.3 points (SD = 4.76), and prevalence of common mental disorders was 41.4%. Lower self-esteem was associated with higher odds of common mental disorders (p < 0.001). There was a significant association between higher prevalence of common mental disorders and low self-esteem.

Transtornos mentais comuns e auto-estima na gestação: prevalência e fatores associados / Common mental disorders and self-esteem in pregnancy: prevalence and associated factors

O objetivo do presente estudo foi verificar a prevalência de transtornos mentais comuns (TMC) e sua relação com auto-estima, bem como outros fatores associados à ocorrência de TMC em gestantes. Foi realizado um estudo transversal aninhado a uma coorte no qual participaram gestantes atendidas no serviço de saúde do Sistema Único de Saúde na cidade de Pelotas, Estado do Rio Grande do Sul, Brasil. Foi utilizado para o rastreamento de transtornos mentais comuns o Self-Reporting Questionnaire (SRQ-20) e, para avalia a auto-estima, a Escala de Auto-Estima de Rosenberg. A amostra constituiu-se de 1.267 gestantes, que tinham em média 25 anos (dp = 6,53). A média de auto-estima foi de 9,3 pontos (dp = 4,76) e a prevalência de TMC em gestantes foi de 41,4 por cento. Evidenciou-se, também, que quanto menor a auto-estima da grávida maiores são as chances de associação a TMC (p < 0,001). Houve uma significativa associação entre maior prevalência de TMC e baixa auto-estima.

The aim of this study was to assess the prevalence of common mental disorders and the association with self-esteem and other factors in pregnant women. A nested cross-sectional study was performed in a cohort of pregnant women treated in the public health system in Pelotas, Rio Grande do Sul State, Brazil. The Self-Reporting Questionnaire (SRQ-20) was used to screen for common mental disorders and the Rosenberg's Self-Esteem Scale for self-esteem. The sample consisted of 1,267 pregnant women with a mean age of 25 years (SD = 6.53). Mean self-esteem was 9.3 points (SD = 4.76), and prevalence of common mental disorders was 41.4 percent. Lower self-esteem was associated with higher odds of common mental disorders (p < 0.001). There was a significant association between higher prevalence of common mental disorders and low self-esteem.