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1.
PLoS Med ; 16(7): e1002853, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31335910

RESUMO

BACKGROUND: With no effective treatments for cognitive decline or dementia, improving the evidence base for modifiable risk factors is a research priority. This study investigated associations between risk factors and late-life cognitive decline on a global scale, including comparisons between ethno-regional groups. METHODS AND FINDINGS: We harmonized longitudinal data from 20 population-based cohorts from 15 countries over 5 continents, including 48,522 individuals (58.4% women) aged 54-105 (mean = 72.7) years and without dementia at baseline. Studies had 2-15 years of follow-up. The risk factors investigated were age, sex, education, alcohol consumption, anxiety, apolipoprotein E ε4 allele (APOE*4) status, atrial fibrillation, blood pressure and pulse pressure, body mass index, cardiovascular disease, depression, diabetes, self-rated health, high cholesterol, hypertension, peripheral vascular disease, physical activity, smoking, and history of stroke. Associations with risk factors were determined for a global cognitive composite outcome (memory, language, processing speed, and executive functioning tests) and Mini-Mental State Examination score. Individual participant data meta-analyses of multivariable linear mixed model results pooled across cohorts revealed that for at least 1 cognitive outcome, age (B = -0.1, SE = 0.01), APOE*4 carriage (B = -0.31, SE = 0.11), depression (B = -0.11, SE = 0.06), diabetes (B = -0.23, SE = 0.10), current smoking (B = -0.20, SE = 0.08), and history of stroke (B = -0.22, SE = 0.09) were independently associated with poorer cognitive performance (p < 0.05 for all), and higher levels of education (B = 0.12, SE = 0.02) and vigorous physical activity (B = 0.17, SE = 0.06) were associated with better performance (p < 0.01 for both). Age (B = -0.07, SE = 0.01), APOE*4 carriage (B = -0.41, SE = 0.18), and diabetes (B = -0.18, SE = 0.10) were independently associated with faster cognitive decline (p < 0.05 for all). Different effects between Asian people and white people included stronger associations for Asian people between ever smoking and poorer cognition (group by risk factor interaction: B = -0.24, SE = 0.12), and between diabetes and cognitive decline (B = -0.66, SE = 0.27; p < 0.05 for both). Limitations of our study include a loss or distortion of risk factor data with harmonization, and not investigating factors at midlife. CONCLUSIONS: These results suggest that education, smoking, physical activity, diabetes, and stroke are all modifiable factors associated with cognitive decline. If these factors are determined to be causal, controlling them could minimize worldwide levels of cognitive decline. However, any global prevention strategy may need to consider ethno-regional differences.


Assuntos
Cognição , Disfunção Cognitiva/etnologia , Grupos Étnicos/psicologia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/psicologia , Comorbidade , Diabetes Mellitus/etnologia , Exercício Físico , Feminino , Educação em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Medição de Risco , Fatores de Risco , Fumar/efeitos adversos , Fumar/etnologia , Acidente Vascular Cerebral/etnologia
2.
Rev Assoc Med Bras (1992) ; 65(3): 452-459, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30994847

RESUMO

OBJECTIVE: To assist clinicians to make adequate interpretation of scientific evidence from studies that evaluate diagnostic tests in order to allow their rational use in clinical practice. METHODS: This is a narrative review focused on the main concepts, study designs, the adequate interpretation of the diagnostic accuracy data, and making inferences about the impact of diagnostic testing in clinical practice. RESULTS: Most of the literature that evaluates the performance of diagnostic tests uses cross-sectional design. Randomized clinical trials, in which diagnostic strategies are compared, are scarce. Cross-sectional studies measure diagnostic accuracy outcomes that are considered indirect and insufficient to define the real benefit for patients. Among the accuracy outcomes, the positive and negative likelihood ratios are the most useful for clinical management. Variations in the study's cross-sectional design, which may add bias to the results, as well as other domains that contribute to decreasing the reliability of the findings, are discussed, as well as how to extrapolate such accuracy findings on impact and consequences considered important for the patient. Aspects of costs, time to obtain results, patients' preferences and values should preferably be considered in decision making. CONCLUSION: Knowing the methodology of diagnostic accuracy studies is fundamental, but not sufficient, for the rational use of diagnostic tests. There is a need to balance the desirable and undesirable consequences of tests results for the patients in order to favor a rational decision-making approach about which tests should be recommended in clinical practice.


Assuntos
Tomada de Decisão Clínica/métodos , Testes Diagnósticos de Rotina/normas , Medicina Baseada em Evidências/normas , Viés , Humanos , Reprodutibilidade dos Testes , Fatores de Risco , Sensibilidade e Especificidade
3.
Drug Alcohol Depend ; 199: 92-100, 2019 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-31029880

RESUMO

BACKGROUND: Web-based personalized normative feedback (PNF) interventions are less effective than their laboratory versions. Participant motivation may account for this reduced effect, but there is only a limited amount of research into the influence of motivation on PNF effectiveness. We evaluated the effectiveness of a web-based PNF in reducing alcohol use and consequences among college students with different motivation levels. METHODS: Pragmatic randomized controlled trial among Brazilian college drinkers aged 18-30 years (N = 4460). Participants were randomized to a Control or PNF group and followed-up after one (T1), three (T2) and six (T3) months. Outcomes were: AUDIT score (primary outcome), the number of consequences, and the typical number of drinks. Motivation for receiving the intervention was assessed with a visual analog scale (range: 0-10). Generalized mixed models assessed intervention effects via two paradigms: observed cases and attrition models. RESULTS: PNF reduced the number of typical drinks at T1 (OR = 0.71, p = 0.002), T2 (OR = 0.60, p < 0.001) and T3 (OR = 0.68, p = 0.016), compared to the control. Motivated students (score ≥3) receiving PNF also reduced the number of typical drinks at T1 (OR = 0.60, p < 0.001), T2 (OR = 0.55, p < 0.001) and T3 (OR = 0.56, p = 0.001), compared to the control. However, the attrition models were more robust at T1 and T2. In contrast, low-motivated students receiving the PNF increased AUDIT score at T3 (b = 1.49, p < 0.001). CONCLUSIONS: The intervention reduced alcohol use, and motivation for receiving the intervention moderated the intervention effects. Motivated students reduced their typical alcohol use, whereas low-motivated students increased their AUDIT score.


Assuntos
Consumo de Álcool na Faculdade/psicologia , Retroalimentação Psicológica , Internet , Motivação , Estudantes/psicologia , Universidades , Adolescente , Adulto , Brasil/epidemiologia , Intervenção Médica Precoce/métodos , Intervenção Médica Precoce/tendências , Retroalimentação Psicológica/fisiologia , Feminino , Humanos , Internet/tendências , Masculino , Motivação/fisiologia , Universidades/tendências , Adulto Jovem
4.
Rev. Assoc. Med. Bras. (1992) ; 65(3): 452-459, Mar. 2019. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-1003040

RESUMO

SUMMARY OBJECTIVE: To assist clinicians to make adequate interpretation of scientific evidence from studies that evaluate diagnostic tests in order to allow their rational use in clinical practice. METHODS: This is a narrative review focused on the main concepts, study designs, the adequate interpretation of the diagnostic accuracy data, and making inferences about the impact of diagnostic testing in clinical practice. RESULTS: Most of the literature that evaluates the performance of diagnostic tests uses cross-sectional design. Randomized clinical trials, in which diagnostic strategies are compared, are scarce. Cross-sectional studies measure diagnostic accuracy outcomes that are considered indirect and insufficient to define the real benefit for patients. Among the accuracy outcomes, the positive and negative likelihood ratios are the most useful for clinical management. Variations in the study's cross-sectional design, which may add bias to the results, as well as other domains that contribute to decreasing the reliability of the findings, are discussed, as well as how to extrapolate such accuracy findings on impact and consequences considered important for the patient. Aspects of costs, time to obtain results, patients' preferences and values should preferably be considered in decision making. CONCLUSION: Knowing the methodology of diagnostic accuracy studies is fundamental, but not sufficient, for the rational use of diagnostic tests. There is a need to balance the desirable and undesirable consequences of tests results for the patients in order to favor a rational decision-making approach about which tests should be recommended in clinical practice.


RESUMO OBJETIVO: Auxiliar os clínicos na interpretação adequada das evidências científicas de estudos que avaliam testes diagnósticos, de modo a permitir seu uso racional na prática clínica. MÉTODOS: Revisão narrativa da literatura dos principais conceitos, desenhos de estudo, interpretação adequada dos dados de acurácia diagnóstica e realização de inferências sobre o impacto do teste diagnóstico na prática clínica. RESULTADOS: A maioria da literatura que avalia o desempenho de testes diagnósticos utiliza como delineamento os estudos transversais. Ensaios clínicos randomizados, avaliando desfechos clínicos, que seriam considerados ideais, são escassos. Os estudos transversais mensuram desfechos de acurácia diagnóstica que são considerados indiretos e insuficientes para definir o real benefício para os pacientes. Dentre os desfechos, as razões de verossimilhança positiva e negativa são as mais úteis para a decisão da conduta clínica. Variações no delineamento transversal do estudo, que podem acrescentar vieses aos resultados, bem como outros domínios que contribuem para diminuir a confiabilidade dos achados, são discutidos, além de como extrapolar tais achados de acurácia em impacto e consequências consideradas importantes para o paciente. Aspectos sobre custos, tempo para a obtenção do resultado, preferências e valores dos pacientes devem, preferencialmente, participar da tomada de decisão. CONCLUSÃO: Conhecer a metodologia dos estudos de acurácia diagnóstica é fundamental, porém não suficiente, para o uso racional de testes diagnósticos. Há a necessidade de se ponderarem as consequências desejáveis e indesejáveis dos resultados dos testes para os pacientes, de modo a favorecer a tomada de decisão racional acerca de qual teste recomendar na prática clínica.

5.
Rev Saude Publica ; 52Suppl 2(Suppl 2): 4s, 2018 Oct 25.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30379286

RESUMO

OBJECTIVE: To investigate macroregional variations in cognitive function in a national sample representative of the Brazilian population aged 50 years and older. METHODS: Data from the baseline of the Longitudinal Study of Brazilian Elderly (ELSI-Brazil), collected between 2015 and 2016, were used. Memory was measured by means of a 10-word list and executive function, by semantic verbal fluency, based on the naming of animals. Gender, age, education, and rural or urban residence were potentially confounding. RESULTS: Among the 9,412 ELSI-Brazil participants, 9,085 were included in the analysis; 53.9% were women and the average age was 63.0 (0.42) years. After adjusting for potential confounding variables, average scores for memory and verbal fluency were lower in the Northeast region and higher in the Midwest and Southeast, respectively. In the South region, higher scores were found for immediate and combined memory. In all regions, older participants and those with lower schooling had worse scores for memory and verbal fluency. CONCLUSIONS: There are differences in cognitive function among older adults in the different macroregions, independent of age, gender, schooling, and rural or urban residence.


Assuntos
Cognição/fisiologia , Transtornos da Memória/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Escolaridade , Feminino , Humanos , Estudos Longitudinais , Masculino , Transtornos da Memória/epidemiologia , Transtornos da Memória/fisiopatologia , Pessoa de Meia-Idade , Testes Neuropsicológicos , População Rural , População Urbana
6.
Rev. saúde pública (Online) ; 52(supl.2): 4s, 2018. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-979036

RESUMO

ABSTRACT OBJECTIVE To investigate macroregional variations in cognitive function in a national sample representative of the Brazilian population aged 50 years and older. METHODS Data from the baseline of the Longitudinal Study of Brazilian Elderly (ELSI-Brazil), collected between 2015 and 2016, were used. Memory was measured by means of a 10-word list and executive function, by semantic verbal fluency, based on the naming of animals. Gender, age, education, and rural or urban residence were potentially confounding RESULTS Among the 9,412 ELSI-Brazil participants, 9,085 were included in the analysis; 53.9% were women and the average age was 63.0 (0.42) years. After adjusting for potential confounding variables, average scores for memory and verbal fluency were lower in the Northeast region and higher in the Midwest and Southeast, respectively. In the South region, higher scores were found for immediate and combined memory. In all regions, older participants and those with lower schooling had worse scores for memory and verbal fluency. CONCLUSIONS There are differences in cognitive function among older adults in the different macroregions, independent of age, gender, schooling, and rural or urban residence.


RESUMO OBJETIVO Investigar as variações macrorregionais da função cognitiva em amostra nacional representativa da população brasileira com 50 anos ou mais. MÉTODOS Foram utilizados dados da linha de base do Estudo Longitudinal dos Idosos Brasileiros (ELSI-Brasil), coletados entre 2015 e 2016. A memória foi aferida por meio de lista de 10 palavras e a função executiva, pela fluência verbal semântica, baseada na nomeação de animais. Como potenciais variáveis de confusão, incluímos: sexo, idade, escolaridade e residência rural ou urbana. RESULTADOS Entre os 9.412 participantes do ELSI-Brasil, 9.085 foram incluídos na análise; 53,9% eram mulheres e a média de idade foi 63,0 (0,42) anos. Após ajustes por potenciais variáveis de confusão, os escores médios para memória e fluência verbal foram menores na região Nordeste e maiores no Centro-Oeste e Sudeste, respectivamente. Na região Sul, foram encontrados maiores escores para memória imediata e combinada. Em todas as regiões, participantes mais velhos e com menor escolaridade apresentaram piores escores para memória e fluência verbal. CONCLUSÕES Existem diferenças na função cognitiva entre adultos mais velhos nas distintas macrorregiões, que são independentes da idade, sexo, escolaridade e residência rural ou urbana.

8.
Br J Gen Pract Open ; (4)Apr. 18, 2017.
Artigo em Inglês | Coleciona SUS | ID: biblio-833428

RESUMO

Brazil occupies half of the South American landmass, and is the fifth largest country in the world. The current population estimate is 207 million. Demographic and epidemiological changes, as well as nutritional transition, have affected mortality and morbidity in the country. The leading causes of disability-adjusted life years (DALYs) in 2010 were ischaemic heart disease, interpersonal violence, lower back pain, stroke, and road injury.(AU)


Assuntos
Assistência Integral à Saúde , Estratégia Saúde da Família , Programas Nacionais de Saúde , Atenção Primária à Saúde , Brasil , Equipe de Assistência ao Paciente , Cobertura Universal do Seguro de Saúde
9.
PLoS Med ; 14(3): e1002271, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-28350797

RESUMO

In a Perspective, Cleusa Ferri and K. S. Jacob discuss the assessment, recognition, and care of people living with dementia in low- and middle-income countries.


Assuntos
Demência/epidemiologia , Demência/prevenção & controle , Países em Desenvolvimento , Demência/etiologia , Humanos , Pobreza
10.
Geriatr Gerontol Int ; 17(11): 1849-1857, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28060438

RESUMO

AIM: As little is known about alcohol and tobacco consumption concordance between older spouses in low- and middle-income countries, the present study aimed to estimate this in older couples from five Latin American countries. METHODS: This study is a secondary analysis of data collected between 2003 and 2007 by the 10/66 Dementia Research Group, from 1451 couples aged over 65 years from Cuba, the Dominican Republic, Peru, Mexico and Puerto Rico. Kappa statistic was used to assess the agreement of the behavior beyond chance, and logistic regression models with meta-analyses were used to estimate the factors associated with concordance. RESULTS: The mean age of the total sample was 74.8 years (SD 6.6). The results showed high levels of agreement rates in relation to drinking and smoking (75.9% and 85% of couples, respectively, did not drink or smoke), which were beyond the agreement expected by chance. Increased age was associated with concordance on both being non-drinkers (OR 1.03, 95% CI 1.01-1.05) and non-smokers (OR 1.05, 95% CI 1.02-1.07); and having a larger social network was associated with less likelihood of the couple being non-drinkers (OR 0.93, 95% CI 0.88-0.98). Attending religious meetings was associated with increased likelihood of the couple being non-smokers (OR 1.19, 95% CI 1.01-1.41). Socioeconomic circumstances were not associated with couples' concordance. CONCLUSIONS: Older Latin American couples have high levels of concordance in drinking and smoking habits, which increases with age, and were not associated with socioeconomic circumstances, but were with social network. This knowledge can assist the development of policies and interventions to promote health among this growing population. Geriatr Gerontol Int 2017; 17: 1849-1857.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Cônjuges/psicologia , Uso de Tabaco/epidemiologia , Idoso , Feminino , Humanos , América Latina/epidemiologia , Masculino , Fatores de Risco , Cônjuges/estatística & dados numéricos
11.
BJGP Open ; 1(2): bjgpopen17X100857, 2017 Apr 19.
Artigo em Inglês | MEDLINE | ID: mdl-30564662
12.
Soc Psychiatry Psychiatr Epidemiol ; 52(1): 77-86, 2017 01.
Artigo em Inglês | MEDLINE | ID: mdl-27783128

RESUMO

PURPOSE: The objective of this study was to investigate the psychosocial factors associated with violence by women against their children, using a household survey. METHODS: Households in two neighborhoods in Juiz de Fora, Brazil, with different socioeconomic profiles, were selected through probability sampling and surveyed. A total of 446 women with children up to 18 years of age were interviewed. A sociodemographic questionnaire, the CTSPC (Parent-Child Conflict Tactics Scales), the CES-D (Center for Epidemiologic Studies Depression Scale) and the AUDIT (Alcohol Use Disorders Identification Test) were applied. Using STATA statistical software, logistic regression analysis was performed to investigate the association between psychosocial variables and domestic violence against children. RESULTS: The prevalence of violence by mothers against their children during the 3 months prior to data collection was as follows: psychological aggression, 70.5% (n = 304); corporal punishment, 51.4% (n = 232); and physical maltreatment, 9.8% (n = 46). Women with a higher educational level exhibited lower odds of committing psychological aggression (OR 0.47; CI 0.24-0.91) and corporal punishment (OR 0.32; CI 0.16-0.64). Age was associated with corporal punishment, with older women (OR 0.94; CI 0.91-0.97) reporting a lower frequency of this type of violence against their children. Residing in the neighborhood with higher socioeconomic status reduced the odds of reporting psychological aggression (OR 0.45; CI 0.27-0.75). Maternal depression (OR 3.75; CI 1.51-9.31) and harmful drinking (OR 4.73; CI 1.17-19.10) were risk factors for physical maltreatment. CONCLUSIONS: The results point to the need for preventive strategies for mother-child violence in low and middle income countries, with a focus on the mothers' education and mental health, especially with regard to the younger ones.


Assuntos
Agressão/psicologia , Violência Doméstica/psicologia , Saúde Mental , Mães/psicologia , Punição/psicologia , Adolescente , Adulto , Brasil , Criança , Pré-Escolar , Escolaridade , Feminino , Humanos , Masculino , Fatores de Risco , Classe Social
13.
BMC Womens Health ; 15: 78, 2015 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-26403827

RESUMO

BACKGROUND: Domestic violence and harmful alcohol consumption are considered major public health problems worldwide. These phenomena often co-occur, and they share several risk factors. Nevertheless, few in-depth studies have supported integrated interventions for both phenomena, in particular among Latin American women. This project will study the consumption of alcoholic beverages among women and its relationship with patterns of domestic violence; furthermore, it will assess the effect of a brief intervention (BI) aimed at modifying these behaviors using a community household sample. METHODS/DESIGN: This project is divided into two studies. Study 1 will employ a cross-sectional observational design and will be conducted using a household sample of adult women (approximate sample size = 1600) to assess harmful alcohol consumption and domestic violence patterns. Study 2, will be a randomized clinical trial based on specific cases from Study 1, assessing the effect of a brief intervention on women who exhibit harmful levels of alcohol consumption (AUDIT ≥ 8). Approximately 73 women will be assigned to one of two groups, either a treated group (TG) or a control group (CG). A sociodemographic questionnaire, a questionnaire concerning general health and substance use, and four other standardized instruments (i.e., the Alcohol Use Disorder Identification Test [AUDIT; used to investigate problems related to alcohol consumption], the Center for Epidemiologic Studies Depression Scale [CES-D; used to measure depressive symptoms], and the Revised Conflict Tactics Scales and Parent-child Conflict Tactics Scales [CTS2 and CTSPC; used to obtain information on violence among couples and between parents and children, respectively]) will be used to collect data. DISCUSSION: The study protocol will employ a household survey of a representative sample from a neighborhood in a middle income country, where well-conducted household surveys remain rare. The present work represents a step toward a better understanding of violence in women's lives and its interaction with alcohol consumption and expands the discussion on the potential strategies for public health actions seeking to prevent both domestic violence and harmful alcohol consumption. TRIAL REGISTRATION: Brazilian Clinical Trials Registry: RBR-7rjt4t. Registered 17 October 2013.


Assuntos
Violência Doméstica/prevenção & controle , Comportamento de Ingestão de Líquido , Entrevista Motivacional/estatística & dados numéricos , Adulto , Brasil , Estudos Transversais , Violência Doméstica/psicologia , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Inquéritos e Questionários
14.
Geriatr Gerontol Int ; 14(1): 23-31, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-23682773

RESUMO

Some studies have shown differences in specific cognitive ability domains between the sexes at 60 years-of-age. However is important to analyze whether the rate of cognitive decline is also similar between the sexes after this age. The present study examined previously published literature to investigate whether cognitive decline is distinct between men and women after the age of 60 years. A systematic review was carried out with the PubMed, LILACS and PsycINFO databases (2001-2011) using the following search terms: aging, aged, cognitive function, mild cognitive impairment, mental health and cognition. We analyzed longitudinal research that used neuropsychological tests for evaluating cognitive function, showed results separated by sex and that excluded participants with dementia. Elderly women showed better performance in tests of episodic memory, whereas elderly men had a better visuospatial ability. Only one study detected distinct rates of cognitive decline in specific tests between the sexes. Despite differences observed in some domains, most of the studies showed that this rate is similar between the sexes until the age of 80 years. It is unclear whether sex influences the rate of cognitive decline after the age of 80 years. The present review observed that sex does not determine the rate of cognitive decline between 60 and 80 years-of-age. The contextual and cultural factors that involve men and women might determine a distinct decline between them, rather than sex alone.


Assuntos
Cognição/fisiologia , Disfunção Cognitiva , Fatores Etários , Disfunção Cognitiva/epidemiologia , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/fisiopatologia , Progressão da Doença , Feminino , Saúde Global , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores Sexuais
18.
Säo Paulo; s.n; 1999. 165 p.
Tese em Português | LILACS | ID: lil-272399

RESUMO

Introdução. Existe uma tendência dos estudos sobre o uso de cocaína, no Brasil e em outros países, de focalizarem sobre a prevalência do uso em populações específicas tais como. estudantes e usuários em tratamento ou sobre comportamentos de risco entre usuários de droga injetável. Muitos aspectos do uso de cocaína no Brasil não foram investigados. Poucas pesquisas têm sido feitas, por exemplo, em relação à via de administração e nenhum estudo foi feito comparando usuários de cocaína tratados e não tratados e fatores associados ao comportamento de procurar tratamento. Estes têm implicações para o entendimento do uso e abuso de substâncias e dos problemas relacionados a este uso e para a implementaçâo de estratégias efetivas de prevenção e tratamento. Objetivos Principais. Investigar padrões de uso de droga e problemas associados em amostras de usuários de cocaína em tratamento e na comunidade em São Paulo, explorando fatores associados à via de administração e à procura de tratamento. Desenho: Estudo transversal realizado entre dezembro de 1996 a dezembro de 1997. Amostragem/"settings". Trezentos e trinta e dois usuários regulares de cocaína foram entrevistados. Duzentos e trinta e sete eram pacientes de serviços de atendimentos a usuários de drogas e 95 eram usuários de cocaína que não haviam procurado tratamento no último ano. As técnicas de bola-de-neve e do Entrevistador com Acesso Privilegiado foram utilizadas para se alcançar os usuários na comunidade. Instrumentos. Questionário estruturado detalhado que incluía os seguintes instrumentos padronizados SDS (Severity of Dependence Scale), GHQ-28 (General Health Questionnaire-versão 28), CAGE. Resultados. O padrão de consumo das duas populações foi alto, sendo que os usuários em tratamento tinham um nível de consumo ainda mais pesado. Usuários na comunidade estavam mais envolvidos em atividades ilegais, eram mais prováveis de relatar efeitos adversos da cocaína, de estarem envolvidos em prostituição e de terem morado na rua. Os usuários de crack, tinham mais problemas sociais e de saúde e maior envolvimento em atividades ilegais, do que os usuários de cocaína intranasal. Os sujeitos neste estudo, estavam usando drogas por um longo tempo antes de procurar tratamento. Os fatores encontrados estar associados ao primeiro contato com um serviço de tratamento foram: gravidade do uso, alcoolismo, não estar envolvido em atividades ilícitas e reconhecer que têm problemas ...(au)


Assuntos
Cocaína , Cocaína Crack , Aceitação pelo Paciente de Cuidados de Saúde , Transtornos Relacionados ao Uso de Substâncias
19.
J. bras. psiquiatr ; 44(6): 311-315, jun. 1995. tab
Artigo em Português | LILACS | ID: lil-311146

RESUMO

O objetivo deste trabalho foi categorizar os motivos e estudar o padrão dos episódios de recaída, em pacientes dependentes de álcool e outras drogas, durante o tratamento, na Unidade de Dependência de Drogas do Centro de Pesquisa em Psicobiologia da Escola Paulista de Medicina. A amostra foi formada por 103 pacientes, alocados em dois grupos: Grupo não recaída (n=50) e Grupo recaída (n=53). Os dois grupos não apresentaram diferença quanto aos dados sociodemográficos. Em relação à gravidade da dependência, houve predominância de pacientes com dependência grave no grupo recaída e com dependência leve no grupo não recaída. Os pacientes que recaíram apresentaram índice de abandono superior aos que não recaíram. Os determinantes intrapessoais nos episódios de recaída, sendo que no primeiro se destacaram os "estados emocionais negativos", impulso e tentação e no segundo "pressão social" e "conflitos interpessoais". Neste estudo as situações de recaída foram desencadeadas principalmente pelos estados emocionais negativos sugerindo que estas possam representar uma resposta ao não enfrentamento dessas situações. Técnicas de Prevenção de Recaída devem visar auxiliar o cliente a desenvolver estratégias de enfrentamento para tais situações


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Sintomas Afetivos , Alcoolismo , Pacientes Desistentes do Tratamento , Meio Ambiente , Motivação , Recidiva , Reforço Psicológico , Transtornos Relacionados ao Uso de Substâncias/psicologia , Transtornos Relacionados ao Uso de Substâncias/reabilitação , Seguimentos , Relações Interpessoais
20.
J. bras. psiquiatr ; 6(44): 311-315, jun. 1995.
Artigo | Index Psicologia - Periódicos técnico-científicos | ID: psi-2899

RESUMO

O objetivo deste trabalho foi categorizar os motivos e estudar o padrao dos episodios de recaida, em pacientes dependentes de alcool e outras drogas, durante o tratamento, na Unidade de Dependencia de Drogas do Centro de Pesquisa em Psicologia da Escola Paulista de Medicina. A amostra foi formada por 103 pacientes, alocados em dois grupos: Grupo nao recaida (n=50) e Grupo recaida (n=53). Os dois grupos nao apresentaram diferenca quanto aos dados sociodemograficos. Em relacao a gravidade da dependencia, houve predominancia de pacientes com depencia grave no grupo recaida e com dependencia leve no grupo nao recaida. Os pacientes que recairam apresentaram indice de abandono superior aos que nao recairam. Os determinantes intrapessoais predominaram sobre os determinantes interpessoais nos episodios de recaida, sendo que no primeiro se destacaram os 'estados emocionais negativos', impulso e tentacao e no segundo 'pressao social' e 'conflitos interpessoais'. Neste estudo as situacoes de recaida foram desencadeadas principalmente pelos estados emocionais negativos sugerindo que estas possam representar uma resposta ao nao enfrentamento dessas situacoes. Tecnicas de Prevencao de Recaida devem visar auxiliar o cliente a desenvolver estrategias de enfrentamento para tais situacoes.


Assuntos
Pacientes , Transtornos Relacionados ao Uso de Substâncias , Alcoolismo , Recidiva , Prevenção de Doenças , Terapêutica , Pacientes , Alcoolismo , Prevenção de Doenças , Terapêutica
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