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1.
Artigo em Russo | MEDLINE | ID: mdl-31464284

RESUMO

AIM: To establish an effect of alcohol dependence on the cognitive functions of patients with schizophrenia. MATERIAL AND METHODS: One hundred patients with paranoid schizophrenia were examined. Half of them had a co-occurring diagnosis of alcohol dependence syndrome. Memory, attention, thinking were studied. Comparisons were made between groups, depending on the presence of the addictive disorder. RESULTS: Attention and short-term memory are at the low border of normal values in both groups. No significant between-group differences were found. In Benton test, errors characteristic of schizophrenia were more frequent in the main group. 'Organic' errors were prevalent in the control group. Mild thinking disorders of organic type were significantly more frequent in the main group. CONCLUSION: Co-occurring alcohol dependence does not significantly influence intelligence but significant organic stigmas contribute to the structure of the cognitive profile of patients. The prevalence of organic disturbances in the structure of thinking in patients with co-occurring alcohol abuse was revealed. The best indicators of attention were demonstrated by patients with attack-like schizophrenia without substance abuse. This suggests that the influence of the alcohol factor differs in continuous and attack-like progressive schizophrenia.


Assuntos
Alcoolismo , Transtornos Cognitivos , Psicologia do Esquizofrênico , Alcoolismo/psicologia , Cognição , Transtornos Cognitivos/complicações , Comorbidade , Humanos , Memória de Curto Prazo
2.
Nord J Psychiatry ; 73(6): 357-364, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31271336

RESUMO

Background: Psychiatric disorders tend to be developmental, and longitudinal settings are required to examine predictors of psychiatric phenomena. Replicating and combining data and results from different birth cohorts, which are a source of reliable data, can make research even more valuable. The Finnish Psychiatric Birth Cohort Consortium (PSYCOHORTS) project combines birth cohorts in Finland. Aim: The aim of this paper is to introduce content, plans and perspectives of the PSYCOHORTS project that brings together researchers from Finland. In addition, we illustrate an example of data harmonization using available data on causes of death. Content: PSYCOHORTS includes eight Finnish birth cohorts. The project has several plans: to harmonize different data from birth cohorts, to incorporate biobanks into psychiatric birth cohort research, to apply multigenerational perspectives, to integrate longitudinal patterns of marginalization and inequality in mental health, and to utilize data in health economics research. Data on causes of death, originally obtained from Finnish Cause of Death register, were harmonized across the six birth cohorts using SAS macro facility. Results: Harmonization of the cause of death data resulted in a total of 21,993 observations from 1965 to 2015. For example, the percentage of deaths due to suicide and the sequelae of intentional self-harm was 14% and alcohol-related diseases, including accidental poisoning by alcohol, was 13%. Conclusions: PSYCOHORTS lays the foundation for complex examinations of psychiatric disorders that is based on compatible datasets, use of biobanks and multigenerational approach to risk factors, and extensive data on marginalization and inequality.


Assuntos
Transtornos Mentais/mortalidade , Adolescente , Adulto , Alcoolismo/mortalidade , Alcoolismo/psicologia , Causas de Morte , Estudos de Coortes , Feminino , Finlândia/epidemiologia , Humanos , Masculino , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Fatores de Risco , Comportamento Autodestrutivo/mortalidade , Comportamento Autodestrutivo/psicologia , Fatores Socioeconômicos , Suicídio/estatística & dados numéricos , Adulto Jovem
3.
Rev Med Liege ; 74(5-6): 300-303, 2019 05.
Artigo em Francês | MEDLINE | ID: mdl-31206270

RESUMO

Psychiatric complications are commonly associated with alcoholism. Psychological symptoms appear during intoxication or in patients with concomitant psychiatric disorders or substance-induced psychiatric disorders. Moreover, the assessment of the psychiatric symptomatology is particularly challenging in patients who express difficulties to accept that the disorder is due to alcoholism. Psychotic reactions, affective disorders and anxiety disorders are the main psychiatric complications of alcoholism.


Assuntos
Alcoolismo , Transtornos Mentais , Transtornos Relacionados ao Uso de Substâncias , Alcoolismo/complicações , Alcoolismo/psicologia , Humanos
4.
BMC Public Health ; 19(1): 727, 2019 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-31185955

RESUMO

BACKGROUND: A physically active lifestyle contributes to the prevention of lifestyle diseases, promotion of physical health, and reduction of pain, among other benefits. Being physically active also promotes mental health for many individuals, in the form of improved mood, increased self-efficacy and reduced risk of depression. Alcohol-dependent individuals may experience a better quality of life when supplementing their treatment with physical exercise. This study aimed to evaluate the effect of exercise on Quality of Life among patients with alcohol use disorder in a large randomized controlled trial. METHODS: The study had three arms: Patients were allocated to (A) treatment as usual, (B) treatment as usual and supervised group exercise two days a week of one hour each, (C) treatment as usual and individual physical exercise minimum two days a week. Duration of the intervention was six months. Data on values of Quality of Life were collected at baseline (before treatment start and at time of enrollment in the study), and at follow-up (at six months after enrollment in the study) using the EQ-5D questionnaire and the EQ-VAS. The sample consisted of 117 consecutive patients, and the follow-up rate was 66.6%. Intention-to-treat analyses were conducted to evaluate the effect of exercise on quality of life. RESULTS: Although not statistically significant, a substantial portion of the participants in the individual exercise condition reported that they had no pain or discomfort (one of the five quality of life dimensions measured by EQ-5D questionnaire) compared to the controls at follow-up. No difference was found between the groups regarding the EQ-VAS. CONCLUSION: The exercise intervention had no effect on quality of life for patients with alcohol use disorder, nor was quality of life improved across the total sample. More research in how to improve quality of life for patients with alcohol use disorder is needed. TRIAL REGISTRATION: ISRCTN74889852 (retrospectively registered, date: 16/05/2013).


Assuntos
Alcoolismo/psicologia , Alcoolismo/terapia , Terapia por Exercício/métodos , Exercício/psicologia , Qualidade de Vida/psicologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Autoeficácia , Inquéritos e Questionários , Resultado do Tratamento
5.
Neuropsychiatr ; 33(3): 160-164, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31218547

RESUMO

This case report is about a 44-year-old woman with alcohol-related end-stage liver disease. Initial contact with the patient was made in the alcohol-outpatient clinic of the Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University of Vienna. Due to a particularly poor general condition, Child Pugh Score C/MELD Score 20, the patient was admitted to ward 4A, with the clinical and scientific focus of treating patients with alcohol use disorder. The withdrawal process was complicated by a multitude of factors associated with end-stage liver disease. By explaining the theoretical background of possible somatic as well as psychiatric complications of end-stage liver disease and elaborating on treatment options a comprehensive overview of the psychiatric and somatic management of this patient population is given.


Assuntos
Alcoolismo/complicações , Alcoolismo/psicologia , Doença Hepática Terminal/complicações , Doença Hepática Terminal/terapia , Adulto , Alcoolismo/reabilitação , Doença Hepática Terminal/psicologia , Feminino , Humanos
6.
AIDS Behav ; 23(9): 2432-2442, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31218545

RESUMO

African American women experience higher rates of HIV than other women in the United States, and stigma has been identified as an important determinant of engagement in HIV care. Our study examined whether key variables moderated the effect of an anti-stigma intervention on outcomes among African American women receiving treatment for HIV. Twelve potential moderators included: age, years lived with HIV, marital status, employment status, education level, PTSD diagnosis, alcohol use, social support, baseline CD4 count, baseline viral load, and number of children. Outcomes included changes in: HIV-related stigma, social support, depressive symptoms, PTSD symptoms, alcohol use, viral load, and engagement in HIV care. Results suggest that the intervention is associated with greater improvement in engagement in care among participants with PTSD or depression at baseline, and may help maintain engagement in care among participants experiencing certain mental health conditions. This provides opportunities to address discriminatory structural barriers that lead to stigma and drop-offs in HIV care.


Assuntos
Afro-Americanos/psicologia , Alcoolismo/psicologia , Depressão/psicologia , Infecções por HIV/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Estigma Social , Apoio Social , Transtornos de Estresse Pós-Traumáticos/psicologia , Adolescente , Adulto , Afro-Americanos/estatística & dados numéricos , Idoso , Alcoolismo/epidemiologia , Fármacos Anti-HIV/uso terapêutico , Contagem de Linfócito CD4 , Depressão/epidemiologia , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/etnologia , Humanos , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Educação de Pacientes como Assunto , Fatores Socioeconômicos , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Estados Unidos/epidemiologia , Carga Viral
7.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(5): 493-498, 2019 May 10.
Artigo em Chinês | MEDLINE | ID: mdl-31177726

RESUMO

Objective: To understand the prevalence of alcohol use and related factors in HIV positive and HIV negative males. Methods: Baseline data were from the prospective cohort study of comparative HIV and aging research in Taizhou of Zhejiang province from January to December, 2017. The information about alcohol use in the last month was collected through a face-to-face questionnaire interview. Participants were categorized into non-current drinkers, light/moderate drinkers and heavy drinkers according to the US National Institute on Alcoholism and Alcohol Abuse (NIAAA) standard. Results: A total of 1 367 HIV positive males and 2 418 HIV negative males were included. Current alcohol use rate (35.2%, 481/1 367) and heavy alcohol use rate (5.0%, 24/481) were significantly lower in HIV positive males than in HIV negative males (48.0%, 1 161/2 418; 23.5%, 273/1 161), but the proportion of drinking wine and yellow rice wine were significantly higher (21.8%, 105/481; 9.1%, 44/481) in HIV positive males than in HIV negative males (13.5%, 157/1 161; 5.8%, 67/1 161). The multivariate multinomial logistic regression analysis results showed that larger waist circumference, current smoking and regular physical exercise were associated with heavy alcohol use behavior in HIV positive males, and age ≥30 years, current smoking, regular physical exercise, higher score of depressive symptoms, heterosexual transmission route and baseline CD(4)(+)T cells counts of 200-499 cells/µl were significantly associated with mild/moderate alcohol use behavior in HIV positive males. Conclusions: The alcohol use rate was significantly lower in HIV positive males than in HIV negative males in Taizhou. It is important to strengthen intervention on alcohol drinking behavior and chronic disease risk factors, such as larger waist circumference, smoking and so on.


Assuntos
Consumo de Bebidas Alcoólicas/psicologia , Alcoolismo/psicologia , Infecções por HIV/psicologia , Soronegatividade para HIV , Consumo de Bebidas Alcoólicas/epidemiologia , Alcoolismo/epidemiologia , China/epidemiologia , Infecções por HIV/epidemiologia , Humanos , Entrevistas como Assunto , Masculino , Prevalência , Estudos Prospectivos , Inquéritos e Questionários
8.
Wiad Lek ; 72(4): 579-583, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31055536

RESUMO

OBJECTIVE: Introduction: The article considers social-psychological features of value orientations of patients with alcohol dependence. The state of the problem under consideration in the psychological literature has been studied. The analysis of empirical research of value orientations of patients with alcohol dependence has been conducted. The aim: The aim of the paper is to identify social-psychological features of value orientations of patients with al cohol dependence. PATIENTS AND METHODS: Materials and methods: The research has been conducted at full-time treatment department of Transcarpathian Oblast Narcological Dispensary (Uzhhorod, Ukraine). The experiment involved 42 respondents (29 men and 13 women) of different age, the department patients, suffering on alcoholism. The techniques have been performed individually with each patient. The following methods have been used: 1. Method of «Valuable Orientation¼ by M. Rokich. 2. Questionnaire on Terminal Values (QTV) by I.G.Senin. 3. Purpose-life orientation test (method of PLO) by D.A. Leontiev. RESULTS: Results: It has been found out that the group hierarchy of values in cases with chronic alcoholism is characterised by an explicit orientation to specific vital values. There is a characteristic reverse development of the value sphere of an individual in cases with chronic alcoholism, which is displayed in the formation of orientations on the lower levels of the value system. The results of empirical research have shown that among the patients with alcohol dependence the preference is given to terminal values, values - goals. CONCLUSION: Conclusions: It has been generalised that value orientations are the component of the structure of an individual, which reflects the life experience gained by an individual in the individual development, and represents the core of consciousness, taking into account how personality makes decisions on important vital issues.


Assuntos
Alcoolismo/psicologia , Valores Sociais , Feminino , Humanos , Masculino , Personalidade , Inquéritos e Questionários , Ucrânia
9.
Alcohol Alcohol ; 54(3): 287-294, 2019 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-31087085

RESUMO

AIM: This preliminary investigation evaluated the link between alcohol craving and insomnia in actively drinking patients with alcohol dependence (AD). METHODS: We conducted a secondary analysis of data from a clinical trial of treatment-seeking patients with AD who drank heavily (N = 61). The Penn Alcohol Craving Scale (PACS) evaluated alcohol craving, and the Short Sleep Index (SSI) assessed insomnia symptoms. We used linear regression models for baseline cross-sectional assessments. Linear mixed effects regression models evaluated craving scores longitudinally across insomnia groups (+/-), and insomnia scores longitudinally across craving groups(high/low). These longitudinal analyses were conducted separately in those treated with placebo (N = 32) and quetiapine (N = 29). RESULTS: The mean (standard deviation) for PACS total score was 15.9 (8.5) and for SSI was 2.1 (2.3). Alcohol craving was associated with the insomnia symptom of difficulty falling asleep (P = 0.03; effect size = -0.7) and with the SSI total score (P = 0.04, effect size = -0.7). In the longitudinal analysis, insomnia+ subjects had consistently higher PACS total scores, relative to the insomnia- group. The PACS score demonstrated significant group × time interactions in both treatment groups. Insomnia+ individuals demonstrated a relatively steeper rate of decline in the craving with quetiapine treatment (P = 0.03). Insomnia- individuals in the placebo group demonstrated a transient reduction in craving until week 8, followed by an increase in scores(P = 0.004). The SSI score did not demonstrate any interactive effect over time across the craving groups in either treatment arm. CONCLUSION: Insomnia was associated with higher alcohol craving and quetiapine differentially reduced craving in those with insomnia.


Assuntos
Alcoolismo/tratamento farmacológico , Fissura/efeitos dos fármacos , Fumarato de Quetiapina/uso terapêutico , Distúrbios do Início e da Manutenção do Sono/tratamento farmacológico , Adolescente , Adulto , Idoso , Alcoolismo/complicações , Alcoolismo/psicologia , Antidepressivos/uso terapêutico , Estudos Transversais , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Distúrbios do Início e da Manutenção do Sono/complicações , Adulto Jovem
10.
Alcohol Alcohol ; 54(3): 310-324, 2019 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-30942386

RESUMO

AIMS: Alcohol use disorders (AUDs) are highly disabling neuropsychiatric conditions. Although evidence suggests a high burden of AUDs in young adults, few studies have investigated their life course predictors. It is crucial to assess factors that may influence these disorders from early life through adolescence to deter AUDs in early adulthood by tailoring prevention and intervention strategies. This review aims to assess temporal links between childhood and adolescent predictors of clinically diagnosed AUDs in young adults. METHODS: We systematically searched PubMed, Scopus, PsycINFO and Embase databases for longitudinally assessed predictors of AUDs in young adults. Data were extracted and assessed for quality using the Newcastle-Ottawa quality assessment tool for cohort studies. We performed our analysis by grouping predictors under six main domains. RESULTS AND CONCLUSION: Twenty two studies met the eligibility criteria. The outcome in all studies was measured according to the Diagnostic Statistical Manual of Mental Disorders. Our review suggests strong links between externalizing symptoms in adolescence and AUDs in young adulthood, as well as when externalizing symptoms co-occur with illicit drug use. Findings on the role of internalizing symptoms and early drinking onset were inconclusive. Environmental factors were influential but changed over time. In earlier years, maternal drinking predicted early adult AUD while parental monitoring and school engagement were protective. Both peer and parental influences waned in adulthood. Further high-quality large longitudinal studies that identify distinctive developmental pathways on the aetiology of AUDs and assess the role of early internalizing symptoms and early drinking onset are warranted.


Assuntos
Alcoolismo/psicologia , Controle Interno-Externo , Fatores Etários , Meio Ambiente , Humanos , Estudos Longitudinais , Fatores de Risco
11.
Alcohol Alcohol ; 54(3): 279-286, 2019 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-30989164

RESUMO

AIMS: Treatment of patients with comorbidity of mental health problems and alcohol use disorder (AUD) constitutes a challenge in many countries. The article aimed at exploration of personal experiences of clinicians and patients with the comorbidity regarding its assessment, treatment and organization of care in Poland and the UK. METHODS: Data were collected via in-depth, semi-structured interviews with clinicians (N = 28) and patients (N = 81) in both countries, according to a unified study protocol. Maximum variation sampling was applied to both study groups. All interviews' transcripts were coded (CAQDA) and the consistency of coding across centres was assessed. Data analysis was performed according to the principles of thematic analysis. RESULTS: Our data show that most patients with AUD admitted at the psychiatric wards-apart from assessment which is a standard procedure during admission-receive only minimal support during their hospital stay. This is the consequence of two factors: lack of trained staff prepared to help those patients and a priority given to self-referrals by AUD units. At the same time, it is recognized by clinicians and patients that more support is needed to encourage the utilization of AUD services and to prevent the drop-out. CONCLUSIONS: In order to improve the system response, the use of screening instruments in the process of the assessment of AUD and establishment of special procedures supporting motivation and adherence to treatment and preventing drop-out merits consideration. Moreover, the psychiatric wards and the AUD services could possibly profit from formalization of the collaboration between services.


Assuntos
Alcoolismo/epidemiologia , Alcoolismo/psicologia , Atitude do Pessoal de Saúde , Transtornos Mentais/epidemiologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Adulto , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polônia/epidemiologia , Reino Unido/epidemiologia
12.
Alcohol Alcohol ; 54(3): 209-215, 2019 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-31008507

RESUMO

AIMS: Differences in DNA methylation of the serotonin transporter gene (SLC6A4) have been shown to alter SLC6A4 expression and predict brain functions in healthy individuals. This study investigated the association between SLC6A4 promoter methylation and threat-related amygdala activation in individuals with alcohol dependence (AD). METHODS: Methylation of the SLC6A4 promoter region was assessed using peripheral blood DNA from 45 individuals with AD and 45 healthy controls (HCs). All participants completed an emotional face matching task in a 3-T magnetic resonance imaging (MRI) scanner. RESULTS: Results did not reveal any association between SLC6A4 promoter methylation variation and threat-related amygdala activation in HCs or individuals with AD. Furthermore, methylation in the promoter region of SLC6A4 did not significantly differ between the groups. CONCLUSIONS: Our results do not replicate a previous finding that increased methylation in the promoter region of SLC6A4 is associated with threat-related amygdala activation in healthy individuals and further show that there is no such association in individuals with AD. Given that the number of imaging epigenetics studies on SLC6A4 is very limited to date, these inconsistent results indicate that future research is needed to clarify its association with amygdala reactivity in both healthy and clinical populations.


Assuntos
Alcoolismo/genética , Alcoolismo/fisiopatologia , Tonsila do Cerebelo/fisiopatologia , Metilação de DNA , Medo/fisiologia , Regiões Promotoras Genéticas , Proteínas da Membrana Plasmática de Transporte de Serotonina/genética , Adulto , Alcoolismo/psicologia , Estudos de Casos e Controles , Feminino , Neuroimagem Funcional , Humanos , Imagem por Ressonância Magnética , Masculino , Adulto Jovem
13.
Eur Addict Res ; 25(4): 191-197, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30999312

RESUMO

BACKGROUND: The additive effect of parental alcohol use disorders (AUD) is conventionally defined as an increasing risk of the offspring developing AUD relative to family history negative, < family history positive with 1 parent (FHP1), < FHP2. The few studies on the additive effect of parental AUD have focused on the risk of development of offspring AUD and not on the degree of multidimensional AUD addiction severity. AIMS: The aims of the present study were to examine the frequency of treatment-seeking outpatients exposed to FHP1 and FHP2 and whether addiction severity was impacted by the additive effect of parental AUD among AUD female and male offspring. METHODS: This cross-sectional  study was based on 3,361 consecutive treatment-seeking outpatients from 2006 to 2016, assessed by means of the -European Addiction Severity Index (EUROP-ASI). The -EUROP-ASI assessed multidimensional addiction severity, comprising alcohol and other drug use, somatic and psychiatric health status, family and other social status, economy and employment-related problems and criminal status composite scores at treatment entry. RESULTS: Among females, 40.38% had FHP1 and 15.68% FHP2, whereas males had 40.90% FHP1 and 13.24% FHP2. No conventional additive effect was found on the composite scores among both genders. However, another type of synergistic additive effect, only manifesting with exposure to FHP2, was found for employment-related problems and psychiatric status composite scores among male offspring. CONCLUSIONS: Exposure to parental AUD is strikingly high among treatment-seeking outpatients. Nonetheless, the additive effect has a modest impact on multidimensional addiction severity and is mostly related to psycho-social impairment among treatment-seeking male offspring.


Assuntos
Alcoolismo/terapia , Filho de Pais Incapacitados/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Índice de Gravidade de Doença , Adulto , Alcoolismo/psicologia , Assistência Ambulatorial , Comportamento Aditivo/psicologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Sexuais
14.
Value Health ; 22(4): 446-452, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30975396

RESUMO

BACKGROUND: Paired-gamble methods have been proposed to avoid the "certainty effect" associated with standard gamble methods. OBJECTIVE: This study examines the role of starting-point effects in paired-gamble methods. In particular, it examines how the utilities so derived vary as a function of the probabilities of the stimulus lottery. METHODS: A sample of 455 members of the Spanish general population valued 9 health states via face-to-face interviews. Subjects were randomly placed into 3 subgroups, which differed in terms of the stimulus gamble's probability. Nonparametric tests and an interval regression model were used to test if utilities change when the probability distribution is modified. RESULTS: Nonparametric tests showed that the probability of a health state being considered worse than death did not differ among subgroups. Nevertheless, changes in the stimulus gamble did produce significant differences in the distribution of utilities: the higher the probability of full health in the stimulus, the higher the utility elicited. Regression estimates support the existence of starting-point effects when the utilities are obtained under expected utility. According to the prospect theory, the conclusions depend on the reference point considered. When the reference points used are death or the health state evaluated, we observe differences among these groups. Nevertheless, when full health is used, these differences disappear. CONCLUSION: This research suggests that paired-gamble methods may also be susceptible to starting-point effects. Yet the differences are small, and they disappear when the data are analyzed using prospect theory with full health as the reference point.


Assuntos
Alcoolismo/diagnóstico , Indicadores Básicos de Saúde , Nível de Saúde , Teoria da Probabilidade , Qualidade de Vida , Alcoolismo/mortalidade , Alcoolismo/psicologia , Alcoolismo/terapia , Efeitos Psicossociais da Doença , Interpretação Estatística de Dados , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Estatísticos , Preferência do Paciente , Probabilidade , Anos de Vida Ajustados por Qualidade de Vida , Fatores Socioeconômicos , Espanha/epidemiologia
15.
An Acad Bras Cienc ; 91(1): e20180008, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30994752

RESUMO

The study aimed to know the daily life of women with alcoholic companions and the provided care. This is a comprehensive-interpretative, qualitative study, guided by the thematic Oral History method. Data collection occurred by semistructured interview. The empirical material was subjected to content analysis under the light of the King's Theory of Goal Attainment. Women are frustrated and frightened by the alcoholic companion's behavior and lifestyle, and still feel judged by society. Many abandon their life projects and self-care due to the overload caused by the companion's absence in the care of home and children. The family care they develop focuses on maintaining the family and protecting from further damage. The study revealed that these women are sick due to the companion's dependence and, even supporting a type of family care, they cannot control the effects of the alcohol in the family. This reinforces the need for health professionals' greater bond and involvement, establishing therapeutic projects in which women feel involved and, at the same time, supported.


Assuntos
Atividades Cotidianas/psicologia , Alcoolismo/psicologia , Relações Familiares/psicologia , Cônjuges/psicologia , Mulheres/psicologia , Adolescente , Adulto , Brasil , Assistência à Saúde , Saúde da Família , Feminino , Humanos , Entrevistas como Assunto , Pessoa de Meia-Idade , Pesquisa Qualitativa , Meio Social , Adulto Jovem
16.
Rev. pesqui. cuid. fundam. (Online) ; 11(3): 687-693, abr.-maio 2019.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-988293

RESUMO

Objective: The study's purpose has been to recognize the interfering factors on the ambulatory treatment adherence by drug users. Methods: It is a descriptive study with a qualitative approach. Data were collected over the period from August to December 2015 through an interview process with seven users and following taken to thematic content analysis. Results: The first contact with drugs usually occurs by friends influence, while the search for treatment in the Psychosocial Care Center for Alcohol and other Drugs [Centros de Atenção Psicossocial Álcool e outras Drogas (CAPS-AD)] occurs by own person's will, considering that the family interferes positively in the initiation and also in the continuity of the treatment. The factors favoring adherence to treatment were as follows: the availability of health professionals to provide the care, which goes against the difficulty in accessing the service. Conclusion: The following was perceived as necessary in order to maintain the adherence to ambulatory treatment: the user's desire to stop using drugs, family support, personal bonds with the professionals, and easy access to the service in regard to the geography, financial and structural parameters


Objetivo: Conhecer os fatores que interferem na adesão de usuários de drogas ao tratamento ambulatorial. Métodos: Estudo descritivo, de natureza qualitativa, cujos dados foram coletados entre agosto e dezembro de 2015 por meio de entrevista com sete usuários e submetidos à análise de conteúdo temática. Resultados: O primeiro contato com as drogas normalmente ocorre por influência de amigos, enquanto a busca por tratamento no CAPS-ad ocorre por vontade própria, sendo que a família interfere positivamente no início e também na continuidade do tratamento. Os fatores que favorecem a adesão ao tratamento foram: disponibilidade dos profissionais de saúde no atendimento aos pacientes, o que se contrapõe à dificuldade de acesso ao serviço. Conclusão: Para manter a adesão ao tratamento no âmbito ambulatorial se faz necessário: desejo do usuário em parar de usar drogas, apoio familiar, vínculo com os profissionais e facilidade de acesso ao serviço, em termos geográfico, financeiro e estrutural


Objetivo: Conocer los factores que interfieren en la adhesión de usuarios de drogas al tratamiento ambulatorial. Métodos: Estudio descriptivo, de naturaleza cualitativa, cuyos datos fueron recolectados entre agosto y diciembre de 2015 por medio de una entrevista con siete usuarios y sometidos al análisis de contenido temático. Resultados: El primer contacto con las drogas normalmente ocurre por influencia de amigos, mientras que la búsqueda por tratamiento en el CAPS-ad ocurre por voluntad propia, siendo que la familia interfiere positivamente al inicio y también en la continuidad del tratamiento. Los factores que favorecen la adhesión al tratamiento fueron: disponibilidad de los profesionales de salud en la atención a los pacientes, lo que se contrapone a la dificultad de acceso al servicio. Conclusión: Para mantener la adhesión al tratamiento en el ámbito ambulatorio se hace necesario: deseo del usuario en dejar de usar drogas, apoyo familiar, vínculo con los profesionales y facilidad de acceso al servicio, en términos geográfico, financiero y estructural


Assuntos
Humanos , Masculino , Feminino , Adulto , Drogas Ilícitas , Alcoolismo/psicologia , Alcoolismo/terapia , Serviços de Saúde Mental/estatística & dados numéricos , Apoio Social , Serviços de Saúde Mental/provisão & distribução , Motivação
17.
Depress Anxiety ; 36(6): 522-532, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30838764

RESUMO

BACKGROUND: It is unknown whether social anxiety disorder (SAD) has a unique association with alcohol use disorder (AUD) over and beyond that of other anxiety disorders, how the associations develop over time, and whether the associations are likely to be causal. METHODS: Diagnoses of AUD, SAD, generalized anxiety disorder, panic disorder, agoraphobia, and specific phobias were assessed twice using the Composite International Diagnostic Interview among 2,801 adult Norwegian twins. The data were analyzed using logistic regression analyses and multivariate biometric structural equation modeling. RESULTS: SAD had the strongest association with AUD, and SAD predicted AUD over and above the effect of other anxiety disorders. In addition, SAD was prospectively associated with AUD, whereas other anxiety disorders were not. AUD was associated with a slightly elevated risk of later anxiety disorders other than SAD. Biometric modeling favored a model where SAD influenced AUD compared to models where the relationship was reversed or due to correlated risk factors. Positive associations between AUD and other anxiety disorders were fully explained by shared genetic risk factors. CONCLUSIONS: Unlike other anxiety disorders, SAD plausibly has a direct effect on AUD. Interventions aimed at prevention or treatment of SAD may have an additional beneficial effect of preventing AUD, whereas interventions aimed at other anxiety disorders are unlikely to have a similar sequential effect on AUD.


Assuntos
Alcoolismo/complicações , Alcoolismo/psicologia , Transtornos de Ansiedade/complicações , Transtornos de Ansiedade/psicologia , Fobia Social/complicações , Fobia Social/psicologia , Adulto , Agorafobia/complicações , Agorafobia/psicologia , Feminino , Humanos , Masculino , Noruega , Transtorno de Pânico/complicações , Transtorno de Pânico/psicologia , Transtornos Fóbicos/complicações , Transtornos Fóbicos/psicologia , Fatores de Risco , Gêmeos/psicologia , Adulto Jovem
18.
Alcohol Alcohol ; 54(3): 235-242, 2019 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-30882135

RESUMO

AIM: To assess the feasibility and acceptability of screening for alcohol misuse and delivering brief advice to eligible patients attending NHS dental practices in London. METHODS: A two-arm cluster randomized controlled feasibility trial was conducted. Twelve dental practices were recruited and randomized to intervention and control arms. Participants attending for a dental check were recruited into the study and were eligible if they consumed alcohol above recommended levels assessed by the AUDIT-C screening tool. All eligible participants were asked to complete a baseline socio-demographic questionnaire. Six months after the completion of baseline measures, participants were contacted via telephone by a researcher masked to their allocation status. The full AUDIT tool was then administered. Alcohol consumption in the last 90 days was also assessed using the Form 90. A process evaluation assessed the acceptability of the intervention. RESULTS: Over a 7-month period, 229 participants were recruited (95.4% recruitment rate) and at the 6 months follow-up, 176 participants were assessed (76.9% retention rate). At the follow-up, participants in the intervention arm were significantly more likely to report a longer abstinence period (3.2 vs. 2.3 weeks respectively, P = 0.04) and non-significant differences in AUDIT (44.9% vs. 59.8% AUDIT positive respectively, P = 0.053) and AUDIT C difference between baseline and follow-up (-0.67 units vs. -0.29 units respectively, P = 0.058). Results from the process evaluation indicated that the intervention and study procedures were acceptable to dentists and patients. CONCLUSIONS: This study has demonstrated the feasibility and acceptability of dentists screening for alcohol misuse and providing brief advice.


Assuntos
Consumo de Bebidas Alcoólicas/prevenção & controle , Alcoolismo/diagnóstico , Odontologia/métodos , Adulto , Alcoolismo/psicologia , Atitude do Pessoal de Saúde , Aconselhamento , Estudos de Viabilidade , Feminino , Humanos , Londres , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde
19.
Drug Alcohol Depend ; 198: 34-38, 2019 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-30877955

RESUMO

BACKGROUND: Interoception may contribute to substance use disorder as it relates to the body's experience of substance use or withdrawal. However, only a few studies have directly investigated associations between interoception and alcohol use. The objective of this study was to compare individuals with alcohol use disorder (AUD) and healthy controls on interoceptive sensibility and accuracy. METHODS: The sample was comprised of two groups: individuals meeting criteria for AUD (N = 114) and healthy controls (N = 110) not meeting criteria for AUD. Interoceptive sensibility was assessed with a self-report measure (the Private Body Consciousness subscale) and interoceptive accuracy - with a behavioral measure (the Schandry test). In addition, associations between interoception and other well-recognized correlates of AUD (sleep problems, depressive and anxiety symptoms, impulsivity) were tested. Barratt's Impulsiveness Scale, Brief Symptom Inventory, and Athens Insomnia Scale were utilized to assess psychopathological symptoms as covariates. RESULTS: When controlling for level of anxiety, sleep problems, age, sex and education, individuals with AUD scored significantly higher on self-reported interoceptive sensibility and lower on interoceptive accuracy in comparison to healthy controls. Higher interoceptive sensibility was associated with more severe sleep problems and anxiety symptoms. CONCLUSIONS: These results have to be treated as preliminary and need to be replicated; however, findings indicate that interoception may present a novel therapeutic target for treatment of AUD.


Assuntos
Alcoolismo/psicologia , Ansiedade/psicologia , Interocepção , Distúrbios do Início e da Manutenção do Sono/psicologia , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Psicopatologia , Autorrelato , Sono , Adulto Jovem
20.
BMC Public Health ; 19(1): 307, 2019 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-30871596

RESUMO

BACKGROUND: Around 585,000 people in Denmark engage in harmful use of alcohol with 140,000 suffering from outright alcohol dependence. The concerned significant others (CSOs) are affected by the drinking, often suffering almost as much as the person with alcohol use disorder. Community Reinforcement and Family Training (CRAFT) is aimed at CSOs who struggle unsuccessfully, in an effort to motivate their loved ones to stop drinking and seek treatment. The aims of this study are 1) To implement CRAFT interventions into the daily routine of operating Danish alcohol treatment centers 2) To investigate whether 6-week-individual CRAFT, 6-week-open group-based CRAFT or CRAFT based on self-help material, is efficient in getting problem drinkers to seek treatment for their alcohol problems 3) To investigate which of the three interventions (individual, group or self-directed CRAFT) is the most effective and in which group of population. METHODS: The study is a three-arm, cluster randomized controlled trial: A: individual CRAFT, group CRAFT, and CRAFT as a self-help intervention. A total of 405 concerned significant others to persons with alcohol abuse will be recruited from 24 alcohol outpatient clinics. The participants will fill out a questionnaire regarding i.e. life quality, if the drinking person entered treatment (main outcome) and satisfaction with the intervention, at baseline and after 3 and 6 months. DISCUSSION: We expect to establish evidence as to whether CRAFT is efficient in a Danish treatment setting and whether CRAFT is most effective at individual, group or self-help material only. TRIAL REGISTRATION: Clinical trials.gov ID: NCT03281057 . Registration date: September 13th, 2017.


Assuntos
Alcoolismo/terapia , Terapia Familiar/métodos , Reforço Social , Grupos de Autoajuda , Adulto , Alcoolismo/psicologia , Dinamarca , Feminino , Seguimentos , Humanos , Masculino , Motivação , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Centros de Tratamento de Abuso de Substâncias/organização & administração , Resultado do Tratamento
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