Patterns of alcohol use between genders: A cross-cultural evaluation

Introduction: Alcohol use by men and women is very much influenced by social habits and customs. Cultural peculiarities and biological differences between the sexes require more focused and standardized studies. The objective was to systematize information on patterns of alcohol use between the sexes.Method: A literary review (1972-2004) identified 96 publications (Lilacs, Scielo, Medline) and some related books.Results and conclusions: Men drank more and presented more problems (legal, family, social, clinical, traumas and mortality) associated with alcohol use; the consequences of alcohol use in developing countries with low death rates is even higher. Women can face more discrimination by using alcohol as well as worse health problems when they abuse drinking (liver, pancreas, and central and peripheral nervous system problems, psychiatric comorbidity, etc.); sexual abuse is more commonly associated with women than discussing the different responses to treatment. As for social roles/responsibilities exercised by women, there are indications that marriage, employment, and children have a good influence, discouraging alcohol use, while divorce, unemployment, and no children contribute to higher consumption. For both sexes, religion was a protective factor for alcohol use; acculturation was a strong influence in the pattern of alcohol use, and alcohol worsened the evolution of existing psychiatric disorders. (c) 2006 Elsevier B.V. All rights reserved.

Alcohol use and falls among the elderly in Metropolitan São Paulo, Brazil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Alcohol use disorders in patients with obsessive-compulsive disorder: The importance of appropriate dual-diagnosis

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Utilização do alcohol use disorders identification test (Audit) para identificação do consumo de álcool entre estudantes do ensino médio

Alcohol is one of the drugs most widely used among teenagers. Just recently, studies have been developed regarding the screening of use of alcohol by this population. This work aimed to investigate the use of AUDIT as a method for screening and evaluation of alcohol consumption among High School students. The sample was composed by 1227 students from two public schools, who answered to the Alcohol Use Disorders Identification Test (AUDIT) and informed their socioeconomic level, religion, and occurrence of relationship problems caused by drunkenness of family members. Using an 8 cut-off point, AUDIT has identified 17.8% of students with risk drinking. These results have revealed that AUDIT is easy to be applied and well accepted by the students. It was also evident the importance of this instrument in the follow-up programs of prevention and intervention of alcoholic beverages use.

Sexual abuse and alcohol use among women in metropolitan Sao Paulo, Brazil: a general population study

OBJECTIVE:The present study aimed at estimating the prevalence of lifetime sexual abuse among women and at investigating its association with alcohol consumption.METHOD:Population-based survey conducted through a representative and stratified cluster sample of metropolitan São Paulo. GENACIS questionnaire was used. Sample unit was the home, and all residents aged 18 years and over were interviewed. The outcome was lifetime sexual abuse. The univariate statistical analysis used the Rao-Scott test. Logistic regression was used for the multivariate analysis.RESULTS:The final sample totalized 1,216 women aged 18 years and over; the response rate was 75.0%. Most women were married (56.6%) and had less than 12 years of formal education (59.0%); 46.2% were aged between 25 and 44 years, and 44.4% had a low income. Of the respondents, 7.5% reported having suffered lifetime sexual abuse. Multiple logistic regression model showed an association between lifetime sexual abuse and being a heavy drinker (OR = 4.97) and being a former drinker (OR = 2.04).CONCLUSIONS:There are few population studies in Brazil investigating sexual abuse and its relation to alcohol use. Although the prevalence of lifetime sexual abuse in the present study was smaller than that observed in other studies, it is a highly expressive percentage on account of its social and economic impact, as well as its potential effect on the health system.

Depressive symptoms and harmful alcohol use in hepatitis C patients: prevalence and correlates

Introduction It is important to understand the characteristics and vulnerabilities of people who have hepatitis C because this disease is currently an important public health problem. The objective of this study was to estimate the prevalence of depressive symptoms and harmful alcohol use in patients with hepatitis C and to study the association between these outcomes and demographic, psychosocial and clinical variables. Methods This cross-sectional, descriptive and analytical study involved 82 hepatitis C patients who were being treated with pegylated interferon and ribavirin at a public university hospital. The primary assessments used in the study were the Alcohol Use Disorders Identification Test and the Beck Depression Inventory. Bivariate analyses were followed by logistic regression. Results The prevalence of depressive symptoms was 30.5% (n=25), and that of harmful alcohol use was 34.2% (n=28). Logistic regression analysis showed that individuals who were dissatisfied with their social support (OR=4.41; CI=1.00-19.33) and were unemployed (OR=6.31; CI=1.44-27.70) were at a higher risk for depressive symptoms, whereas harmful alcohol use was associated with the male sex (OR=6.78; CI=1.38-33.19) and the use of illicit substances (OR=7.42; CI=1.12-49.00). Conclusions High prevalence rates of depressive symptoms and harmful alcohol use were verified, indicating vulnerabilities that must be properly monitored and treated to reduce emotional suffering in this population.

Relations between Depression, Alcohol and Gender in the Metropolitan Region of São Paulo, Brazil

Como parte do projeto GENACIS, este artigo visou estimar a prevalência de depressão em amostra urbana de São Paulo, Brasil, assim como a associação entre depressão e padrão de uso de álcool segundo gênero. Para tanto, foi realizado inquérito epidemiológico com amostra probabilística e por conglomerados, com um total de 2083 adultos. Utilizou-se o CIDI SF para identificação de depressão. A análise estatística utilizou o teste de Rao Scott e regressão logística multivariada. A taxa de resposta foi de 74,9%. Predominaram mulheres (58,8%), menores de 40 anos de idade (52%). A prevalência de depressão foi de 28,3% para as mulheres e 12,7% para os homens. Entre os homens, 61,1% são de bebedores no último ano e a depressão esteve associada ao padrão de consumo de álcool, à maior frequência de binge drinking e à presença de problemas decorrentes do álcool. Entre as mulheres, 69,5% são abstinentes e a depressão se associou à convivência com cônjuge com problemas devidos ao álcool. Os resultados ressaltam que a associação entre depressão e consumo de álcool é distinta entre os gêneros.

Alcohol and Quality of Life Among Social Groups for the Elderly in Sao Jose dos Campos, Brazil

This study aims to investigate alcohol consumption within social groups for the elderly in So Jos, dos Campos-Brazil, and to check for a correlation between alcohol consumption and quality of life. A sample of 500 individuals participating on social groups for the elderly were interviewed by using the Alcohol Use Disorders Identification Test (AUDIT) to verify alcohol consumption; the Medical Outcomes Study 36 Item Short Form (SF-36), for evaluating quality of life; and the Oral Health Impact Profile short form (OHIP-14), for evaluating oral health-related quality of life. The average alcohol consumption was very low (1.48), being higher in men (2.23) than women (1.09). The SF-36 average score for the domain of physical function was 70.5; for role-physical function 64.9; for bodily pain,68.3; for general health 73.8; for vitality,72.4; for social function 82.8; for role-emotional function 72.3 and for mental health 75.0. The OHIP-14 average score was 3.87. AUDIT did not correlate with SF-36 domains, or with OHIP-14. However, there was a negative correlation between OHIP 14 and all SF-36 domains. This elderly sample has a very low consumption of alcohol, and no correlation was found between alcohol consumption and oral and medical quality of life.

Validity of alcohol screening instruments in general population gender studies: an analytical review

The present study is an analytical review of the methodology used in studies of efficacy of screening instruments to detect harmful use/ alcohol dependence according to the gender in population surveys. Systematic review of bibliography was done, using data from Web of Science, Pubmed and PsycInfo. Population studies were included without date range, in English, Spanish or Portuguese languages, with sample of adults, evaluating psychometric characteristics of any alcohol screening instrument, whereas studies in special population or under treatment as well as prevalence of alcohol consumption were excluded. Thirteen studies were selected to be included in the present review. According to the studies, the instruments that presented a better performance among men were AUDIT and its derivatives (6 studies) and CAGE (2 studies), whereas among women, AUDIT and its derivatives (7 studies), followed by CAGE (3 studies). The increase of consumption and problems related to alcohol use and its implications for public health indicate the need and urgency for adequacy of screening instruments to differences of gender in general population. The population surveys in the area are scarce. Furthermore, the found studies present heterogeneous methodology which makes accurate comparisons difficult.

Raciocínio moral e uso abusivo de bebidas alcoólicas por adolescentes

O uso abusivo de álcool por adolescentes é uma questão que preocupa os envolvidos com a educação, uma vez que as consequências desse fato podem gerar sérios prejuízos ao processo ensino-aprendizagem e ao adolescente que abusa. Com o objetivo de contribuir para o debate na busca de uma intervenção efetiva que possa ser utilizada, sobretudo nas escolas, procuramos detectar a possível relação entre uso abusivo de álcool e raciocínio moral. Para tanto, participaram alunos do ensino médio de uma escola pública, selecionados por meio da aplicação do AUDIT (The Alcohol Use Disorder Identification Test), que posteriormente foram entrevistados, conforme a Moral Judgement Interview (MJI) proposta por Kohlberg. Os resultados obtidos revelam níveis e estágios morais aquém dos esperados. Concluímos que a prevenção pode ser pensada por meio da Educação Moral como uma proposta de intervenção efetiva contra o uso abusivo de álcool e outras drogas.

Uso de álcool e drogas por estudantes de medicina da Unesp

INTRODUÇÃO: O objetivo deste trabalho foi analisar a prevalência do uso de drogas por estudantes da Faculdade de Medicina de Botucatu - Unesp, comparada com outras oito escolas médicas paulistas (uso na vida, nos últimos 12 meses e nos últimos 30 dias). A pesquisa foi realizada entre 1994 e 1995, com 5.227 estudantes do 1o ao 6o ano de graduação. MATERIAL E MÉTODO: Foi usado um questionário de auto-respostas, anônimo, incluindo o questionário da Organização Mundial da Saúde para levantamento de uso de drogas e álcool. Setenta e um por cento (3.725) dos alunos responderam ao mesmo, e destes, 421 eram de Botucatu. RESULTADOS: Não houve diferenças estatisticamente significantes entre escolas e, nos 30 dias anteriores ao preenchimento do questionário, a prevalência do uso de drogas para os estudantes de Botucatu foi a seguinte, com a variação entre outras escolas mostrada entre parênteses: álcool 50% (42-50%); tabaco 7% (7-13%); solventes 8% (7-12%); maconha 6% (6-16%); benzodiazepínicos (BZD) 3% (2-9%); cocaína 0,5% (0,2-4%); anfetaminas 1 % (0-1%). Embora tenha se encontrado um uso crescente de todas as drogas do 1o ao 6o ano, e em especial os BZD, os estudantes não aprovam este uso. A análise de regressão logística indicou que o uso de álcool e drogas foi favorecido por: a) ser homem; b) perder aulas sem razão e referir ou ter muito tempo livre nos finais de semana; e c) ter uma atitude favorável em relação ao uso de álcool e drogas. Diferentemente de outras escolas, na Unesp não houve diferenças estatisticamente significantes de gênero em relação ao uso de tranqüilizantes. No entanto, as mulheres iniciam uso mais precocemente e o fazem mais freqüentemente. Também as mulheres já faziam uso de maconha antes de entrar para a faculdade (30% mulheres X 10% homens), o contrário ocorrendo com solventes (50% homens X 2% mulheres), sendo essas diferenças estatisticamente significantes. CONCLUSÕES: Embora a pesquisa tenha focalizado o uso (não abuso ou dependência), os resultados sugerem a necessidade de as universidades estabelecerem uma política clara de orientação sobre uso de drogas e álcool para os estudantes, incluindo mudanças curriculares e programas de prevenção.

Prevention of Risky drinking among students at a Brazilian University

Aim: The aim of this paper was to compare the quantity and frequency of alcohol use and its associated negative consequences between two groups of college students who were identified as being risky drinkers. Subjects were randomly allocated in a clinical trial to intervention or control groups. Methods: Risky drinking use was defined as Alcohol Use Disorders Identification Test (AUDIT) >= 8 and/or Rutgers Alcohol Problem Index (RAPI) >= 5 problems in the previous year. Students who had undergone the Brief Alcohol Screening and Intervention for College Students (BASICS) (N = 145 at baseline; 142 at 12 months, and 103 at 24 months, loss of 29.7%) were compared with a control group (N = 121 at baseline; 121 at 12 months and 113 at 24 months, loss of 9.3%), the nonintervention group. Variables included drinking frequency, quantity and peak consumption, dependence assessment, and family and friends' abuse assessment. Results: Treated students at a 24-month follow-up decreased quantity of alcohol use per occasion and lowered AUDIT and RAPI scores. Conclusions: This is the first brief intervention work on risky drinking with college students in Brazil and the results are encouraging. However, it is difficult to conduct individual prevention strategies in a country where culture fosters heavy drinking through poor public policy on alcohol and lack of law enforcement.

Expectativas positivas com o uso de álcool e o beber se embriagando: diferenças de gênero em estudo do Projeto GENACIS, São Paulo, Brasil

O objetivo deste trabalho foi investigar as expectativas de homens e mulheres com relação ao uso do álcool e a associação dessas com o comportamento de beber com embriaguez. Foi realizado inquérito epidemiológico, domiciliar, transversal, de base populacional, com amostra probabilística estratificada por conglomerados, na Região Metropolitana de São Paulo, Brasil. Foram entrevistadas 2.083 pessoas de ambos os sexos utilizando-se o questionário GENACIS (Gender, Alcohol and Culture: An International Study). Beber com embriaguez foi considerada variável dependente, e foram construídos modelos de regressão logística para cada sexo, ajustando-se os modelos para idade, escolaridade e renda. Todas as expectativas, exceto achar mais fácil falar com companheiro, associaram-se ao comportamento de beber com embriaguez. Nosso estudo mostrou que beber com embriaguez pode estar associado a expectativas com uso do álcool. Compreender essas expectativas pode contribuir para elaboração de estratégias mais efetivas de prevenção do beber excessivo.

Violência entre parceiros íntimos e álcool: prevalência e fatores associados

Objective. To estimate physical violence between intimate partners and to examine the association between violence and sociodemographic variables, use of alcohol, and other related factors.Method. This epidemiologic survey included a stratified probabilistic sample representative of the population from the city of São Paulo in economic and educational terms. The Gender, Alcohol and Culture: An International Study (GENACIS) questionnaire was employed. The sampling unit was the home, where all individuals older than 18 years were candidates for interview. The final sample included 1 631 people. Statistical analysis employed the Rao Scott test and logistic regression.Results. The response rate was 74.5%. Most participants were female (58.8%), younger than 40 years of age (52%), or had 5 to 12 years of schooling. of the overall group, 5.4% reported having been victims of physical violence by an intimate partner and 5.4% declared having been aggressors of intimate partners in the past 2 years. Most men declared that none of those involved had ingested alcohol at the moment of aggression. Most women reported that nobody or only the man had drunk. Being a victim or an aggressor was associated with younger age and having a heavy-drinking partner. Women suffered more serious aggression, requiring medical care, and expressed more anger and disgust at aggression than men.Conclusions. The results underscore the importance of the association between alcohol use and risk of aggression between intimate partners, and may contribute to the design of public policies aimed to control this situation.

Uso de álcool entre adolescentes escolares: um estudo-piloto

O uso de álcool entre adolescentes é um tema que preocupa profissionais da saúde pelos prejuízos acarretados e pela displicência da sociedade quanto ao uso desta droga por essa faixa etária. Este artigo analisa o consumo de álcool entre alunos do ensino médio de três escolas de Cascavel-PR. O instrumento utilizado foi o Alcohol Use Disordens Identification Test (AUDIT), além de levantamento de informações sobre o nível socioeconômico, religião e o beber problemático de familiar. O resultado mostrou que 34,7% dos estudantes bebem de maneira arriscada, não havendo diferenças significativas por escola, gênero e nível socioeconômico. Ter familiar que bebe foi considerado fator de risco e ter religião, fator protetor. Esta pesquisa pode alertar a sociedade paranaense para a necessidade de estudos mais amplos, com o objetivo de desenvolver políticas públicas que incluam projetos de prevenção e intervenção dirigidos à população jovem.