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.

Gross Motor Deficits in Children Prenatally Exposed to Alcohol: A Meta-analysis

BACKGROUND AND OBJECTIVES: Gross motor (GM) deficits are often reported in children with prenatal alcohol exposure (PAE), but their prevalence and the domains affected are not clear. The objective of this review was to characterize GM impairment in children with a diagnosis of fetal alcohol spectrum disorder (FASD) or moderate to heavy maternal alcohol intake.METHODS: A systematic review with meta-analysis was conducted. Medline, Embase, Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, PEDro, and Google Scholar databases were searched. Published observational studies including children aged 0 to <= 18 years with (1) an FASD diagnosis or moderate to heavy PAE, or a mother with confirmed alcohol dependency or binge drinking during pregnancy, and (2) GM outcomes obtained by using a standardized assessment tool. Data were extracted regarding participants, exposure, diagnosis, and outcomes by using a standardized protocol. Methodological quality was evaluated by using Strengthening the Reporting of Observational Studies in Epidemiology guidelines.RESULTS: The search recovered 2881 articles of which 14 met the systematic review inclusion criteria. The subjects' mean age ranged from 3 days to 13 years. Study limitations included failure to report cutoffs for impairment, nonstandardized reporting of PAE, and small sample sizes. The meta-analysis pooled results (n = 10) revealed a significant association between a diagnosis of FASD or moderate to heavy PAE and GM impairment (odds ratio: 2.9; 95% confidence interval: 2.1-4.0). GM deficits were found in balance, coordination, and ball skills. There was insufficient data to determine prevalence.CONCLUSIONS: The significant results suggest evaluation of GM proficiency should be a standard component of multidisciplinary FASD diagnostic services.

Aspectos da fluência na narrativa oral de indivíduos com Transtorno do Espectro Alcoólico Fetal

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

Psychiatric disorders and psychiatric consultation in a general hospital: A case- control study

Introduction: Psychiatric consultation (PC) has been considered an efficient tool to develop research, to track and to give assistance benefiting patients, health professionals and the institution. However, it has not been much used in Brazil. Although 30 to 50% of general hospital (GH) inpatients may present a psychiatric disorder, only 1 to 12% of them are referred to assessment. The aims of this study were: to assess mental disorders in a GH; to identify which of these patients are sent to psychiatric care; to verify alleged reasons for referral to psychiatric consultation, and to examine the relationship between PC and psychiatric learning (during medical school and residence). Methods: A case-control patient study was conducted (47 cases and 94 controls) to analyze in detail the following variables: socio-demographic; clinical; degree of information (about the disease and diagnostic/therapeutic procedures), and relationship between patient and health team. Psychiatric diagnoses were made according to the ICD- 10 criteria. The Self Report Questionnaire (SRQ), the CAGE and Brief Psychiatric Rating Scale (BPRS) were used as well as a specifically designed questionnaire to collect clinical and demographic data. Results: Behavioral alterations, either of elation or of depression, were the main for requesting a PC; 95.8% of the cases and 27.7% of the controls had a mental disorder. Organic mental disorders and alcohol-related disorders were the most frequent diagnoses in group I (cases), while anxiety, depressive and alcohol-related disorders were predominant in group II (controls). Control group patients were better informed and more able to establish an appropriate relationship with the health team than case patients. The logistic regression showed CAGE-positive patients having 12.85 times greater risk of being referred to PC, followed by unemployed patients (2.44 times more PC referrals). Discussion: The SRQ and CAGE were quite useful in the screening of possible patients and might be important for medical students to learn and use as generalists. Further research is needed to verify if and how the newly-established service will improve the diagnostic and treatment skills of our students.

Towards a post-traumatic subtype of obsessive-compulsive disorder

We evaluated whether traumatic events are associated with a distinctive pattern of socio-demographic and clinical features of obsessive-compulsive disorder (OCD). We compared socio-demographic and clinical features of 106 patients developing OCD after post-traumatic stress disorder (PTSD; termed post-traumatic OCD), 41 patients developing OCD before PTSD (pre-traumatic OCD), and 810 OCD patients without any history of PTSD (non-traumatic OCD) using multinomial logistic regression analysis. A later age at onset of OCD, self-mutilation disorder, history of suicide plans, panic disorder with agoraphobia, and compulsive buying disorder were independently related to post-traumatic OCD. In contrast, earlier age at OCD onset, alcohol-related disorders, contamination-washing symptoms, and self-mutilation disorder were all independently associated with pre-traumatic OCD. In addition, patients with post-traumatic OCD without a previous history of obsessive-compulsive symptoms (OCS) showed lower educational levels, greater rates of contamination-washing symptoms, and more severe miscellaneous symptoms as compared to post-traumatic OCD patients with a history of OCS. © 2011 Elsevier Ltd.

Validade e coerência de instrumentos utilizados em avaliações clínicas de idosos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Alcoolismo estudo epidemiológico no município de Araraquara(SP)

Pós-graduação em Alimentos e Nutrição - FCFAR

Síndrome de Burnout e o consumo de álcool em funcionários de penitenciárias do município de Itirapina-SP

Pós-graduação em Alimentos e Nutrição - FCFAR

Padrões intergeracionais de violência familiar associada ao abuso de bebidas alcoólicas: um estudo baseado em genogramas

The objective of this study was to analyze intergenerational patterns of alcohol related violence (ARV). An intentional sample comprising 42 family members was selected according to a set of criteria, including history of ARV. A genogram based on anonymous semi-structured taped interviews was created. The Content Analysis pointed to different patterns of repetition of intergenerational ARV. The most recurrent ones were those of lineal consanguinity (father/son) and through marriage. We observed similarities over the generations of each family as regards the pattern of alcohol consumption; the type of violence; the family reaction and the family life cycle in which ARV was intensified. Our results confirm the intergenerational reproduction of ARV. In conclusion, it is important to create intervention strategies to prevent intergenerational repetition of this association of behaviors.

Chronic nicotine activates stress/reward-related brain regions and facilitates the transition to compulsive alcohol drinking

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Off line extraction of phenol from human urine sample with isoamyl alcohol and determination by HPLC

This method has been developed for extraction and determination of phenol in a urine sample by high performance liquid chromatography.After acid hydrolysis, the free phenol was extracted with isoamyl alcohol solvent, followed by back extraction with 0.5 mol.L-1 sodium hydroxide solution and analyzed by an isocratic HPLC Varian System, equipped with reverse-phase column (MicroPak-C-18). The mobile phase was acetonitrile in 0.01 mol.L-1 hydrochloric acid solution, (20:80 v/v), and at a now-rate of 1.0 mL.min-1. The chromatogram was monitored at 220 nm in room temperature. The identification was based on retention time and the quantification was performed by automatic peak-area determination, corrected for the external standards method.The recovery was higher than 99.5 % for phenol and reproducibility of method was shown to be 2.3% standard deviation and 5.6% coefficient of variance (n=20). The limit detection was 0.05 mgL(-1) and a range of 0.05 to 20.0 mgL(-1) of phenol for linearity.

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)

Health-related behavior and quality of life among the elderly: a population-based study

OBJETIVO: Analisar a associação de comportamentos saudáveis com a qualidade de vida relacionada à saúde em idosos. MÉTODOS: Estudo transversal de base populacional que envolveu 1.958 idosos residentes em quatro áreas do estado de São Paulo, em 2001/2002. A qualidade de vida foi aferida com o uso do instrumento Medical Outcomes Study SF-36-Item Short Form Health Survey. As oito escalas e os dois componentes do instrumento constituíram as variáveis dependentes e as independentes foram atividade física, freqüência semanal de ingestão de bebida alcoólica e hábito de fumar. Modelos de regressão linear múltipla foram usados para controlar o efeito de sexo, idade, escolaridade, trabalho, área de residência e número de doenças crônicas. RESULTADOS: Atividade física foi positivamente associada com as oito escalas do SF-36. As maiores associações foram encontradas em aspectos físicos (β = 11,9), capacidade funcional (β = 11,3) e no componente físico. Idosos que ingeriam bebida alcoólica pelo menos uma vez por semana apresentaram melhor qualidade de vida do que os que não ingeriam. Comparados com os que nunca fumaram, os fumantes tiveram pior qualidade de vida no componente mental (β = -2,4). CONCLUSÕES: Os resultados apresentam que praticar atividade física, consumir bebida alcoólica moderadamente e não fumar são fatores positivamente associados a uma melhor qualidade de vida em idosos.