Objectives: To compare suicide rates observed in Brazil after the onset of the COVID-19 pandemic with the estimated rate based on suicide deaths between 2010 and 2020, and identify sociodemographic variables associated with this outcome. Methods: Ecological time-series study. Data were obtained from Brazilian Unified Health System Department of Information Technology (DATASUS), with the structural break of the data set in March 2020. The number of actual suicides observed and the number of expected suicides if there were no COVID-19 pandemic were analyzed through bayesian structural time series modeling. Results: The overall incidence of suicides in Brazil remained stable after the start of the COVID-19 pandemic compared to what would be expected. However, there was a significant increase in suicide deaths among women (6.9%) and older adult (9.1%). Analysis by macro-regions of the country showed significant increases in suicide deaths in the Center-West (7.4%), Northeast (5.7%), and Southeast (10%). Stratified analyses revealed differences according to age, sex, education, and skin color. Conclusions: Despite stability in the overall number of suicides, this phenomenon occurs heterogeneously among different population groups and regions of Brazil. Rates have increased in populations with a history of poor access to health, which may have been more severely impacted by the pandemic.

Objective: Conduct a systematic review and meta-analysis to evaluate levels of anger among substance users compared to non-user controls and to analyze the possible association between anger and psychoactive substance use (PSU). Methods: The procedures of this review followed the Meta-Analyzes of Observational Studies in Epidemiology (MOOSE) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Four electronic databases (MEDLINE, EMBASE, BIREME, PsycINFO) were searched. Results: Twelve studies were included in the meta-analysis; 10 used the State-Trait Anger Expression Inventory (STAXI) anger trait subscale and two used the Buss-Perry-Aggression Questionnaire (BPAQ) anger subscale. The sample included 2,294 users of psychoactive substances and 2,143 non-users, all male. The mean difference in anger scale scores between users and non-users was 2.151 (95%CI 1.166-3.134, p ≤ 0.00, inconsistency index [I2] = 98.83) standard deviations. Age and abstinence duration did not moderate the difference in anger between substance users and non-users. Conclusion: Users of psychoactive substances had elevated anger scores compared to non-users, which represents a high risk of relapse. It is suggested that PSU treatment programs include intensive anger management modules, focusing on factors such as dealing with daily stressors, family conflicts, frustrations, and problems.

O processo de psicodiagnóstico no ambiente hospitalar configura-se com especificidades, como a necessidade de interlocução entre as equipes, eventual dificuldade em acessá-las e grande demanda de solicitações. Este estudo busca mapear as solicitações de avaliação psicológica para crianças e adolescentes no contexto ambulatorial de um hospital geral de alta complexidade do SUS, considerando perfil de pacientes, equipes médicas solicitantes e demanda institucional para este exame. A partir destes resultados, propõe-se um novo sistema de gestão do psicodiagnóstico visando otimização em termos de custo efetividade. A análise do perfil dos pacientes e das solicitações do exame geraram a proposição de ações que visam otimizar os encaminhamentos, melhorar o fluxo de pacientes atendidos e estruturar o suporte às equipes de acordo com suas especificidades. A reformulação do fluxo assistencial propiciou uma perspectiva de gestão, possibilitando maior integração do psicodiagnóstico com demais processos assistenciais ofertados pela psicologia e de estreitamento com as equipes solicitantes.

Psychological assessment in hospitals is marked by the need and the hardship of effective communication among professionals and a huge demand of this service. This study illustrates the demand of psychological evaluation for children and adolescents in an outpatient unit of a public general hospital, considering patients demographics, medical specialties that demand this exam and institutional demand. The ultimate goal is to propose a new management model for this exam to improve cost effectiveness of referrals. The remodeling of the care flow improved the integration among psychological assessment and other psychological interventions, and the communication between the requesting physician and the psychologist.

Abstract Introduction Drug-related crimes, especially drug trafficking, account for a large part of incarcerations not only in Brazil, but also worldwide. It is not clear whether the change in the drug law has contributed to the increase in the number of drug trafficking prisoners. Few studies have investigated gender differences and the growth of drug trafficking offenses in the Brazilian southern state of Rio Grande do Sul. Objective To investigate the growth of the prison population in the state of Rio Grande do Sul, emphasizing incarcerations for drug trafficking and gender differences. Method This was an ecological study using secondary data collected from official databases of the Brazilian National Penitentiary Department (Departamento Penitenciário [DEPEN]), affiliated with the Brazilian Ministry of Justice. Results Between 2006 and 2015, incarcerations increased by 27% (25% men, 83% women). Incarcerations for drug trafficking accounted for 11% of total arrests in 2006 (11% men, 20% women) and 45% in 2015 (47% men, 91% women), corresponding to an increase of 427% (415% among men, 723% among women). Conclusions Imprisonment for drug trafficking has increased considerably, especially among women. This may be due to factors such as: increase of drug trafficking, increase in the numbers of gangs in the state, and changes in the Brazilian drug law. These results highlight an emerging challenge in public health from the perspective of human rights and gender.

RESUMO Transtornos psiquiátricos são amplamente evidenciados em pacientes que buscam tratamentos estéticos. Apesar de não configurarem necessariamente uma contraindicação para a realização de procedimentos, o reconhecimento desses sintomas pelo profissional tende a contribuir para o fortalecimento da relação profissional-paciente e para um melhor prognóstico, reduzindo as chances de insatisfação, complicações e agravos nos sintomas psiquiátricos, além de evitar complicações legais. No presente artigo, os transtornos psiquiátricos mais comuns no domínio cosmético e estético foram apresentados e discutidos, assim como as orientações para o reconhecimento de sintomas e de manuseio destes pacientes por profissionais de saúde. estéticos procedimentos profissionalpaciente paciente prognóstico insatisfação legais artigo discutidos saúde

ABSTRACT Psychiatric disorders are widely reported in patients seeking aesthetic treatments. Although they are not necessarily a contraindication for procedures, the recognition of these symptoms by the professional tends to strengthen the professional-patient relationship, thus leading to a better prognosis. This reduces the chances of dissatisfaction, complications, and aggravation of psychiatric symptoms, in addition to avoiding legal complications. In this article, the most common psychiatric disorders arising in cosmetic and aesthetic treatment are presented and discussed, as well as guidelines for recognizing the symptoms and managing these patients. treatments procedures professionalpatient patient relationship prognosis dissatisfaction complications article discussed

Resumo Objetivo: Identificar sintomas de ansiedade, depressão e sentimentos de desesperança em pacientes dependentes químicos em tratamento ambulatorial e verificar a existência de correlações com os diferentes âmbitos da qualidade de vida. Métodos: Estudo transversal com 25 homens em recuperação para dependência química, selecionados por conveniência. Foram avaliados sintomas de depressão (Inventário de Depressão de Beck-II), ansiedade (Inventário de Ansiedade de Beck) desesperança (Escala de Desesperança de Beck) e qualidade de vida (World Health Organization Quality of Life instrument-Abbreviated version [WHOQOL-Bref]), bem como perfil sociodemográfico, uso de substâncias e histórico familiar. Variáveis categóricas foram apresentadas como frequências e percentuais, e variáveis quantitativas, como médias e desvios-padrão ou medianas e intervalos interquartis. Foram utilizadas também correlações de Spearman com nível de significância de 5%. Resultados: O estudo revelou prevalência de 32% para depressão, 24% para ansiedade e 12% para desesperança, em níveis moderado/grave. As correlações entre os inventários Beck e o WHOQOL-Bref foram significantes; entretanto, os impactos diferiram nos quatro domínios avaliados. Conclusões: De modo geral, observaram-se prejuízos globais na vida dos sujeitos, tanto frente a sintomas psiquiátricos e qualidade de vida quanto sobre relacionamentos e questões ocupacionais, em níveis semelhantes. Os resultados apontam que, quanto menor a pontuação nesses inventários, melhor a qualidade de vida em alguns domínios, indicando haver correlação negativa entre sintomas psiquiátricos e qualidade de vida.

Abstract Objective: To identify symptoms of anxiety, depression, and feelings of hopelessness in patients in outpatient treatment for substance dependency and to test for correlations with various aspects of their quality of life. Methods: A cross-sectional study of a sample of 25 men in recuperation from substance dependency, selected by convenience. We assessed symptoms of depression (Beck Depression Inventory-II), anxiety (Beck Anxiety Inventory), hopelessness (Beck Hopelessness Scale), and quality of life (World Health Organization Quality of Life instrument-Abbreviated version [WHOQOL-Bref]), and also analyzed sociodemographic profile, substance abuse, and family history. Categorical variables were expressed as frequencies and percentages and quantitative variables as means and standard deviations or as medians and interquartile ranges. We also analyzed Spearman correlations to a 5% significance level. Results: The study revealed prevalence rates of 32% for depression, 24% for anxiety, and 12% for hopelessness, at a moderate/severe level. Correlations between Beck scales and WHOQOL-Bref were significant; but impacts differed in the four areas evaluated. Conclusions: Overall, we observe global negative impacts on subjects' lives, affecting their psychiatric symptoms and quality of life and their relationships and occupational factors to a similar degree. The results show that the lower the scores on these scales, the better the quality of life in some areas, indicating that there is a negative correlation between psychiatric symptoms and quality of life.

Objectives: Depressive symptoms are associated with worse outcomes in patients with bipolar disorder (BD). However, scarce data are available regarding neurocognitive profiles across different areas of functioning among BD patients with moderate and severe depression. Our objective was to assess cognition and global functioning in a group of patients with bipolar depression. Methods: Data were available for 100 patients with bipolar depression (78% female) and 70 controls (64% female) paired by age and education level. Cognitive function was assessed with a neuropsychological test battery. Functioning was assessed with the Functioning Assessment Short Test. Results: In patients, severe depression was associated with poorer cognitive performance on measures of executive function. Patients with severe depression showed worse global functioning than those with moderate depression (z = 2.54, p = 0.011). In patients with severe depression, lower global functioning was associated with lower scores in working memory (r = -0.200, p = 0.010), and executive function (r = -0.210, p = 0.007; and r = 0.293, p < 0.001). Conclusion: Our findings suggest cognitive impairment and global functioning impairment are associated with the severity of depressive symptoms in bipolar depression. Intensive treatment of depressive symptoms in patients with BD is crucial to improve cognitive functioning and, consequently, functional outcomes.

Objective: To assess the relationship between crack cocaine use and dimensions of quality of life and social functioning in young adults. Methods: This was a cross-sectional, population-based study involving 1,560 participants in Pelotas, Brazil. Crack cocaine use and abuse were investigated using the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) inventory. Outcomes of interest were quality of life, religiosity, and social functioning in terms of education, occupational status, family structure, and medical treatment history. Results: Lifetime crack cocaine use was associated with poor quality of life, worse functioning, impaired academic performance, and lower religious involvement. A greater maternal presence and higher paternal absence were more also more pronounced in crack cocaine users, who were also more likely to seek psychological and psychiatric treatment than the general population. Conclusion: Quality of life was severely impacted by crack cocaine use, especially in terms of general and physical health. Social functioning also differed between the general population and crack users, who had lower educational attainment and religious involvement. Maternal presence, paternal absence, and mental health-seeking behaviors were also more frequent among crack cocaine users, although these individuals reported lower rates of treatment satisfaction. Crack cocaine users also had significant social impairment, so that interventions involving family management and a greater focus on general health, quality of life, and functioning may make crucial contributions to the recovery of this group.

Objetivo Identificar o estado nutricional e hábitos alimentares de pacientes masculinos em recuperação de dependência química em acompanhamento ambulatorial de uma unidade de adição. Métodos Estudo transversal com 25 pacientes adultos em tratamento ambulatorial para dependência química. Foram aferidos parâmetros antropométricos (peso, estatura, circunferência da cintura e índice de massa corporal) e de composição corporal (bioimpedância elétrica), e foram investigados hábitos alimentares (Questionário de Frequência Alimentar – QFA). As variáveis categóricas são apresentadas como frequências e percentuais e as variáveis contínuas, como média e desvio-padrão ou como mediana e intervalo interquartil. Resultados Observou-se índice de massa corporal médio de 27,73 ± 4,15 kg/m2, com prevalência de sobrepeso de 80% e obesidade de 8%. A média da circunferência da cintura foi de 96,60 ± 9,84 cm e a de percentual de gordura corporal, de 23,24 ± 6,44. A maior parte da amostra estudada [20 (80%)] refere realizar quatro ou mais refeições por dia e 72% referiram aumento do consumo alimentar no período de abstinência. A preferência por alimentos específicos no período de abstinência foi relatada por 12 (48%) pacientes. Em relação ao consumo de alimentos ultraprocessados, destaca-se o consumo diário de pão francês (68%), pães brancos de forma (16%), sucos artificiais (48%), refrigerantes (32%), queijo amarelo (36%), embutidos com alto teor de gordura (36%) e balas e chicletes (32%). Conclusão Os resultados mostram prevalência elevada de sobrepeso e obesidade, além de medida de circunferência da cintura alterada, relato de aumento da ingestão alimentar e consumo diário e semanal elevado de alimentos ultraprocessados.

Objective To identify the nutritional status and dietary habits of male patients recovering from chemical dependency in an ambulatory treatment of an addition unit. Methods Crosssectional study with 25 male patients in ambulatorial treatment for chemical dependency. Anthropometric parameters (weight, height, waist circumference and body mass index) and body composition (bioelectrical impedance) were measured and dietary habits (Food Frequency Questionnaire) were investigated. Categorical variables are shown as frequencies and percentages and continuous variables as mean and standard deviation or as median and interquartile range. Results It was found a body mass index mean of 27.73 ± 4.15 kg/m2, with a prevalence of overweight in 88% of the sample. The waist circumference mean was 96.60 ± 9.84 cm and a percentual body fat mass of 23.24 ± 6.44. The sample majority [20 (80%)] refers do four or more meals a day and 72% reported an increased food intake during the period of abstinence. The preference for specific foods during the abstinence period was reported by 12 (48%) patients. Regarding the consumption of ultra-processed foods, there is a highlight daily consumption of French bread (68%), white pan bread (16%), artificial juices (48%), soft drinks (32%), high-fat cheese (36%), high-fat processed meat (36%), candy and gum (32%). Conclusion The study reveals a high prevalence of overweight and obesity, as well as altered waist circumference, increased food intake and daily and weekly consumption of ultra-processed foods.

Objective: To assess differences in executive functioning between children and adolescents with attention-deficit/hyperactivity disorder (ADHD) comorbid or not with bipolar disorder (BD), and to study the neuropsychological profile of subjects with the comorbidity in a clinical sample from a developing country. Method: Case-control study comparing 23 participants with BD + ADHD and 85 ADHD-only subjects aged 6 to 17 years old. Both groups were drug-free. Executive function domains were assessed with the Stroop Test, the Wisconsin Card Sorting Test, and the Continuous Performance Test II. Results: The group with juvenile BD + ADHD showed a significantly worse performance on the Stroop task, including time in color (p = 0.002), time in color-word (p < 0.001), interference, number or errors in color and color-word (p = 0.001), and number of errors in word cards (p = 0.028). No between-group differences were found in other tests. Conclusions: Our findings suggest that ADHD-only and ADHD + BD do not show differences in inhibitory control and set-shifting domains. However, children and adolescents with BD and comorbid ADHD show greater impairment in processing speed and interference control. This suggests a potentially higher impairment in the dorsolateral prefrontal cortex and may be a potential neuropsychological signature of juvenile BD comorbid with ADHD.

OBJECTIVES: To assess the demographic characteristics, psychiatric symptoms, substance use patterns, and sexual risk behaviors in a sample of club drug users to identify factors associated with unprotected sex during the 12 months prior to the interview. METHODS: This cross-sectional study employed the targeted sampling and ethnographic mapping approaches via face-to-face interviews conducted at bars and electronic music festivals using an adapted, semi-structured version of the Global Appraisal of Individual Needs questionnaire. The sample comprised 240 male and female young adults who had used ecstasy and/or LSD in the 90 days prior to the interview and who were not receiving treatment for alcohol or drug abuse. RESULTS: Of the 240 subjects selected (mean age: 22.9±4.5 years), 57.9% were men; of the male subjects, 52.5% reported having had unprotected sex in the previous 12 months. Of the total sample, 63.33% reported having had unprotected sex. Multivariate regression analysis showed that anal sex (PR = 1.26; 95% confidence interval (CI): 1.044-1.543; p = 0.017) and the use of alcohol/drugs to make sex last longer (PR = 1.430; 95% CI: 1.181-1.732; p<0.001) are associated with unprotected sex. CONCLUSIONS: The implementation of intervention strategies aimed at reducing sexually risky behaviors should take into consideration the specific characteristics of drug users and should include the development of safer sex negotiation skills.