Abstract Objective: To describe the changes in alcohol and drug use by Brazilian adolescents during the COVID-19 pandemic (April-August 2021), and to analyze the relationship between alcohol use changes and psychiatric symptomatology. Methods: A secondary analysis with a longitudinal approach was performed with data from a cluster-randomized controlled trial, conductedin73publicmiddleschoolsinthreeBrazilian cities, to evaluate the effectiveness of a drug use prevention program. The sample included 535 students (61% girls; Mage = 15.2 years). Data were collected pre-intervention (February-March 2019), after 9 months (November-December 2019), and after 26 months (April-August 2021), when the students were in their first year of high school. The authors analyzed drug use prevalence (alcohol, binge drinking, tobacco, inhalants, marijuana, cocaine, and crack) in a lifetime, past year, and past month periods, and the association between alcohol use change subsamples with psychiatric symptoms. Logistic regressions were adjusted by sex, age, socioeconomic status, city, and group (control and intervention). Results: The present findings suggest that the COVID-19 pandemic led to a decrease in past-year substance use and in past-month substance use frequency, despite the gradually increased (but decelerating) prevalence of lifetime use. However, some adolescents initiated, maintained, or increased the frequency of their alcohol use. Mainly, they were more likely to present behavioral problems, as well as symptoms of inattentive hyperactivity, and peer and emotional problems. Conclusions: Despite the extensive decline in substance use during the pandemic period, these results suggest an association between previous mental health conditions and behavioral risk factors, leading to increased alcohol consumption and behavioral disorders manifestations. Objective COVID19 COVID 19 COVID-1 AprilAugust April August 2021, 2021 , 2021) symptomatology Methods clusterrandomized cluster randomized trial conductedinpublicmiddleschoolsinthreeBrazilian conductedin publicmiddleschoolsinthreeBrazilian cities program 53 61% 61 (61 girls 152 15 2 15. years. years . years) preintervention pre intervention FebruaryMarch February March 2019, 2019 2019) NovemberDecember November December school alcohol, (alcohol drinking tobacco inhalants marijuana cocaine crack periods sex age status city control intervention. intervention) Results pastyear pastmonth but decelerating However initiated maintained Mainly problems hyperactivity Conclusions period factors manifestations COVID1 1 COVID- 202 5 6 (6 201 20 (

This is the first of two documents prepared by experts for the Brazilian S20 mental health report. These reports outline strategies aimed at addressing the exacerbated mental health challenges arising from a post-pandemic world. Ongoing psychiatric epidemiology research has yielded evidence linking mental health with intricate social determinants, including gender, race/ethnicity, racism, socioeconomic status, social deprivation, and employment. More recently, the focus has expanded to also encompass violence and social oppression. By prioritizing prevention and early intervention, harnessing technology, and fostering community support, we can mitigate the long-term impact of emerging mental disorders throughout the life course. By utilizing evidence-based practices and forging partnerships between the health and education sectors, S20 countries can promote the health and safety of their student population, paving the way for a more promising future for the next generations. The first document focuses on addressing the mental health concerns of vulnerable populations, catering to the needs of children, youth, and aging populations, assessing the current state of alcohol and drug addictions, scaling up psychosocial interventions in primary care, exploring the potential integration of health and educational systems, and emphasizing the imperative adoption of human rights in mental health policies. S S2 report postpandemic post pandemic world determinants gender raceethnicity race ethnicity race/ethnicity racism status deprivation employment recently oppression intervention technology support longterm long term course evidencebased based sectors population generations populations children youth addictions care systems policies

Abstract Objective: Peer violence is a serious type of school violence that is associated with emotional and behavioral problems. The objective of this study was to analyze violence between peers and its associations with students’ social skills. Methods: We used a cross-sectional survey nested within a cluster-randomized controlled trial (REBEC/Brazil, U1111-1228-2342) to evaluate peer violence among elementary school students and its association with prosocial behaviors and mental problems. Teachers answered an adapted version of the Revised Olweus Bully/Victim Questionnaire (OBVQ) and the Brazilian adaptation of the Teacher Observation of Classroom Adaptation-Checklist (TOCA-C) scale for each student. Children completed a sociodemographic questionnaire. The participants were 1,152 5-to-14-year-old children from Brazilian public schools, 79.70% of whom reported being involved in violent situations. Results: Children who had both committed and suffered violence were less likely to exhibit prosocial behaviors. Children who committed and suffered violence and those who only committed violence were more likely to experience concentration problems and exhibit disruptive behaviors. Conclusion: This study suggests that peer violence is associated with fewer prosocial behaviors and more behavioral problems. Thus, more specialized mental health care is required for children involved in peer violence, in addition to implementation and maintenance of programs to prevent and reduce violence and develop prosocial behaviors in schools. Objective skills Methods crosssectional cross sectional clusterrandomized cluster randomized REBEC/Brazil, REBECBrazil REBEC Brazil (REBEC/Brazil U111112282342 U U1111 1228 2342 U1111-1228-2342 BullyVictim Bully Victim OBVQ (OBVQ AdaptationChecklist Adaptation Checklist TOCAC TOCA C (TOCA-C student questionnaire 1152 1 152 1,15 5to14yearold toyearold 5 14 year old schools 7970 79 70 79.70 situations Results Conclusion Thus REBEC/Brazil U11111228234 U111 122 234 U1111-1228-234 115 15 1,1 yearold 797 7 79.7 U1111122823 U11 12 23 U1111-1228-23 11 1, 79. U111112282 U1 2 U1111-1228-2 U11111228 U1111-1228- U1111122 U1111-1228 U111112 U1111-122 U11111 U1111-12 U1111-1 U1111-

Resumo O Programa Educacional de Resistência às Drogas (PROERD) é o programa escolar de prevenção mais disseminado no Brasil, seu atual currículo é baseado no programa norte-americano Keepin’it REAL (kiR). Não há na literatura evidência de efetividade do PROERD na prevenção ao uso de drogas, sendo necessários estudos complementares que auxiliem a compreensão desses achados. O objetivo do presente estudo é realizar uma síntese das evidências do efeito do currículo que deu origem ao PROERD: o kiR. Através de revisão sistemática encontrou-se 17 estudos que reportaram resultados de efeito de diferentes versões do kiR no uso de drogas e/ou violência. Com exceção do estudo brasileiro, não foram encontrados estudos que avaliassem o efeito no uso de drogas da versão aplicada por policiais (DARE-kiR), a mesma implementada pelo PROERD. Foram encontradas evidências favoráveis do kiR na prevenção ao uso de drogas para o currículo do 7º ano, que contrariam os resultados de efeito nulo do PROERD. Não foram encontradas evidências internacionais do efeito do kiR no currículo do 5º ano, assim como o estudo do PROERD. Sugere-se que revisões no currículo do 7º ano do PROERD para que ele possa refletir os resultados internacionais e que o currículo do 5º ano posso ser repensado considerando as evidências negativas internacionais.

Abstract The Drug Resistance Educational Program (PROERD) is Brazil’s most widespread school-based prevention program; its current curriculum is based on the North American Keepin’ it REAL (kiR) program. There is no evidence of the effectiveness of PROERD in preventing drug use, pointing to the need for further studies to understand these findings. The aim of the study was to synthesis the evidence of the effect of the kiR curriculum (PROERD) through a systematic review. We found 17 studies that reported the effects of different versions of kiR on drug use and/or violence. Except for the Brazilian study, no studies were found that assessed the effect on drug use of the version applied by police officers (DARE-kiR), the same one implemented by PROERD. Favorable evidence of kiR in drug use prevention was found for the 7th-grade curriculum, which contradicts the PROERD’s null-effect results. No international evidence of the effect of kiR was found in the 5th-grade curriculum, in the same line as the PROERD’s study. It is suggested that PROERD’s 7th-grade curriculum should be revised to reflect international results and that the 5th-grade curriculum should be reconsidered in light of the negative international evidence.

Resumo O Programa Educacional de Resistência às Drogas (PROERD) é o programa escolar de prevenção mais disseminado no Brasil, seu atual currículo é baseado no programa norte-americano Keepin’it REAL (kiR). Não há na literatura evidência de efetividade do PROERD na prevenção ao uso de drogas, sendo necessários estudos complementares que auxiliem a compreensão desses achados. O objetivo do presente estudo é realizar uma síntese das evidências do efeito do currículo que deu origem ao PROERD: o kiR. Através de revisão sistemática encontrou-se 17 estudos que reportaram resultados de efeito de diferentes versões do kiR no uso de drogas e/ou violência. Com exceção do estudo brasileiro, não foram encontrados estudos que avaliassem o efeito no uso de drogas da versão aplicada por policiais (DARE-kiR), a mesma implementada pelo PROERD. Foram encontradas evidências favoráveis do kiR na prevenção ao uso de drogas para o currículo do 7º ano, que contrariam os resultados de efeito nulo do PROERD. Não foram encontradas evidências internacionais do efeito do kiR no currículo do 5º ano, assim como o estudo do PROERD. Sugere-se que revisões no currículo do 7º ano do PROERD para que ele possa refletir os resultados internacionais e que o currículo do 5º ano posso ser repensado considerando as evidências negativas internacionais.

Abstract The Drug Resistance Educational Program (PROERD) is Brazil’s most widespread school-based prevention program; its current curriculum is based on the North American Keepin’ it REAL (kiR) program. There is no evidence of the effectiveness of PROERD in preventing drug use, pointing to the need for further studies to understand these findings. The aim of the study was to synthesis the evidence of the effect of the kiR curriculum (PROERD) through a systematic review. We found 17 studies that reported the effects of different versions of kiR on drug use and/or violence. Except for the Brazilian study, no studies were found that assessed the effect on drug use of the version applied by police officers (DARE-kiR), the same one implemented by PROERD. Favorable evidence of kiR in drug use prevention was found for the 7th-grade curriculum, which contradicts the PROERD’s null-effect results. No international evidence of the effect of kiR was found in the 5th-grade curriculum, in the same line as the PROERD’s study. It is suggested that PROERD’s 7th-grade curriculum should be revised to reflect international results and that the 5th-grade curriculum should be reconsidered in light of the negative international evidence.

RESUMO O presente estudo analisa os efeitos da pandemia de Covid-19 sobre a saúde mental dos estudantes durante parte do período de suspensão das aulas presenciais. Trata-se de estudo transversal, aplicado entre outubro e dezembro de 2020, baseado em questionário on-line de autorrelato respondido por estudantes entre 13 e 20 anos, do 9º ano do Ensino Fundamental e do Ensino Médio, que acompanhavam as atividades escolares remotas em 21 escolas públicas estaduais e municipais, localizadas nas periferias dos municípios de São Paulo e Guarulhos. Para a análise dos dados, utilizaram-se dois modelos de regressão linear múltipla, tendo como variáveis dependentes os escores de depressão pelo Inventário de Depressão Infantil e de ansiedade pelo Scared (Screen for Child Anxiety Related Emotional Disorders). O tempo de exposição às telas, a inversão do sono e o sexo feminino, combinados com as dificuldades do ensino remoto e outros marcadores sociais (como cor/raça e casos de Covid-19 em casa), estão associados a sintomas de depressão e ansiedade durante a primeira onda da Covid-19 na Região Metropolitana de São Paulo, reforçando a importância da rotina escolar na vida desses jovens e os desafios colocados às escolas para a promoção da saúde mental dos estudantes no período pós-pandemia.

ABSTRACT This study analyzes the effects of the COVID-19 pandemic on students’ mental health during part of the suspension of in-person classes. The study is a cross-sectional survey carried out from October2020 to December 2020. An online self-report questionnaire was answered by thirteen- to twenty-year old students, from the 9th grade (Middle School) to high school, who followed remote school activities in 21 state and municipal public schools located in peripheral areas of the cities of São Paulo and Guarulhos. Two linear regression models were used in the analysis, considering as dependent variables the depression scores as provided by the Child Depression Inventory and anxiety by the SCARED (Screen for Child Anxiety Related Emotional Disorders). The time of exposure to the screens, the inversion of sleep periods and the female gender, along with the difficulties of remote education and other social markers (such as color/race and cases of COVID-19 at home) are associated with symptoms of depression and anxiety during the first wave of the COVID-19 in the Metropolitan area of São Paulo. The findings reinforce the importance of school routine in the lives of those young people and the challenges posed to schools to promote students’ mental health in the post-pandemic reality.

Resumo O Questionário revisado de bullying de Olweus (rBVQ) é um instrumento internacionalmente utilizado para identificar bullying, mas devido às dificuldades de estudantes brasileiros na leitura e escrita, foi adaptado para uso áudio-guiado em smartphones. Investigou-se a validade do construto por meio de análise confirmatória fatorial em uma solução de dois fatores. Participaram 1742 e 2316 alunos de quintos e sétimos anos de trinta escolas públicas de São Paulo. Encontrou-se excelentes índices de adequação para ambos os anos escolares (quintos: CFI = 0,985; RMSEA = 0,020; sétimos: CFI = 0,990; RMSEA = 0,015) e cargas fatoriais maiores que 0,4 para todos os itens, indicando sua relevância para o construto. O rBVQ demonstrou excelentes propriedades psicométricas e pode ajudar estudos futuros que objetivam investigar bullying em populações com perfis semelhantes. Além disso, este estudo inova por avaliar um instrumento áudio-guiado e utilizando tecnologia móvel.

Abstract The revised Olweus Bully/Victim Questionnaire (rBVQ) is an internationally used instrument to identify bullying, but due to Brazilian students’ low proficiency in reading and writing, it had to be adapted for audio-guided use through smartphones. We investigated construct validity, using Confirmatory Factor Analysis (CFA), under a two-correlated factor solution. Participated 1,742 fifth graders and 2,316 seventh graders from 30 public schools in the city of São Paulo. We found excellent fit indices models for both grades (fifth grade: CFI=0.985, RMSEA=0.020; seventh grade: CFI=0.990, RMSEA=0.015), as well as factor loading higher than 0.4 for all items, indicating their relevance to the construct. The rBVQ demonstrated excellent psychometric properties and may help future studies that aim to investigate bullying in populations with similar profiles. In addition, this study innovates by evaluating an audio-guided instrument and using mobile technology.

Resumen El Cuestionario Revisado de Bullying de Olweus (rBVQ) es un instrumento utilizado internacionalmente para identificar bullying, pero debido a las dificultades de estudiantes brasileños en la lectura y la escritura, se ha adaptado su uso por medio de audioguías en smartphones. Se investigó la validez del constructo mediante el Análisis Factorial Confirmatorio, bajo un modelo de dos factores. Participaron 1742 y 2316 estudiantes de quinto y séptimo curso de 30 escuelas públicas de São Paulo. Excelentes tasas de adecuación fueron encontradas para ambos casos (quinto año: CFI=0,985, RMSEA=0,020; séptimo año: CFI=0,990, RMSEA=0,015), además de cargas factoriales superiores a 0,4 para todos los ítems, lo que indica su relevancia para el constructo. El instrumento rBVQ ha presentado excelentes propiedades psicométricas y puede ayudar a futuros estudios pretendan investigar el bullying en poblaciones con perfiles similares. Además, este estudio innova al evaluar un instrumento guiado por audio, empleando la tecnología móvil.

RESUMO O presente estudo analisa os efeitos da pandemia de Covid-19 sobre a saúde mental dos estudantes durante parte do período de suspensão das aulas presenciais. Trata-se de estudo transversal, aplicado entre outubro e dezembro de 2020, baseado em questionário on-line de autorrelato respondido por estudantes entre 13 e 20 anos, do 9º ano do Ensino Fundamental e do Ensino Médio, que acompanhavam as atividades escolares remotas em 21 escolas públicas estaduais e municipais, localizadas nas periferias dos municípios de São Paulo e Guarulhos. Para a análise dos dados, utilizaram-se dois modelos de regressão linear múltipla, tendo como variáveis dependentes os escores de depressão pelo Inventário de Depressão Infantil e de ansiedade pelo Scared (Screen for Child Anxiety Related Emotional Disorders). O tempo de exposição às telas, a inversão do sono e o sexo feminino, combinados com as dificuldades do ensino remoto e outros marcadores sociais (como cor/raça e casos de Covid-19 em casa), estão associados a sintomas de depressão e ansiedade durante a primeira onda da Covid-19 na Região Metropolitana de São Paulo, reforçando a importância da rotina escolar na vida desses jovens e os desafios colocados às escolas para a promoção da saúde mental dos estudantes no período pós-pandemia.

ABSTRACT This study analyzes the effects of the COVID-19 pandemic on students’ mental health during part of the suspension of in-person classes. The study is a cross-sectional survey carried out from October2020 to December 2020. An online self-report questionnaire was answered by thirteen- to twenty-year old students, from the 9th grade (Middle School) to high school, who followed remote school activities in 21 state and municipal public schools located in peripheral areas of the cities of São Paulo and Guarulhos. Two linear regression models were used in the analysis, considering as dependent variables the depression scores as provided by the Child Depression Inventory and anxiety by the SCARED (Screen for Child Anxiety Related Emotional Disorders). The time of exposure to the screens, the inversion of sleep periods and the female gender, along with the difficulties of remote education and other social markers (such as color/race and cases of COVID-19 at home) are associated with symptoms of depression and anxiety during the first wave of the COVID-19 in the Metropolitan area of São Paulo. The findings reinforce the importance of school routine in the lives of those young people and the challenges posed to schools to promote students’ mental health in the post-pandemic reality.

Resumo O Programa Elos é resultante da adaptação cultural brasileira do Good Behavior Game (GBG), uma estratégia preventiva para a gestão de sala de aula, visando diminuir comportamentos agressivos e disruptivos. O objetivo foi discutir a eficácia do Elos em sua implementação, em 16 escolas públicas de ensino fundamental, em duas cidades brasileiras, em 2016. Delineado como ensaio clínico controlado não randomizado, com 1.731 estudantes, em 80 turmas divididas entre experimental e controle, utilizou-se Generalized Estimating Equation para verificar o efeito do programa. Houve indicações da eficácia do Elos na redução da agressividade em meninos. Esses resultados estão alinhados com outros estudos internacionais do GBG e sugerem que, após um estudo randomizado, o programa estaria pronto para sua disseminação no Brasil.

Abstract The Elos Program resulted from a Brazilian cultural adaptation of the Good Behavior Game, a preventive strategy for classroom management to reduce aggressive and disruptive behaviors. The goal is to discuss the Elos Program’s efficacy during its implementation in 16 elementary Brazilian public schools in two cities in 2016. The design was a non-randomized controlled trial with 80 classes in each group, experimental and control, involving 1,731 students. The study used the Generalized Estimating Equation model to verify the program's effect. Elos seemed to be effective in reducing aggressiveness and disruptive behavior in boys. These results are aligned with others GBG international studies and suggest that, after a randomized trial, the program would be ready to be disseminated in Brazil.

Los objetivos de este estudio fueron describir la prevalencia del consumo excesivo de alcohol (binge drinking) y otros niveles de consumo, así como analizar las características sociodemográficas asociadas al consumo excesivo de alcohol por adolescentes brasileños de entre los 15 y los 17 años. La encuesta domiciliaria transversal aplicó un cuestionario sobre consumo excesivo de alcohol (frecuencia semanal, dosis promedio consumida al día y consumo excesivo de alcohol) a 2.315 adolescentes de la Encuesta Nacional de Salud de 2019. Se realizaron un análisis descriptivo del consumo de alcohol desde las características sociodemográficas y un modelo de regresión logística multivariado. La prevalencia de consumo excesivo de alcohol en los últimos 30 días fue del 8,1% (IC95%: 6,2-10,3). Los adolescentes que no asistían a la escuela (OR = 2,8; IC95%: 1,6-5,0) tenían más probabilidades de consumir alcohol en exceso que los estudiantes que asistían a la escuela. El mayor nivel socioeconómico (medido por la escala de riqueza) también se asoció con mayores probabilidades de consumir alcohol en exceso en comparación con los adolescentes con un nivel socioeconómico más bajo (por ejemplo, quintil 5 vs. quintil 1: OR = 2,9; IC95%: 1,1-7,7). Las mujeres tenían menos probabilidades (OR = 0,5; IC95%: 0,2-0,8) de consumir alcohol en exceso que los varones. Se encontró una alta prevalencia de consumo excesivo de alcohol entre los adolescentes, especialmente entre los varones, que no asistían a la escuela y con un nivel socioeconómico más alto. El seguimiento de los niveles de consumo de alcohol en adolescentes puede aportar información importante para las políticas o acciones destinadas a la prevención del consumo excesivo de alcohol. binge drinking 1 años frecuencia semanal 2315 2 315 2.31 2019 multivariado 3 81 8 8,1 IC95% IC95 IC (IC95% 6,210,3. 62103 6,2 10,3 . 6 10 6,2-10,3) 2,8 28 1,65,0 1650 1,6 5,0 0 1,6-5,0 medido riqueza ejemplo vs 2,9 29 9 1,17,7. 1177 1,1 7,7 7 1,1-7,7) 0,5 05 0,20,8 0208 0,2 0,8 0,2-0,8 varones alto 231 31 2.3 201 8, IC9 (IC95 210 6,210,3 6210 62 6, 103 10, 6,2-10,3 2, 65 1,65, 165 16 1, 50 5, 1,6-5, 1,17,7 117 11 77 7, 1,1-7,7 0, 20 0,20, 020 02 08 0,2-0, 23 2. (IC9 21 6,210, 621 6,2-10, 1,65 1,6-5 1,17, 1,1-7, 0,20 0,2-0 (IC 6,210 6,2-10 1,6- 1,17 1,1-7 0,2- 6,21 6,2-1 1,1- 6,2-

Os objetivos deste estudo foram descrever a prevalência de consumo excessivo de álcool (binge drinking) e outros padrões de consumo e analisar as características sociodemográficas associadas ao consumo excessivo de álcool em adolescentes brasileiros de 15 a 17 anos. Nesta pesquisa domiciliar transversal, 2.315 adolescentes da Pesquisa Nacional de Saúde de 2019 responderam a um questionário sobre o consumo excessivo de álcool (frequência semanal, dose média consumida em um dia e consumo excessivo de álcool). Foram realizados uma análise descritiva do consumo de álcool por características sociodemográficas e um modelo de regressão logística multivariável. A prevalência de consumo excessivo de álcool nos últimos 30 dias foi de 8,1% (IC95%: 6,2-10,3). Os adolescentes que não frequentavam a escola (OR = 2,8; IC95%: 1,6-5,0) apresentaram maiores chances de consumo excessivo de álcool do que os alunos que frequentavam a escola. Um maior nível socioeconômico (medido por meio do escore de riqueza) também foi associado a maiores chances de consumo excessivo de álcool em comparação com adolescentes com menor nível socioeconômico (por exemplo, quintil 5 vs. quintil 1: OR = 2.9; IC95%: 1,1-7,7). Meninas tiveram menores chances (OR = 0,5; IC95%: 0,2-0,8) de consumo excessivo de álcool do que meninos. Observou-se uma alta prevalência de consumo excessivo de álcool entre adolescentes, principalmente entre meninos, que não frequentam a escola e com maior nível socioeconômico. O monitoramento de padrões de consumo de álcool em adolescentes pode fornecer informações importantes sobre políticas e ações para prevenção do consumo excessivo de álcool. binge drinking 1 anos transversal 2315 2 315 2.31 201 frequência semanal . álcool) multivariável 3 81 8 8,1 IC95% IC95 IC (IC95% 6,210,3. 62103 6,2 10,3 6 10 6,2-10,3) 2,8 28 1,65,0 1650 1,6 5,0 0 1,6-5,0 medido riqueza exemplo vs 2.9 29 9 1,17,7. 1177 1,1 7,7 7 1,1-7,7) 0,5 05 0,20,8 0208 0,2 0,8 0,2-0,8 meninos Observouse Observou se 231 31 2.3 20 8, IC9 (IC95 210 6,210,3 6210 62 6, 103 10, 6,2-10,3 2, 65 1,65, 165 16 1, 50 5, 1,6-5, 2. 1,17,7 117 11 77 7, 1,1-7,7 0, 0,20, 020 02 08 0,2-0, 23 (IC9 21 6,210, 621 6,2-10, 1,65 1,6-5 1,17, 1,1-7, 0,20 0,2-0 (IC 6,210 6,2-10 1,6- 1,17 1,1-7 0,2- 6,21 6,2-1 1,1- 6,2-

This study aimed to estimate the prevalence of binge drinking and other alcohol consumption patterns and analyze the sociodemographic characteristics associated with binge drinking among Brazilian adolescents aged 15 to 17 years. A cross-sectional household survey including 2,315 adolescents from the 2019 Brazilian National Health Survey who answered a questionnaire on alcohol consumption (weekly frequency, average amount consumed in a drinking day, and binge drinking). A descriptive analysis of alcohol consumption by sociodemographic characteristics and a multivariable logistic regression model were performed. The prevalence of binge drinking (past 30 days) was 8.1% (95%CI: 6.2-10.3). Adolescents who did not attend school (OR = 2.8; 95%CI: 1.6-5.0) had greater odds of binge drinking than adolescents attending school. Higher socioeconomic status (measured via wealth score) was also associated with higher odds of binge drinking compared with lower socioeconomic status (e.g., 5th quintile vs. 1st quintile: OR = 2.9; 95%CI: 1.1-7.7). Girls had lower odds of binge drinking (OR = 0.5; 95%CI: 0.2-0.8) than boys. The prevalence of binge drinking among adolescents, especially boys, who did not attend school and had higher socioeconomic status was high. Monitoring alcohol consumption patterns in adolescents may provide important information on policies or actions to prevent binge drinking. 1 years crosssectional cross sectional 2315 2 315 2,31 201 weekly frequency day . drinking) performed past 3 days 81 8 8.1 95%CI 95CI CI 95 (95%CI 6.210.3. 62103 6.2 10.3 6 10 6.2-10.3) 2.8 28 1.65.0 1650 1.6 5.0 5 0 1.6-5.0 measured score e.g., eg e g (e.g. th vs st 2.9 29 9 1.17.7. 1177 1.1 7.7 7 1.1-7.7) 0.5 05 0.20.8 0208 0.2 0.8 0.2-0.8 boys high 231 31 2,3 20 8. 210 6.210.3 6210 62 6. 103 10. 6.2-10.3 2. 65 1.65. 165 16 1. 50 5. 1.6-5. e.g. (e.g 1.17.7 117 11 77 7. 1.1-7.7 0. 0.20. 020 02 08 0.2-0. 23 2, 21 6.210. 621 6.2-10. 1.65 1.6-5 e.g 1.17. 1.1-7. 0.20 0.2-0 6.210 6.2-10 1.6- 1.17 1.1-7 0.2- 6.21 6.2-1 1.1- 6.2-

This study aimed to estimate the prevalence of binge drinking and other alcohol consumption patterns and analyze the sociodemographic characteristics associated with binge drinking among Brazilian adolescents aged 15 to 17 years. A cross-sectional household survey including 2,315 adolescents from the 2019 Brazilian National Health Survey who answered a questionnaire on alcohol consumption (weekly frequency, average amount consumed in a drinking day, and binge drinking). A descriptive analysis of alcohol consumption by sociodemographic characteristics and a multivariable logistic regression model were performed. The prevalence of binge drinking (past 30 days) was 8.1% (95%CI: 6.2-10.3). Adolescents who did not attend school (OR = 2.8; 95%CI: 1.6-5.0) had greater odds of binge drinking than adolescents attending school. Higher socioeconomic status (measured via wealth score) was also associated with higher odds of binge drinking compared with lower socioeconomic status (e.g., 5th quintile vs. 1st quintile: OR = 2.9; 95%CI: 1.1-7.7). Girls had lower odds of binge drinking (OR = 0.5; 95%CI: 0.2-0.8) than boys. The prevalence of binge drinking among adolescents, especially boys, who did not attend school and had higher socioeconomic status was high. Monitoring alcohol consumption patterns in adolescents may provide important information on policies or actions to prevent binge drinking.

Os objetivos deste estudo foram descrever a prevalência de consumo excessivo de álcool (binge drinking) e outros padrões de consumo e analisar as características sociodemográficas associadas ao consumo excessivo de álcool em adolescentes brasileiros de 15 a 17 anos. Nesta pesquisa domiciliar transversal, 2.315 adolescentes da Pesquisa Nacional de Saúde de 2019 responderam a um questionário sobre o consumo excessivo de álcool (frequência semanal, dose média consumida em um dia e consumo excessivo de álcool). Foram realizados uma análise descritiva do consumo de álcool por características sociodemográficas e um modelo de regressão logística multivariável. A prevalência de consumo excessivo de álcool nos últimos 30 dias foi de 8,1% (IC95%: 6,2-10,3). Os adolescentes que não frequentavam a escola (OR = 2,8; IC95%: 1,6-5,0) apresentaram maiores chances de consumo excessivo de álcool do que os alunos que frequentavam a escola. Um maior nível socioeconômico (medido por meio do escore de riqueza) também foi associado a maiores chances de consumo excessivo de álcool em comparação com adolescentes com menor nível socioeconômico (por exemplo, quintil 5 vs. quintil 1: OR = 2.9; IC95%: 1,1-7,7). Meninas tiveram menores chances (OR = 0,5; IC95%: 0,2-0,8) de consumo excessivo de álcool do que meninos. Observou-se uma alta prevalência de consumo excessivo de álcool entre adolescentes, principalmente entre meninos, que não frequentam a escola e com maior nível socioeconômico. O monitoramento de padrões de consumo de álcool em adolescentes pode fornecer informações importantes sobre políticas e ações para prevenção do consumo excessivo de álcool.

Los objetivos de este estudio fueron describir la prevalencia del consumo excesivo de alcohol (binge drinking) y otros niveles de consumo, así como analizar las características sociodemográficas asociadas al consumo excesivo de alcohol por adolescentes brasileños de entre los 15 y los 17 años. La encuesta domiciliaria transversal aplicó un cuestionario sobre consumo excesivo de alcohol (frecuencia semanal, dosis promedio consumida al día y consumo excesivo de alcohol) a 2.315 adolescentes de la Encuesta Nacional de Salud de 2019. Se realizaron un análisis descriptivo del consumo de alcohol desde las características sociodemográficas y un modelo de regresión logística multivariado. La prevalencia de consumo excesivo de alcohol en los últimos 30 días fue del 8,1% (IC95%: 6,2-10,3). Los adolescentes que no asistían a la escuela (OR = 2,8; IC95%: 1,6-5,0) tenían más probabilidades de consumir alcohol en exceso que los estudiantes que asistían a la escuela. El mayor nivel socioeconómico (medido por la escala de riqueza) también se asoció con mayores probabilidades de consumir alcohol en exceso en comparación con los adolescentes con un nivel socioeconómico más bajo (por ejemplo, quintil 5 vs. quintil 1: OR = 2,9; IC95%: 1,1-7,7). Las mujeres tenían menos probabilidades (OR = 0,5; IC95%: 0,2-0,8) de consumir alcohol en exceso que los varones. Se encontró una alta prevalencia de consumo excesivo de alcohol entre los adolescentes, especialmente entre los varones, que no asistían a la escuela y con un nivel socioeconómico más alto. El seguimiento de los niveles de consumo de alcohol en adolescentes puede aportar información importante para las políticas o acciones destinadas a la prevención del consumo excesivo de alcohol.

Several stressors associated with the coronavirus disease 2019 (COVID-19) are expected to affect the mental health of global populations: the effects of physical distancing, quarantine, and social isolation; the emotional suffering of health and other frontline workers; neuropsychiatric sequelae in those affected by the virus; the impact to families of lives lost to the disease; differential effects for those with severe mental disorders; and the consequences of social and economic deterioration. In this context, we sought: to form a panel of Brazilian experts on child and adolescent health, neurodevelopment, health services, and adult and elderly mental health; and to compile evidence-based interventions to support suggested policy changes in Brazil to mitigate the expected increase in mental health disorders during the pandemic and its mental health consequences. The following actions are recommended: 1) invest in prevention programs for the safe return of students to schools; 2) adopt evidence-based psychosocial interventions to maintain an adequate environment for child and adolescent development; 3) target socially vulnerable populations and those experiencing discrimination; 4) train primary care teams to solve common mental health problems, provide needs-based assessments, and manage long-term, at-home care for older patients; 5) invest in technological advancements (e.g., telemedicine, e-Health, and web-based algorithms) to promote coordinated care; 6) increase access to and literacy in the use of computers and mobile phones, especially among older adults; 7) expand protocols for remote, brief psychotherapy interventions and psychoeducation to manage common mental health problems.

Objective: To detect latent patterns of drug-related problems and their predictors among adolescents. Methods: A three-wave randomized controlled trial was conducted among 6,391 7th and 8th graders (51.02% girls) at 72 public schools in six Brazilian cities to evaluate the #Tamojunto school-based drug prevention program. Patterns of drug use and behavior problems were identified through latent class analysis, and logistic regression analyses were used to detect predictors of high-risk and low-risk groups. Results: Two groups were found that best explained the patterns of drug use and problem behaviors: high drug use/high problems and low drug use/low problems, representing 36.7 and 63.3% of the sample, respectively. No program effect was a determinant of the risk of belonging to these groups. Any reported problem behavior in the year preceding baseline assessment increased the likelihood of belonging to the high-risk group at the 21-month follow-up by 16 times. Alcohol use at baseline and female gender increased the likelihood of belonging to the high-risk group by 70%. Conclusion: Previous behavior problems and alcohol use were the strongest predictors of higher risk, suggesting that effective earlier interventions and early screening for alcohol use and behavioral problems are needed at schools, particularly for girls. Clinical trial registration: Registro Brasileiro de Ensaios Clínicos (REBEC), RBR-4mnv5g

The present study analyzes the effects of the Covid-19 pandemic on students' mental health during part of the suspension of the in-person classes. The study is a cross-sectional survey completed between October and December 2020. An online self-report questionnaire was answered by students between 13 and 20 years of age, from the 9th grade to high school, who followed remote school activities in 21 state and municipal public schools located in the suburbs of the municipalities of São Paulo and Guarulhos. Two linear regression models were used in the analysis, considering as dependent variables the depression scores by the Child Depression Inventory and anxiety by the SCARED (Screen for Child Anxiety Related Emotional Disorders). The time of exposure to the screens, the inversion of sleep, and the female gender, simultaneously with the difficulties of remote education and other social markers (such as color/race and cases of Covid-19 at home), are associated with symptoms of depression and anxiety during the first wave of the Covid-19 in the metropolitan area of São Paulo. The findings reinforce the importance of school routine in the lives of these young people and the challenges posed to schools to promote students' mental health in the post-pandemic reality.

O presente estudo analisa os efeitos da pandemia de Covid-19 sobre a saúde mental dos estudantes durante parte do período de suspensão das aulas presenciais. Trata-se de estudo transversal, aplicado entre outubro e dezembro de 2020, baseado em questionário online de autorrelato respondido por estudantes entre 13 e 20 anos, do 9º ano do Ensino Fundamental e do Ensino Médio, que acompanhavam as atividades escolares remotas em 21 escolas públicas estaduais e municipais, localizadas nas periferias dos municípios de São Paulo e Guarulhos. Para a análise dos dados, utilizou-se dois modelos de regressão linear múltipla, tendo como variáveis dependentes os escores de depressão pelo Inventário de Depressão Infantil e de ansiedade pelo SCARED (Screen for Child Anxiety Related Emotional Disorders). O tempo de exposição às telas, a inversão do sono e o sexo feminino, combinados com as dificuldades do ensino remoto e outros marcadores sociais (como cor/raça e casos de Covid-19 em casa), estão associados a sintomas de depressão e ansiedade durante a primeira onda da Covid-19 na região metropolitana de São Paulo, reforçando a importância da rotina escolar na vida desses jovens e os desafios colocados às escolas para a promoção da saúde mental dos estudantes no período pós-pandemia.

Objective: Mental illness is an important public health concern, often starting early in life and particularly impacting children from low-and middle-income countries. Our aims were to 1) determine, in a representative sample of public preschool 4- to 5-year old children in Brazil, the prevalence of internalizing and externalizing disorders and socioemotional development delays; and 2) to identify modifiable risk factors associated with mental, behavioral, or developmental disorders (MBDD), such as microsystem (i.e., parent-child relationship), mesosystem (social support), and macrosystem contextual factors (neighborhood disadvantage). Methods: A random sample of public preschool children was recruited in the city of Embu das Artes (São Paulo metropolitan area) (n=1,292 from 30 public preschools). Six-month prevalence of MBDD was measured using the Child Behavior Checklist (CBCL) and the Ages and Stages Questionnaires: Social-Emotional (ASQ:SE). Results: Six-month prevalence estimates were 25.4% for internalizing disorders, 12.1% for externalizing disorders, and 30.3% for socioemotional development delays. MBDD prevalence estimates were higher in families with stressful relationships and parental depression or anxiety, and in families with lower social capital. Conclusion: At least 25% of preschool children living in an urban area in Brazil presented a mental health disorder. These mental disorder were associated with modifiable factors such as stressful family relationships and lower social capital. Prevention and intervention measures such as family therapy are needed to decrease such high prevalence.