Objective: This study investigated the relationship between impulsivity and early trauma through a network analysis in individuals diagnosed with different substance use disorders. Methods: In a cross-sectional design, the sample included 556 men with substance use disorders (195 with alcohol use, 157 with cocaine/crack use, and 214 with polysubstance use). Early trauma and impulsive behavior were assessed using the Childhood Trauma Questionnaire and the Barratt Impulsiveness Scale, respectively. The connection between trauma and impulsivity was assessed using network analysis through a fused graphical lasso algorithm. Results: No connection was observed between impulsivity and trauma networks in individuals with alcohol use disorder. In those with cocaine use disorder, networks were linked through the motor domain and sexual abuse nodes. Inverse connections were observed between the emotional neglect node and perseverance, but not the non-planning node. In polysubstance use, the connection between impulsivity and trauma networks was weak, with the cognitive complexity node connecting to the trauma network through physical abuse. There connections were inversely proportional between the motor domain and emotional neglect nodes, as well as between cognitive instability and physical neglect. Conclusion: Our results suggest that the relationship between the type of early (childhood) trauma and the expression of impulsivity could lead to different substance use profiles. Objective Methods crosssectional cross sectional design 55 195 (19 15 cocainecrack crack 21 use. . use) Scale respectively algorithm Results disorder nodes perseverance nonplanning non planning weak Conclusion childhood (childhood profiles 5 19 (1 1 2 (

RESUMO Objetivos: o estudo buscou avaliar o apego materno-fetal, os traumas na infância e as forças de caráter em mulheres que fizeram uso de crack durante a gestação, internadas em hospital público, em Porto Alegre. Métodos: foram entrevistadas 24 gestantes, em um delineamento transversal, e aplicados os instrumentos: Questionário sobre Traumas na Infância, Escala de Apego Materno-Fetal e Escala de Forças e Virtudes. Resultados: foi encontrado um grau médio ou alto de apego materno-fetal e alta frequência de traumas sofridos na infância, destacando-se abuso emocional e negligência física. Não houve associação significativa entre o vínculo materno fetal e a ocorrência de traumas na infância. As forças de caráter com maior escore foram: bravura, autenticidade e amor. Conclusões: Apesar das condições adversas, foi observado que as gestantes tinham um elevado apego materno-fetal. A identificação das forças de caráter que se destacaram pode ajudar para um tratamento mais efetivo dessas mulheres, sendo esta uma boa estratégia no planejamento de políticas de saúde pública. Objetivos maternofetal, maternofetal fetal, gestação público Alegre Métodos 2 transversal instrumentos Infância MaternoFetal Materno Fetal Virtudes Resultados destacandose destacando física bravura amor Conclusões adversas maternofetal. fetal. pública

ABSTRACT Objective: the study aimed to evaluate maternal-fetal attachment, childhood traumas, and character strengths in women who used crack during pregnancy admitted to a public hospital in Porto Alegre. Methods: twenty-four pregnant women were interviewed, in a cross-sectional design, and were applied the instruments: Childhood Trauma Questionnaire (CTQ), Maternal-Fetal Attachment Scale and the Characters Strenghts Scale. Results: a medium or high degree of maternal-fetal attachment and a high frequency of childhood traumas was found, standing out emotional abuse and physical neglect. There was no significant association between maternal-fetal bonding and the occurrence of trauma in childhood. The character strengths that obtained the highest scores among the pregnant women were bravery, authenticity and love. Conclusion: despite the adverse conditions, it was observed that the pregnant women had a high maternal-fetal attachment. Identifying the strengths that stood out may contribute to the more effective treatment of these women, this being a good strategy in the planning of public health policies. Objective maternalfetal maternal fetal Alegre Methods twentyfour twenty four interviewed crosssectional cross sectional design instruments CTQ, CTQ , (CTQ) MaternalFetal Maternal Fetal Results found neglect bravery love Conclusion conditions policies (CTQ

Abstract In much of the West, including Brazil, drug use has increased since social distancing began in response to the pandemic. Use of smoked and modified drugs, and their impacts on health, may contribute to aggravate the effects of the pandemic. However, studies on the relationship between use of smoked drugs and the new coronavirus are still scarce and have not received enough attention in global health recommendations. This paper aims to briefly review the relationship between use of smoked drugs and acute respiratory syndrome coronavirus 2 [SARS-CoV-2]. Recent studies also suggest that drug consumption increases the risk of contamination by SARS-CoV-2 and leads to worse prognosis, particularly consumption of drugs that affect lung function. Use of smoked drugs, especially tobacco, is strongly associated with lung diseases that are risk factors for contamination by SARS-CoV-2. It is essential to develop strategies based on specific characteristics of drug users and for mental health professionals to be included in strategic teams. It is also necessary to invest in information campaigns regarding risks and prevention of harm caused by smoked drugs as well as to design strategies that facilitate access to psychosocial treatment during the pandemic. West Brazil pandemic However recommendations SARSCoV2. SARSCoV2 SARSCoV SARS CoV . [SARS-CoV-2] SARS-CoV- prognosis function tobacco 2. teams [SARS-CoV-2 SARS-CoV [SARS-CoV- [SARS-CoV

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: This study aimed to evaluate whether progression from first drug use to crack-cocaine use differs according to gender, and whether the report of sexual or physical violence impacts the time of progression. Methods: We interviewed 896 crack-cocaine users (548 men; 348 women) from addiction treatment units. Cox regression models evaluated the time of progression from first drug use to crack use. We analyzed gender differences according to the absence or presence of sexual or physical violence, also considering whether violence, when present, had occurred before or after the onset of crack use. Results: Women presented a faster progression to crack use regardless of exposure to sexual or physical violence (p < 0.05). Compared to unexposed men, there was a similar progression for men exposed to sexual or physical violence before the first use of crack (p = 0.167 and p = 0.393, respectively). In both genders, we observed a faster progression among individuals exposed to these types of violence after the onset of crack use (p < 0.01). Conclusions: We found a faster progression to crack use among women and among individuals exposed to sexual and physical violence after the onset of crack use. These results encourage differentiated treatment strategies, focused on gender and individual characteristics.

Abstract Introduction Changes in brain-derived neurotrophic factor (BDNF) have been linked to the neuroadaptative consequences of chronic alcohol use and associated with disease severity and prognosis. Few studies have evaluated the influence of drug withdrawal and clinical and sociodemographic data on BDNF levels in severe alcohol users. Objectives Our goals were (1) to evaluate variation in BDNF levels during alcohol withdrawal and, (2) to assess the influence of putative confounding factors on BDNF levels. Methods Our sample consists of 62 men with alcohol use disorder undergoing a detoxification process. Serum BDNF levels were measured using a commercial sandwich-ELISA kit, at two points: before and after the detoxification period. Results We found an increase in BDNF levels during alcohol withdrawal (25.4±9.6 at admission vs. 29.8±10.2 ng/ml at discharge; p < 0.001), even after controlling for potential confounders (positive family history, number of days between blood sample collections, and age) (Generalized Estimating Equation: coefficient = -4.37, 95% confidence interval [95%CI] -6.3; -2.4; p < 0.001). Moreover, individuals who had first-degree relative with alcohol dependence had smaller increases in BDNF levels than individuals with no family history (14.8 [95%CI -5.3; 35.6] vs. 35.3 [95%CI 15.4; 74.8]; p = 0.005). Conclusions In summary, variation in BDNF levels seems to be influenced by withdrawal in severe alcohol users. A positive family history of alcohol dependence could also be a factor that influences variation in this biomarker.

Abstract This study aims to analyze the mechanisms through which the coronavirus disease (COVID-19) pandemic impacts on well-being at work and on productivity. The secondary objective is to identify stress management strategies for the work environment during the pandemic. This is an integrative review. Phase 1 consisted of searches of open access electronic databases (MEDLINE, SciELO, Bireme, and LILACS) for papers published in 2020 addressing mental health, work, and pandemics. Phase 2 consisted of selecting literature recommended by specialists in occupational psychiatry and positive psychology. These materials were read and critically analyzed. Forty references were included in the literature review. The articles reviewed were classified into the following categories: articles concerning work relationships in Brazil; articles describing the impact of pandemics on mental health and work; articles focusing on the work of health professionals during pandemics; articles about well-being at work; and papers proposing strategies to improve well-being and productivity and to promote mental health. The COVID-19 pandemic can have a significant impact on workers’ mental health and productivity. Most professionals face a need to adapt to changes, which can decrease their feeling of well-being. Consequently, strategies to promote well-being and mental health in the work environment should be a priority. Work routines were modified after the COVID-19 pandemic set in and assessing these changes is essential to maintain workers’ mental health. By so doing, it is possible to promote general well-being and post-traumatic recovery and reduce stress levels.

Abstract The coronavirus disease (COVID-19) pandemic is one of the greatest contemporary challenges. Feelings of fear and uncertainty triggered by this pandemic have had noxious effects on people’s mental health. This seems to have increased during quarantine and there is evidence of an intensification of reward-directed behavior. Nevertheless, there are few studies dealing with pornography consumption during this period. The aim of this manuscript is to contextualize this phenomenon during the pandemic and suggest some clinical recommendations on the matter.

Abstract The COVID-19 pandemic is unquestionably impacting on the mental health of the population worldwide. Fear of contamination can both increase levels of stress in healthy individuals and intensify psychiatric symptoms in patients with pre-existing conditions, especially obsessive-compulsive disorder (OCD). During the COVID-19 pandemic, the imminent risk of contamination creates a logical need for self-surveillance and hygiene habits. However, this kind of information can have drastic implications for subjects with OCD, since cognitive distortions and compensatory strategies (cleansing rituals) are no longer irrational or oversized – rather, these ideas become legitimate and socially accepted, generating plausible validation for the intensification of compulsive cleaning rituals. Patients who presented remission of OCD symptoms would be more likely to have a relapse, and subclinical patients may scale up and ultimately be diagnosed with OCD due to the reinforcement of their habits, emotions and thoughts.

Resumo Objetivo: sabe-se que o consumo de álcool entre adolescentes tem se intensificado no contexto nacional e internacional e em função disso o presente estudo foi concebido para avaliar em que medida variáveis como características sociodemográficas, desempenho escolar, padrão de consumo e saúde emocional podem predizer a variável de interesse, consumo recente de álcool, definido como consumo de bebidas alcoólicas nos últimos 30 dias, entre adolescentes de escolas públicas da região metropolitana de Porto Alegre/Rio Grande do Sul-Brasil. Método: trata-se de um estudo transversal, com delineamento observacional-analítico, do qual participaram 124 escolares, 69 meninas e 55 meninos, com idades entre 11 e 18 anos. Todos foram acessados em sala de aula para responderem ao Questionário de Dados Sociodemográficos, Youth Self Report e Questionário sobre o uso de drogas. Resultados: as variáveis com maior impacto no consumo recente de álcool foram o total dos problemas de internalização, ansiedade/depressão e sexo feminino. Ter feito uso de álcool com 15 anos ou menos e reprovação escolar também foram capazes de predizer o uso de álcool. Conclusão: os dados confirmam a multidimensionalidade do fenômeno que deve ser considerada em campanhas de prevenção.

Abstract Objective: It is known that alcohol use has increased both nationally and internationally. The present study was designed to evaluate the extent to wich sociodemographic characteristics, school performance, pattern of consumption and emotional health can predict the variable of interest, recent alcohol use, defined as the consumption of alcoholic beverages in the past 30 days, among adolescents from public schools in the metropolitan region of Porto Alegre/Rio Grande do Sul-Brazil. Methods: This was an observational, analytical, cross-sectional study of 124 students, 70 girls and 54 boys, aged 11 to 18 years. Participants were assessed in the classroom and completed a sociodemographic questionnaire, the Youth Self Report, and a questionnaire on drug use. Results: The variable with the greatest impact on recent alcohol use was total internalizing problems, anxiety/depression, and female sex. First alcohol use at 15 years or younger as well as school failure were also able to predict alcohol use. Conclusion: the data confirm the multidimensionality of the phenomenon that should be considered in prevention campaigns.

Resumen Objetivo: se sabe que el consumo de alcohol entre adolescentes se ha intensificado en el contexto nacional e internacional. En función de ello el presente estudio fue concebido para evaluar en qué medida variables como las características socio-demográficas, el rendimiento escolar, patrón de consumo y la salud emocional pueden predecir la variable de interés, el consumo reciente de alcohol, definido como el consumo de bebidas alcohólicas en los últimos 30 días, entre adolescentes de escuelas públicas de la región metropolitana de Porto Alegre / Rio Grande do Sul-Brasil. Método: se trata de un estudio transversal, con delineamiento observacional-analítico, del cual participaron 124 escolares, 69 niñas y 55 niños, con edades entre 11 y 18 años. Todos fueron accedidos en el aula para responder al Cuestionario de Datos Sociodemográficos, Youth Self Report y Cuestionario sobre el uso de drogas. Resultados: las variables con mayor impacto en lo consumo reciente de alcohol fueron el total de los problemas de internalización, ansiedad/depresión y sexo femenino. Haber hecho uso de alcohol con 15 años o menos y reprobación escolar también fue capaces de predecir el uso de alcohol. Conclusión: los datos confirman lo fenómeno multidimensional que debe ser considerado en campañas de prevención.

Resumo Introdução O vírus da hepatite C (HCV) está relacionado com graves patologias hepáticas, como a cirrose e o carcinoma hepatocelular, causando mais de meio milhão de mortes todos os anos, o que reflete um problema de saúde mundial. Sabe-se que usuários de drogas injetáveis possuem alta prevalência de infecção pelo HCV, sendo por isso considerados um dos maiores grupos de risco. Usuários de cocaína parecem ter maior risco de contrair o vírus do que usuários de outras drogas, e diversas hipóteses para essa associação estão sendo estudadas. Objetivo Revisar evidências de associação da infecção pelo HCV em usuários de cocaína, considerando a relevância das diferentes formas de administração da droga e comportamentos de risco. Métodos Esta foi uma revisão narrativa realizada nos principais bancos de dados científicos. Resultados e conclusão As evidências atuais sugerem que o uso de cocaína pode estar associado com a infecção por HCV devido às especificidades do padrão de consumo da droga, mesmo naqueles indivíduos que não fazem uso de drogas injetáveis, além de outros comportamentos de risco, como tatuagens e sexo desprotegido. Usuários de cocaína injetável parecem estar mais suscetíveis à contaminação do que usuários de cocaína não injetável. Entretanto, há a possibilidade de infecção devido ao compartilhamento de outros equipamentos de uso além das seringas (cachimbos, por exemplo). Além disso, prejuízos do sistema imune causados pela cocaína também parecem estar associados com a suscetibilidade de infecção pelo HCV, além da manutenção e piora dos sintomas da doença.

Abstract Introduction Hepatitis C virus (HCV) infection is related with several liver diseases such as cirrhosis and hepatocellular carcinomas, leading to more than 0.5 million deaths every year and to a great global burden. It is known that injection drug users show a high prevalence of HCV infection, being considered a risk group for this disease. Cocaine users seem to be in greater risk than other drug users, and several hypotheses for this association are being studied. Aim To review data on HCV infection in cocaine users, taking into consideration the relevance of the different routes of drug administration and other risk behaviors. Methods This was a narrative review performed in the main scientific databases. Results and conclusion Data suggest that cocaine use could be associated with HCV infection due to the specificities of cocaine consumption pattern, even in those subjects who do not inject drugs, in addition to other risky behaviors, such as tattooing and unprotected sex. Injectable cocaine users seem to be more susceptible to contamination than users who do not inject drugs. However, evidence is pointing to the possibility of infection by sharing drug paraphernalia other than syringes. Moreover, specific immune system impairments caused by cocaine use are also being linked with HCV infection susceptibility, persistence and increased pathological effects.