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Drug use among medical students in São Paulo, Brazil: a cross-sectional study during the coronavirus disease 2019 pandemic Paulo Brazil crosssectional cross sectional 201 20 2
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Lemos-Santos, Pedro

; Blumrich, Lukas

; Debia, Jordi Blanes

; Castaldelli-Maia, João Mauricio

; Suen, Paulo Jeng Chian

; Malbergier, André

Sao Paulo Medical Journal

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2024, Volume 142 N. 2 elocation e2022493

Abstract: En | Text: En | PDF: En

ABSTRACT BACKGROUND: Medical students demonstrate higher rates of substance use than other university students and the general population. The challenges imposed by the coronavirus disease 2019 (COVID-19) pandemic raised significant concerns about mental health and substance use. OBJECTIVES: Assess the current prevalence of substance use among medical students at the University of São Paulo and evaluate the impact of the COVID-19 pandemic on drug consumption. DESIGN AND SETTING: A cross-sectional study was conducted on 275 medical students from the University of São Paulo Medical School (São Paulo, Brazil) in August 2020. METHODS: Substance use (lifetime, previous 12 months, and frequency of use before and during the COVID-19 pandemic) and socioeconomic data were assessed using an online self-administered questionnaire. Symptoms of depression were assessed using the Patient Health Questionnaire-9. RESULTS: Alcohol was the most consumed substance in their lifetime (95.6%), followed by illicit drugs (61.1%), marijuana (60%), and tobacco (57.5%). The most commonly consumed substances in the previous year were alcohol (82.9%), illicit drugs (44.7%), marijuana (42.5%), and tobacco (36%). Students in the first two academic years consumed fewer substances than those from higher years. There was a decreasing trend in the prevalence of most substances used after the COVID-19 pandemic among sporadic users. However, frequent users maintained their drug use patterns. CONCLUSION: The prevalence of substance use was high in this population and increased from the basic to the clinical cycle. The COVID-19 pandemic may have affected the frequency of drug use and prevalence estimates. BACKGROUND 201 COVID19 COVID 19 (COVID-19 OBJECTIVES COVID-1 consumption SETTING crosssectional cross sectional 27 Brazil 2020 METHODS lifetime, (lifetime 1 months selfadministered self administered questionnaire Questionnaire9. Questionnaire9 Questionnaire 9. 9 Questionnaire-9 RESULTS 95.6%, 956 95.6% , 95 6 (95.6%) 61.1%, 611 61.1% 61 (61.1%) 60%, 60 60% (60%) 57.5%. 575 57.5% . 57 5 (57.5%) 82.9%, 829 82.9% 82 (82.9%) 44.7%, 447 44.7% 44 7 (44.7%) 42.5%, 425 42.5% 42 (42.5%) 36%. 36 36% (36%) However patterns CONCLUSION cycle estimates 20 COVID1 (COVID-1 COVID- 2 202 Questionnaire- 95.6 (95.6% 61.1 (61.1% (60% 57.5 (57.5% 82.9 8 (82.9% 44.7 4 (44.7% 42.5 (42.5% 3 (36% (COVID- 95. (95.6 61. (61.1 (60 57. (57.5 82. (82.9 44. (44.7 42. (42.5 (36 (COVID (95. (61. (6 (57. (82. (44. (42. (3 (95 (61 ( (57 (82 (44 (42 (9 (5 (8 (4

https://doi.org/10.1590/1516-3180.2022.0493.r1.150623

Os efeitos de um treinamento sobre humanização entre médicos comparados a não médicos
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Martins, Clara Barbosa

; Almeida, Jouce Gabriela de

; Malbergier, André

Revista Brasileira de Educação Médica

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2023, Volume 47 N. 2 elocation e062

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo: Introdução: A categoria médica vem sendo considerada pouco competente nos atributos relacionados à humanização. Por isso, mundialmente e no Brasil, mudanças têm sido realizadas nas grades dos cursos de graduação em Medicina para ampliar as disciplinas de humanidades. Além dessas iniciativas, há necessidade de treinamentos em humanização para médicos que se formaram com grades antigas e aqueles que, mesmo graduados a partir das novas diretrizes curriculares, ainda precisam se atualizar na temática. Há poucos estudos quantitativos sobre treinamentos em humanização, especialmente para médicos. Objetivo: Este estudo teve como objetivo avaliar os efeitos de um treinamento sobre humanização para médicos em comparação a não médicos. Método: Realizaram-se treinamentos de 135 minutos sobre humanização para médicos e não médicos em um hospital psiquiátrico universitário em São Paulo (Brasil). As aulas foram ministradas com o uso de slides e acompanhadas de discussão e dramatização. Os sujeitos da pesquisa responderam a um questionário com 34 itens que avaliavam as autopercepções sobre conhecimentos, habilidades e atitudes em humanização antes e 15 dias depois do treinamento. Utilizaram-se testes não paramétricos para comparar os escores entre o grupo de médicos e não médicos. Além disso, realizaram-se regressões lineares múltiplas para as dimensões de conhecimentos, habilidades e atitudes, com o objetivo de avaliar se houve diferença significativa entre gêneros, idades, estados civis, número de filhos, vínculos profissionais, religião, anos de serviço. Resultado: Profissionais médicos e aqueles com seis ou mais anos de serviço apresentaram menores escores em humanização no pré-treinamento. O treinamento gerou aumento dos escores de humanização em todas as categorias profissionais, mas médicos apresentaram maior aumento e se igualaram às outras categorias. Conclusão: Com um treinamento rápido e de baixo custo, verificou-se o aumento da autopercepção em humanização em médicos e não médicos. A diferença entre as categorias profissionais deixou de existir na avaliação realizada após 15 dias do treinamento. Os resultados indicam que médicos podem aumentar suas autopercepções sobre humanização e se igualar aos outros profissionais. Resumo Introdução isso Brasil humanidades iniciativas curriculares temática Objetivo Método Realizaramse Realizaram 13 Brasil. . (Brasil) dramatização 3 conhecimentos 1 Utilizaramse Utilizaram disso realizaramse realizaram gêneros idades civis filhos religião Resultado prétreinamento. prétreinamento pré pré-treinamento Conclusão custo verificouse verificou (Brasil

Abstract: Introduction: The medical category has been considered of little competence regarding the attributes related to humanization. As such, changes have been made in the course curriculums of undergraduate medical courses in Brazil and worldwide to expand the Humanities disciplines. In addition to these initiatives, humanization training is needed for doctors who graduated under the aegis of old curriculums and for those who - even though they graduated with the new curricular guidelines - still need to be updated on the subject. There are few quantitative studies about humanization training, especially for medical doctors. Objective: To evaluate the effects of humanization training on doctors in comparison with non-doctors. Method: Humanization trainings lasting 135 minutes were conducted for doctors and non-doctors in a psychiatric university hospital in São Paulo (Brazil). The classes were conducted with the use of slides and included discussions and a role-playing activity. The research subjects answered a questionnaire with 34 items assessing their self-perceptions about the knowledge, skills and attitudes in humanization before and 15 days after the training. Nonparametric tests were used to compare the scores between the group of doctors and non-doctors. Moreover, multiple linear regressions were performed for the knowledge, skills and attitude dimensions aiming to evaluate whether there was a significant difference between genders, age ranges, marital status, number of children, jobs, religion, years of service. Result: Medical professionals and those with six or more years of service had lower humanization scores at the pre-training moment. The training resulted in an increase in humanization scores in all professional categories, but physicians showed a greater increase and reached the same level as the other categories. Conclusion: A fast and low-cost training resulted in an increase in the self-perception of humanization in doctors and non-doctors. The difference between the professional categories ceased to exist in the evaluation carried out 15 days after the training. The results suggest that doctors can increase their self-perception about humanization and reach the same level as other professionals. Abstract Introduction such disciplines initiatives subject Objective nondoctors. nondoctors non Method 13 Brazil. . (Brazil) roleplaying role playing activity 3 selfperceptions self perceptions knowledge 1 Moreover genders ranges status children jobs religion Result pretraining pre moment Conclusion lowcost low cost selfperception perception (Brazil

https://doi.org/10.1590/1981-5271v47.2-2022075

Postmortem qualitative analysis of psychological, occupational, and environmental factors associated with lethal anesthetic and/or opioid abuse among anesthesiologists: case series
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Serebrenic, Flavia

; Carmona, Maria José Carvalho

; Cunha, Paulo Jannuzzi

; Malbergier, André

Brazilian Journal of Anesthesiology

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aug 2021, Volume 71 N. 4 Pages 317 - 325

Abstract: En | Text: En | PDF: En

Abstract Background Anesthetic and/or opioid abuse is more prevalent among anesthesiologists than in other medical specialties and it has been associated with high mortality. The aim of this study was to evaluate factors associated with lethal anesthetic and/or opioid abuse among anesthesiologists. Methods We evaluated psychological factors, and occupational history and circumstances of death of anesthesiologists who died from anesthetic abuse. Data were obtained post-mortem from colleagues, and relatives. After finding eligible cases, we identified the key informants, who were interviewed personally or via email, through the qualitative method known as “Psychological Autopsy”. Results Eighteen cases of death were identified, but we were able to interview 44% of them (n = 8), most of whom were young males. They died at home or at the hospital and were found “at the scene”. Being an introspective person who did not share personal issues at workplace was the most prevalent personal characteristic. At work, they seemed to perform very well their functions, but some presented subtle changes such as to staying more than usual at the workplace and/or neglecting some of their responsibilities. The main reported factors to explain their substance abuse were emotional problems including psychiatric, excessive hours of work, and other health factors. Conclusion This study identified that emotional disturbances, compulsive work, and general health problems were the more prominent factors involved with those deaths. Further, larger studies are needed to better understand how these factors could be early identified in order to timely prevent anesthetic and/or opioid abuse and several deaths among anesthesiologists.

https://doi.org/10.1016/j.bjane.2021.05.002 295 downloads

COMVC-19: A Program to protect healthcare workers’ mental health during the COVID-19 Pandemic. What we have learned
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Fukuti, Pedro

; Uchôa, Caroline Louise Mesquita

; Mazzoco, Marina Flaborea

; Cruz, Isabella D'Andrea Garcia da

; Echegaray, Mariana V.F.

; Humes, Eduardo de Castro

; Silveira, Júlia Belizário

; Santi, Talita Di

; Miguel, Euripedes Constantino

; Corchs, Felipe

; Fatori, Daniel

; Campello, Guilherme

; Oliveira, Gabriel M. de

; Argolo, Felipe C.

; Ferreira, Felipe de M.

; Machado, Gustavo

; Argeu, Adriana

; Oliveira, Graça Maria Ramos de

; Serafim, Antônio de Pádua

; Siqueira, Luciana de Lima

; Rossi, Luciane de

; Rios, Izabel Cristina

; Oliveira, Talita Rodrigues de

; Antoniazzi, Leilane C. K.

; Gagliotti, Daniel Augusto Mori

; Abelama Neto, Emílio

; Oliveira Junior, Paulo Novais de

; Correia, Aline Villalobo

; Gonçalves, Luca Schilling

; Tortato, Liana Silva

; Busato, Wagner Machado Moraes

; Guimarães-Fernandes, Flávio

; Alves, Marcos

; Leite Netto, Oswaldo Ferreira

; Schoueri, Patrícia de Campos Lindenberg

; Roque, Márcio de Assis

; Merlin, Silvia Stahl

; Boer, Giovana Cardoso Machado

; Sallet, Paulo Clemente

; Malbergier, André

; Spedo, Mariana Abrahão

; Kamitsuji, Carla Satie

; Faria, Elizabeth de

; Moreira, Moacyr Vergara de Godoy

; Kaufman, Arthur

; Abdo, Carmita

; Scanavino, Marco de Tubino

; Lancman, Selma

; Tavares, Hermano

; Polanczyk, Guilherme

; Brunoni, André R.

; Forlenza, Orestes V.

; Barros-Filho, Tarcísio Eloy Pessoa de

Clinics

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2021, Volume 76 elocation e2631

Abstract: En | Text: En | PDF: En

OBJECTIVE: In 2020, the COVID-19 pandemic brought a work and stress overload to healthcare workers, increasing their vulnerability to mental health impairments. In response, the authors created the COMVC-19 program. The program offered preventive actions and mental health treatment for the 22,000 workers of The Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP). This paper aims to describe its implementation and share what we have learned from this experience. METHODS: Workers were able to easily access the program through a 24/7 hotline. Additionally, a mobile phone app that screened for signs and symptoms of emotional distress and offered psychoeducation and/or referral to treatment was made available. Data from both these sources as well as any subsequent psychiatric evaluations were collected. RESULTS: The first 20 weeks of our project revealed that most participants were female, and part of the nursing staff working directly with COVID-19 patients. The most frequently reported symptoms were: anxiety, depression and sleep disturbances. The most common diagnoses were Adjustment, Anxiety, and Mood disorders. CONCLUSIONS: Implementing a mental health program in a multimodal intervention was feasible in a major quaternary public hospital. Our data also suggests that preventive actions should primarily be aimed at anxiety and depression symptoms, with a particular focus on the nursing staff.

https://doi.org/10.6061/clinics/2021/e2631

Investigating gender differences for effectiveness and side effects of varenicline during smoking cessation treatment
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Castellani, Verena

; Gonçalves, Priscila Dib

; Castaldelli-Maia, João Mauricio

; Malbergier, André

Revista da Associação Médica Brasileira

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feb 2020, Volume 66 N. 2 Pages 146 - 152

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO A vareniclina é uma opção farmacológica útil para a cessação do tabagismo. Infelizmente, há uma ausência de estudos sobre a eficácia, retenção e efeitos colaterais para este medicamento em países de baixa e média renda. O presente estudo teve como objetivo investigar diferenças entre gênero em relação a esses desfechos em uma amostra clínica brasileira (n = 124). O protocolo de tratamento de 12 semanas incluiu seis consultas com um psiquiatra e seis sessões de psicoterapia cognitivo-comportamental. Todos os indivíduos receberam vareniclina na primeira avaliação, seguindo a posologia padrão por 12 semanas e instrução para parar de fumar a partir da segunda semana de tratamento. Tanto o Mini-International Neuropsychiatric Interview (MINI) Plus quanto o Teste de Fagerstrom para Dependência de Nicotina foram aplicados no início do estudo. A escala de efeitos colaterais (UKU-Side Effects Rating Scale) foi aplicada nas semanas 3, 7 e 11, e o Questionário Breve de Fissura (Questionnaire of Smoking Urges-Brief) nas semanas 1, 5 e 9 para investigar os efeitos colaterais da medicação e fissura, respectivamente. No final do tratamento de 12 semanas, a abstinência foi avaliada bioquimicamente. Aos 6 e 12 meses após o tratamento, foram realizadas entrevistas telefônicas de acompanhamento para acessar a abstinência de nicotina. As taxas de abstinência e retenção de curto e longo prazo não diferiram entre gêneros. No entanto, as mulheres apresentaram mais efeitos colaterais do que os homens, principalmente na segunda metade do tratamento. Aumento da atividade dos sonhos, redução da duração do sono, constipação e perda de peso foram os efeitos colaterais mais notáveis. Apesar de as mulheres relatarem mais efeitos colaterais que os homens, essa diferença não influenciou as taxas de sucesso do tratamento. tabagismo Infelizmente eficácia renda n 124. 124 . 124) 1 cognitivocomportamental. cognitivocomportamental cognitivo comportamental. comportamental cognitivo-comportamental avaliação MiniInternational Mini International MINI (MINI UKUSide UKU Side Scale 3 11 Questionnaire UrgesBrief Urges Brief Urges-Brief fissura respectivamente bioquimicamente nicotina gêneros entanto homens sonhos sono notáveis

SUMMARY Varenicline is a useful pharmacological option for smoking cessation. Unfortunately, there is a lack of studies on its effectiveness, retention, and side effects in low- and middle-income countries. The present study aimed to investigate gender differences regarding these outcomes in a Brazilian clinical sample (n = 124). The 12-week treatment protocol included six consultations with a psychiatrist and six sessions of cognitive-behavioral therapy. All subjects received varenicline on the first evaluation, following the standard posology for 12 weeks and instructions to stop smoking after the second week of treatment. Both Mini-International Neuropsychiatric Interview (MINI) Plus and Fagerstrom Test for Nicotine Dependence were applied at baseline. The UKU-Side Effects Rating Scale was administered at weeks 3, 7, and 11, and the Questionnaire of Smoking Urges-Brief at weeks 1, 5, and 9 to ascertain the side effects of the medication and craving, respectively. At the end of the 12-week treatment, abstinence was biochemically assessed. At months 6 and 12 after the treatment, follow-up telephone interviews were conducted to access nicotine abstinence. Short- and long-term abstinence and retention rates did not differ between genders. However, women presented more side effects than men, especially in the second half of the treatment. Increased dream activity, reduced duration of sleep, constipation, and weight loss were the most notable side effects. Despite women reporting more side effects than men, this difference did not influence the treatment success rates. cessation Unfortunately effectiveness low middleincome middle income countries n 124. 124 . 124) 12week cognitivebehavioral cognitive behavioral therapy evaluation 1 MiniInternational Mini International MINI (MINI baseline UKUSide UKU Side 3 7 11 UrgesBrief Urges Brief 5 craving respectively assessed followup follow up Short longterm long term genders However men activity sleep constipation

https://doi.org/10.1590/1806-9282.66.2.146 754 downloads

Percepção dos profissionais de saúde mental sobre maconha
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Melo, Patrícia Cruz Furtado de

; Cardoso, Luciana Roberta Donola

; Malbergier, André

Jornal Brasileiro de Psiquiatria

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dec 2018, Volume 67 N. 4 Pages 247 - 254

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Objetivo A percepção sobre a maconha entre profissionais de saúde mental é desconhecida no Brasil. Este estudo teve como objetivo comparar padrões de percepções e de conhecimento sobre maconha entre profissionais da área da saúde mental em três instituições de diferentes perfis. Métodos Setenta profissionais (psiquiatras, psicólogos, assistentes sociais, terapeutas ocupacionais e enfermeiros) de três serviços da área de saúde mental – Hospital Nossa Senhora de Fátima (hospital filantrópico), CAPS-AD (Serviço público especializado no atendimento de álcool e drogas) e Instituto de Psiquiatria do Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (Serviço acadêmico e assistencial) – foram avaliados por meio de um questionário elaborado pelos pesquisadores, composto de 31 afirmativas. Resultados Psiquiatras tendem a discordar mais que os outros profissionais quanto à necessidade de tratamento para o uso de maconha e que a maconha traz prejuízos cognitivos. Os profissionais do Hospital Nossa Senhora de Fátima apresentaram percepção mais favorável à proibição de maconha e valorizaram mais os possíveis prejuízos associados ao uso quando comparados aos profissionais das outras duas instituições. Conclusões A percepção sobre a maconha entre servidores da saúde mental varia de acordo com a profissão e o local de trabalho.

ABSTRACT Objective The perception of marijuana among mental health professionals is unknown in Brazil. The aim of this study was to compare mental health professionals’ perception and knowledge standards about marijuana in three institutions with different profiles. Methods Seventy professionals (psychiatrists, psychologists, social workers, occupational therapists and nurses) from three mental health services – Nossa Senhora de Fátima Hospital (philanthropic hospital), CAPS-AD (public specialized service on treating drugs and alcohol dependents), and the Institute of Psychiatry at the Clinics Hospital, Medical School, University of São Paulo (academic and assistance service) were evaluated through a 31 affirmatives questionnaire created by researchers. Results Psychiatrists disagree more often than other health professionals on the need to treat marijuana users and on the idea that it causes cognitive damages. The professionals from Nossa Senhora de Fátima Hospital are more in favor of the prohibition of marijuana use and consider more the possible damages associated with its use, when compared to professionals from the other two institutions. Conclusions The perception of marijuana among mental health providers may vary according to their profession and work place.

https://doi.org/10.1590/0047-2085000000212 3463 downloads

The influence of depressive symptoms and substance use on adherence to antiretroviral therapy. A cross-sectional prevalence study
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Tufano, Claudia Siqueira

; Amaral, Ricardo Abrantes do

; Cardoso, Luciana Roberta Donola

; Malbergier, André

Sao Paulo Medical Journal

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jun 2015, Volume 133 N. 3 Pages 179 - 186

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

CONTEXTO E OBJETIVO:Adesão ao tratamento antirretroviral (TARV) não é uma condição estável, mas dinâmica, como os transtornos mentais. O objetivo deste estudo foi verificar se a não adesão ao TARV relaciona-se às variáveis demográficas e imunológicas, ao uso de substâncias e à presença de sintomas depressivos.DESENHO E LOCAL:Este estudo transversal de prevalência foi realizado em um serviço público para tratamento de pessoas HIV-positivas na cidade de São Paulo, Brasil, entre julho 2006 e janeiro 2007.MÉTODOS:438 pacientes em regime regular de TARV, que tinham exames laboratoriais recentes, responderam a questionário demográfico, questões sobre uso de substâncias, Escala de Hamilton para Depressão (HAM-D) e Questionário Simplificado de Adesão à Medicação (QSAM).RESULTADOS:A prevalência de não adesão nos últimos três meses (um padrão de interrupção de tratamento) foi de 46,3% e de 27,2% na última semana (um padrão de perda de doses). A interrupção do TARV relacionou-se significativamente a maior idade, menor contagem de células CD4+ e contágio homo/bissexual, enquanto o padrão de perda de doses relacionou-se significativamente com idade mais jovem, pontuação mais alta na HAM-D e maior carga viral de RNA HIV.CONCLUSÃO:A interrupção do TARV pode refletir erros de memória e mudanças nas características demográficas brasileiras da infecção por HIV. A perda de doses pode refletir aspectos de estilo de vida de indivíduos mais jovens. O atendimento de indivíduos HIV-positivos, particularmente os mais jovens, deve envolver intervenções e aconselhamento em relação à presença de sintomas depressivos.

CONTEXT AND OBJECTIVE:Adherence to antiretroviral treatment (ART) is not a stable condition, but is dynamic, like mental conditions. The aim of this study was to examine whether non-adherence to ART is related to demographic and immunological variables, substance use and presence of depressive symptoms.DESIGN AND SETTING:This was a cross-sectional prevalence study carried out at a public AIDS treatment center in the city of São Paulo, Brazil, between July 2006 and January 2007.METHODS:438 patients on regular ART schedules with recent laboratory tests answered a demographic questionnaire, questions about substance use, the Hamilton Depression Rating Scale (HDRS) and the Simplified Medication Adherence Questionnaire (SMAQ).RESULTS:The prevalence of non-adherence over the past three months (a pattern of treatment interruption) was 46.3%, and 27.2% also reported this in the past week (a pattern of missed doses). ART interruption was significantly related to older age, lower CD4+ cell count and homosexual/bisexual transmission. The pattern of missed doses was significantly related to younger age, higher HDRS scores and higher viral load of RNA HIV.CONCLUSION:ART interruption may reflect recall errors and changes to the Brazilian demographic characteristics of HIV infection. The missed doses may reflect lifestyle characteristics of younger individuals. Attendance for HIV-positive individuals, particularly younger patients, should involve interventions and counseling in relation to the presence of depressive symptoms.

https://doi.org/10.1590/1516-3180.2013.7450010 2599 downloads

Problemas escolares e o consumo de álcool e outras drogas entre adolescentes
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Cardoso, Luciana Roberta Donola

; Malbergier, André

Psicologia Escolar e Educacional

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jun 2014, Volume 18 N. 1 Pages 27 - 34

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

A relação entre problemas escolares e o uso de álcool, tabaco e drogas ilícitas em 965 adolescentes dos municípios de Jacareí e Diadema (SP) foi avaliada pelo instrumento de autopreenchimento Drug Use Screening Inventory. Este instrumento avalia o consumo de drogas e problemas a ele relacionados. O uso de substâncias foi associado a repetências, falta de concentração, notas baixas, desejo de abandonar a escola, sentir-se entediado no ambiente escolar, não fazer os deveres, faltar/chegar atrasado e prejuízos acadêmicos decorrentes do uso de drogas. A combinação do uso de álcool e tabaco foi associada a mais problemas escolares do que os encontrados em usuários exclusivos de álcool. Os problemas associados a esta combinação foram semelhantes aos observados em usuários de drogas ilícitas. Gostar da escola foi um fator protetor contra o uso de substâncias. Os resultados mostram a importância de se atentar para o relato de consumo das drogas lícitas combinadas.

The relationship between school problems and the use of alcohol, tobacco and illicit drugs in 965 adolescents in the towns of Jacareí and Diadema (SP) was assessed by us through the self-administered questionnaire DUSI - Drug Use Screening Inventory. This instrument helps assess drug use and related problems. Substance use was associated with , lack of concentration, poor performance, desire to drop out of school, feeling bored at school, ignoring homework, missing/ arriving late at school, and academic impairments resulting from the use of drugs. The combination of alcohol and tobacco was associated with more problems in school than those found in exclusive users of alcohol. The problems associated with this combination were similar to those observed in illicit drug users. Enjoying the school was a protective factor against substance use. The results show the importance of paying attention to the combined consumption of licit drugs.

Se evaluó la relación entre problemas escolares y el uso de alcohol, tabaco y drogas ilícitas en 965 adolescentes de las ciudades de Jacareí y Diadema (SP) con el instrumento de auto-reporte Drug Use Screening Inventor. Este instrumento evalúa el consumo de drogas y problemas que se relacionan con el mismo. El uso de sustancias se asoció a reprobación de cursos, falta de concentración, notas bajas, deseo de abandonar la escuela, sentir tedio en ambiente escolar, no hacer los deberes, faltar/llegar retrasado e perjuicios académicos resultados del uso de drogas. La combinación del uso de alcohol y tabaco se asoció a más problemas escolares de los encontrados en usuarios exclusivos de alcohol. Los problemas asociados a esa combinación fueron semejantes a los observados en usuarios de drogas ilícitas. Gustar de la escuela fue un factor protector contra el uso de sustancias. Los resultados muestran la importancia de prestarse atención al relato de consumo de drogas lícitas combinadas.

19906 downloads Cited 4 times in SciELO

Comorbid psychiatric disorders and stages of change in cannabis-dependent, treatment-seeking patients
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Oliveira, Hercilio P.

; Malbergier, Andre

Brazilian Journal of Psychiatry

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may 2014, Volume 36 N. 2 Pages 101 - 105

Abstract: En | Text: En | PDF: En

Objectives: To determine whether and to what extent cannabis dependence is associated with comorbid psychiatric disorders and specific stages of change in treatment-seeking patients. Methods: We evaluated 80 cannabis-dependent, treatment-seeking patients residing in an urban area. Data on cannabis dependence, psychiatric disorders, and motivation were obtained using the Schedules for Clinical Assessment in Neuropsychiatry and the University of Rhode Island Change Assessment (URICA). Results: A diagnosis of schizophrenia was found to correlate with lower motivation scores (p = 0.038), which could have a negative effect on adherence to treatment. Conclusion: The high prevalence of concurrent psychiatric disorders in cannabis-dependent patients should serve as a stimulus for early screening and treatment of such disorders. Health care professionals should be aware of the magnitude of this association to increase the level of motivation in cannabis-dependent patients with severe concurrent psychiatric disorders.

https://doi.org/10.1590/1516-4446-2013-1187 2747 downloads

10.

A influência dos amigos no consumo de drogas entre adolescentes
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Cardoso, Luciana Roberta Donola

; Malbergier, André

Estudos de Psicologia (Campinas)

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mar 2014, Volume 31 N. 1 Pages 65 - 74

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Objetivou-se avaliar a relação entre variáveis associadas aos amigos e o uso de álcool, tabaco e drogas ilícitas em 965 adolescentes de 50 escolas públicas de Jacareí e Diadema, São Paulo, Brasil. Foi utilizado o Drug Use Screening Inventory para a coleta de dados. Ter amigos que usam substâncias, que têm problemas com a lei, que roubaram/danificaram algo, que vendem drogas, que levam drogas a festas e que ficam entediados quando não bebem em festas aumentou progressivamente o risco de os adolescentes usarem álcool, tabaco e drogas ilícitas. Esse resultado mostra a importância de se avaliar o consumo dessas substâncias separadamente, já que o consumo concomitante de álcool e de tabaco parece ser mais grave do que o consumo isolado de um deles.

This study aimed to evaluate the relationship between the variables associated with friends and alcohol, tobacco, and illicit drug use in 965 adolescents from 50 public schools in Jacarei and Diadema, São Paulo, Brazil. The Drug Use Screening Inventory was used for data collection. Having friends who use substances, who are in trouble with the law, who have stolen/damaged something, who sell drugs, who take drugs to parties, and who get bored when they do not drink at parties progressively increased the risk of adolescents using alcohol, tobacco, both of them, and illicit drugs. This result shows the importance of evaluating the consumption of these substances separately, as the consumption of alcohol and tobacco together seems to be more hazardous than consuming them individually.

https://doi.org/10.1590/0103-166X2014000100007 24300 downloads Cited 1 time in SciELO

11.

Abuso de fármacos anestésicos pelos anestesiologistas
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Jungerman, Flavia Serebrenic

; Alves, Hamer Nastasy Palhares

; Carmona, Maria José Carvalho

; Conti, Nancy Brisola

; Malbergier, André

Revista Brasileira de Anestesiologia

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jun 2012, Volume 62 N. 3 Pages 380 - 386

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

JUSTIFICATIVA E OBJETIVOS: O uso de substâncias psicoativas é um pouco mais alto na classe médica comparado à população geral. Dentre as especialidades médicas, a Anestesiologia é uma das mais atingidas, principalmente por excesso de trabalho e maior acesso aos fármacos. O objetivo deste artigo é revisar a literatura sobre o assunto. Para isso, realizou-se uma pesquisa com as palavras-chaves relacionadas ao assunto no MEDLINE, com artigos dos últimos 30 anos. CONTEÚDO: Apesar da droga de maior abuso entre os anestesiologistas ser o álcool, o abuso de agentes anestésicos é o mais preocupante, devido ao alto potencial de dependência, bem como às suas consequências, muitas vezes letais. Os mais usados são os opioides (fentanil e sufentanil), o propofol e os anestésicos inalatórios. Os profissionais mais jovens são os mais afetados. As consequências do uso vão desde afastamento do local de trabalho até morte. A volta à sala de cirurgia parece levar a alto risco de recaída. Programas de tratamento especializado para a classe médica são propostos nos EUA e na Europa, bem como medidas preventivas, como rigidez no controle de fármacos e identificação dos profissionais sob maior risco de abuso. No Brasil, os anestesiologistas são a segunda especialidade que mais consomem substâncias, porém o assunto é pouco estudado e há uma carência de programas especializados na área. CONCLUSÕES: O abuso de substâncias entre os anestesiologistas é um assunto que necessita maior atenção, principalmente devido às consequências graves que este consumo pode acarretar tanto para o profissional como para os pacientes.

BACKGROUND AND OBJECTIVES: Physicians has a slightly higher rate of psychoactive substance use when compared to the population in general. Anesthesiology is one of the most affected medicine specialties, especially due to overwork and easier access to drugs. This paper aims to carry out a literature review on the topic. Therefore, research was conducted by searching topic-related keywords on papers from the last 30 years available on MEDLINE. CONTENT: Despite the fact that alcohol abuse is the most common among anesthesiologists, the abuse of anesthetic agents causes more concern, due to its high dependence potential and consequences, which are often fatal. The most widely used drugs are opioids (fentanyl and sufentanil), propofol and inhalational anesthetics. Young professionals are the most affected. Among the consequences of drug abuse are workplace absence and even death. The return to operating rooms seems to increase the risk of relapse. In Europe and in the USA there are specialized treatment programs for the middle class, as well as preventive measures, such as strict control of drugs and identification of professionals at high risk of abuse. In Brazil, Anesthesiology is the second medicine specialty with most drug addicts, but the topic has not been much studied and there are few specialized programs in the field. CONCLUSIONS: Substance abuse by anesthesiologists is an issue that needs to be discussed further, especially due to the possibility of severe consequences for professionals and patients.

JUSTIFICATIVA Y OBJETIVOS: El uso de sustancias psicoactivas es un poco más alto en la clase médica si lo comparamos con la población en general. Entre las especialidades médicas, la Anestesiología es una de las más afectadas, principalmente por el exceso de trabajo y la mayor facilidad en el acceso a los fármacos. El objetivo de este artículo, es revisar la literatura sobre el asunto. Para eso, se realizó una investigación con las palabras clave relacionadas con el asunto en el MEDLINE, con los artículos de los últimos 30 años. CONTENIDO: A pesar de que la droga de la que más se abusa entre los anestesiólogos sea el alcohol, el abuso de los agentes anestésicos es lo más preocupante, debido al alto potencial de dependencia como también a sus consecuencias, muchas veces letales. Los más usados son los opioides (fentanil y sulfentanil), el propofol y los anestésicos inhalatorios. Los profesionales más jóvenes son los más afectados. Las consecuencias del uso van desde el alejamiento del local de trabajo hasta la muerte. El regreso al quirófano parece llevar a un alto riesgo de recaída. Programas de tratamiento especializado para la clase médica han sido propuestos en USA y en Europa, como también algunas medidas preventivas, como la rigidez en el control de los fármacos y la identificación de los profesionales que tienen un mayor riesgo de abusar de las sustancias. En Brasil, los anestesiólogos son la segunda especialidad que más consume sustancias, sin embargo, el asunto es poco estudiado y hay una falta de programas especializados en esa área. CONCLUSIONES: El abuso de sustancias entre los anestesiólogos es un asunto que necesita más atención, principalmente debido a las graves consecuencias que ése consumo puede acarrear, tanto para el profesional, como para los pacientes.

23932 downloads

12.

Uso de substâncias na adolescência e problemas familiares
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Malbergier, André

; Cardoso, Luciana Roberta Donola

; Amaral, Ricardo Abrantes do

Cadernos de Saúde Pública

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apr 2012, Volume 28 N. 4 Pages 678 - 688

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Esta pesquisa visou a avaliar a associação entre o consumo de substâncias (álcool, tabaco e drogas ilícitas) e problemas familiares numa amostra de 965 adolescentes em 50 escolas públicas de dois municípios do Estado de São Paulo, Brasil, em 2007. Foi utilizado o Drug Use Screening Inventory (DUSI) para a coleta de dados. O uso de álcool, tabaco e drogas ilícitas foi associado à avaliação negativa da relação familiar, à falta de suporte/monitoramento e ao uso de substâncias por familiares (p < 0,05). Os estudantes que relataram ter feito uso de substâncias apresentaram mais problemas familiares do que aqueles que não consumiram nenhuma substância (p < 0,001). Os adolescentes que usaram álcool e tabaco (p = 0,028) e drogas ilícitas (p < 0,001) relataram ter mais problemas familiares do que aqueles que usaram apenas álcool. Os resultados apontam para a importância de se ficar atento ao consumo de álcool e tabaco entre os adolescentes, já que o relato do consumo das duas substâncias esteve associado a prejuízos familiares significativos, semelhantes ao uso de drogas ilícitas.

This study aimed to evaluate the association between substance use (alcohol, tobacco, and illicit drugs) and family problems among 965 adolescents from 50 public schools in two cities in São Paulo State, Brazil, in 2007. The Drug Use Screening Inventory (DUSI) was used for data collection. Use of alcohol, tobacco, and illicit drugs was associated with a negative assessment of the family relationship, lack of monitoring/support, and psychoactive substance use by family members (p < 0.05). Adolescents that reported having used alcohol, tobacco, and illicit drugs had more family problems than those who did not consume any substance (p < 0.001). Adolescents that used alcohol and tobacco (p = 0.028) and illicit drugs (p < 0.001) reported having more family problems than those who used only alcohol. The results highlight the importance of awareness of alcohol and tobacco use by adolescents, since such use was associated with significant family impairments, similar to illicit drug use.

7243 downloads Cited 18 times in SciELO

13.

Uso de substâncias na adolescência e problemas familiares
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Malbergier, André

; Cardoso, Luciana Roberta Donola

; Amaral, Ricardo Abrantes do

Cadernos de Saúde Pública

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apr 2012, Volume 28 N. 4 Pages 678 - 688

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

13622 downloads Cited 18 times in SciELO

14.

Gender parity and drug use: are girls catching up with boys?
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Malbergier, André

; Cardoso, Luciana Roberta Donola

; Amaral, Ricardo Abrantes do

; Santos, Verena Castellani Vitor

Brazilian Journal of Psychiatry

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mar 2012, Volume 34 N. 1 Pages 16 - 23

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

OBJETIVO: Avaliar as associações entre gênero e uso de álcool, tabaco e outras drogas em adolescentes de 10 a 18 anos dos municípios de Jacareí e Diadema (São Paulo, Brasil). MÉTODOS: O Drug Use Screening Inventory (DUSI) foi respondido por 971 adolescentes. RESULTADOS: Na nossa amostra, 55% eram do sexo masculino, 33,8% relataram ter feito uso de bebidas alcoólicas no último mês, 13,5% de cigarro e 6,4% de drogas ilícitas. Não foi encontrada diferença significativa quanto ao uso de álcool, tabaco e drogas ilícitas entre os gêneros em nenhuma das análises (p > 0,05). O uso de álcool, tabaco e drogas ilícitas foi associado a cidade, idade, grau de escolaridade, repetência escolar, e relacionamento com os pais (p < 0,05). CONCLUSÕES: O consumo entre os adolescentes nesta amostra parece acompanhar recente tendência mundial quanto à equiparação do uso de drogas entre os gêneros. Este resultado deve ser levado em conta pelos profissionais de saúde pública na elaboração de políticas para o problema.

OBJECTIVE: To evaluate the association between gender and use of alcohol, tobacco, and other drugs in adolescents aged 10 to 18 years in the municipalities of Jacareí and Diadema, São Paulo, Brazil. METHODS: A total of 971 adolescents completed the Drug Use Screening Inventory (DUSI). RESULTS: In our sample, 55% of adolescents were male, 33.8% reported having made use in the previous month of alcohol, 13.5% of cigarettes, and 6.4% of illicit drugs. There was no significant difference between genders in the use of alcohol, tobacco, and illicit drugs in any of the analysis (p > 0.05). The use of alcohol, tobacco, and illicit drugs was associated with the city, age, educational level, school failure, and relationship with parents (p < 0.05). CONCLUSIONS: Substance abuse among adolescents in our sample seems to follow the recent global trend towards the equalization of drug use between genders. This result should be taken into account by public health professionals in developing policies for this problem.

5397 downloads Cited 9 times in SciELO

15.

Beber e dirigir
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Amaral, Ricardo Abrantes do

; Malbergier, André

Archives of Clinical Psychiatry (São Paulo)

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2012, Volume 39 N. 6 Pages 210 - 210

Abstract: Pt | Text: Pt | PDF: Pt

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