In December 2019, a new disease caused by a coronavirus was first identified in China and quickly spread across the world, causing a large number of deaths. Quarantine has been implemented in many countries as a measure to prevent the spread of the disease. The impact of this situation on drug use and mental health is still poorly understood. Therefore, this cross-sectional study sought to assess possible associations between quarantine, the use of psychoactive substances, and symptoms of depression and anxiety. The assessment instruments used were the Patient Health Questionnaire-9 (PHQ-9); the General Anxiety Disorder-7 (GAD-7) scale; and an adaptation of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). The sample consisted of 2398 participants who met the following inclusion criteria: being in quarantine, aged 18 years or older, and living in Brazil. There was a decrease in the frequency of use of practically all drugs investigated in the evaluated sample. However, some factors were associated with less variations in the frequency of substance use before and during quarantine. These factors were being male, single, and having an occupation different from homemaker.

Results confirm a relationship between mindfulness and insomnia among female chronic hypnotic users, specifically regarding the ability to observe and act with awareness. A higher score on the "observe" facet was positively correlated with insomnia. This may be because the skill of observing itself, isolated from other mindfulness precepts, does not provide sufficient strategies to cope with the observed discomfort. Increased "acting with awareness-autopilot" was negatively correlated with insomnia severity, arguably because it stimulates breaking automatic patterns of thoughts and behaviors that contribute to the perpetuation of the insomnia cycle.

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Objective: To evaluate dependence among chronic benzodiazepine and Z-drug users in Brazil. Methods: Chronic users of benzodiazepines (n=94), Z-drugs (n=74), or both (n=11) were recruited from the community, underwent a psychiatric evaluation and completed self-report instruments on hypnotic dependence, insomnia, anxiety, and depression. Users of benzodiazepines and Z-drugs were compared using t-tests, and logistic regression models were employed to explore significant predictors of a dependence diagnosis. Results: There was no difference in the prevalence of dependence among benzodiazepine (77.2%) and Z-drug (69.4%) users. Benzodiazepine users reported increased psychosocial aspects of dependence, anxiety, and depression. Preoccupation with the availability of medication (prevalence ratio ) and insomnia (PR = 1.10 [1.02-1.19]) were associated with a diagnosis of dependence (n=175). Conclusion:The prevalence of dependence was similar among both drug classes. The increased self-reported dependence, anxiety, and depression among benzodiazepine users may be due to behavioral rather than pharmacological aspects of medication use. Behaviors related to hypnotic use were important predictors of dependence.

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Objective: To assess psychometric properties of the Benzodiazepine Dependence Self-Report Questionnaire-Portuguese Version (BENDEP-SRQ-PV) in a sample of Brazilian chronic hypnotic users. Methods: One hundred and seventy-nine chronic hypnotic users (benzodiazepines and Z-drugs) were recruited, attended a psychiatric evaluation, and answered the BENDEP-SRQ-PV. Factor structure, reliability, and influence of covariates (dependence diagnosis and type of drug consumed) were assessed in a structural equation modelling environment. Discrimination was assessed with receiver operating characteristic (ROC) plots and stability with the test-retest method. Results: Participants, mostly women (91.6%), aged 51 to 64 years old, had been using hypnotics for an average of 34.8 months, with a mean defined daily dose of 0.72. Psychometric analysis demonstrated construct and criterion validity, reliability, and response stability. The factor structure was maintained as originally proposed: problematic use (ω = 0.73), preoccupation (ω = 0.74), lack of compliance (ω = 0.74), and withdrawal (ω = 0.93). Conclusion: The BENDEP-SRQ-PV is an adequate measure of hypnotic dependence in the Brazilian population of chronic users. Our results support using the scale for follow-up in clinical and research applications and in correlational studies.

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IntroductionDispositional mindfulness can be described as the mental ability to pay attention to the present moment, non-judgmentally. There is evidence of inverse relation between dispositional mindfulness and insomnia and substance use, but as of yet, no studies evaluating the specific association between dispositional mindfulness and the components of hypnotic use disorder.ObjectiveTo evaluate the association between dispositional mindfulness and the components of dependence among female chronic hypnotic users.Design and methodSeventy-six women, chronic users of hypnotics, who resorted to Mindfulness-Based Relapse Prevention for the cessation of hypnotic use were included in the study. The Five Facet Mindfulness Questionnaire (FFMQ) evaluated the levels and facets of mindfulness, and the subscales of the Benzodiazepine Dependence Questionnaire (BENDEP) assessed dependence on hypnotics. We also evaluated sociodemographic variables and symptoms of insomnia and anxiety. The associations between the FFMQ facets and the BENDEP subscales were evaluated with binomial logistic regression, adjusted for income, schooling, anxiety, and insomnia.ResultsWe observed associations between facets of the FFMQ and specific aspects of hypnotic dependence. The facet “observing” was inversely associated with the “concern about lack of availability of the hypnotic” [aOR = 0.87 95% CI (0.79–0.97)], and the facet “non-reacting to inner experience” with “noncompliance with the prescription recommendations” [aOR = 0.86 95% CI (0.75–0.99)]. The total score of the FFMQ was inversely associated to those two dependence subscales [aOR = 0.94 95% CI (0.89–0.99)]. “Observing” and “non-reactivity to inner experience” were also inversely associated with the “impairments related to the withdrawal symptoms” [aOR = 0.84 95% CI (0.73–0.97)] and [aOR = 0.78 95% CI (0.63–0.96)], respectively. The FFMQ was not associated with “awareness of problematic hypnotic use”.ConclusionDispositional mindfulness, specifically the facets “observing” and “non-reactivity to inner experience, were inversely associated with the components of hypnotic dependence related to the anticipation of having the substance, its expected effect, and the impairments caused by the abstinence. We discuss the implications of those results for the clinical practice and future investigations.