C C C C C o n t e x t o o n t e x t o o n t e x t o o n t e x t o o n t e x t o: : :: : A dependência química tende a afetar a família como um todo. Filhos de dependentes químicos têm um risco aumentado para o desenvolvimento da dependência química, bem como para transtornos psiquiátricos, quando comparados com outras crianças.

OBJECTIVE:The aim of this study was to use the AUDIT and Fagerström questionnaires in a general hospital inpatient population to measure the frequency of problem drinking and nicotine dependence, and to see if levels varied between medical speciality. DESIGN:Retrospective cross-sectional study. SETTING:Federally funded public teaching hospital.SAMPLE: 275 inpatients from both genders. MAIN MEASUREMENTS:Socio-demographic data, AUDIT (Alcohol Use Disorders Identification Test) and Fagerström Test for Nicotine Dependence. RESULTS:We interviewed 275 inpatients, 49% of whom were men and 51% women. Thirty-four patients were identified as "cases" by the Audit questionnaire; 22% of the male patients and 3% of the females. Just over 21% of inpatients were current smokers. The gastroenterology (26%) and general medicine (16%) inpatient units had the largest number of individual cases. CONCLUSIONS:Only by knowing the prevalence of alcohol abuse/ dependence and nicotine dependence in a general hospital can we evaluate the need for a specialized liaison service to identify and treat these patients.KEY WORDS: AUDIT. Fagerström. Screening. Liaison psychiatry. Inpatients.• 140Research from other countries largely supports the finding that inpatients are more likely to have problems with alcohol. [9][10][11] The importance of identifying these patients lies in the possibility of providing some form of intervention aimed at reducing alcohol consumption and thereby reducing the risk that the patient will subsequently develop complications of alcohol misuse.Just how and by whom these patients should be identified is open to debate. Short screening instruments have the advantage that they do not take long to fill in and can be used with very little training by almost any health care professional. 12 The CAGE questionnaire is one of the most widely used alcohol screening instruments and has a high sensitivity and specificity for identifying patients with alcohol dependence. However, it has been criticized for not identifying people who are drinking heavily or who have alcohol-related problems but do not as yet show symptoms of alcohol dependence. Indeed it is these very patients who may benefit most from early therapeutic interventions. The AUDIT (Alcohol Use Disorder Identification Test) questionnaire was developed by WHO 13 as a screening instrument specifically designed to identify problem drinkers, as well as those who were already dependent on alcohol. It has a reported sensitivity of 92% and a specificity of 93%.14 Skipsey, et al. 15 found an excellent level of internal consistency in the identification of "hard" drinkers and alcohol dependence. When compared with the MAST (Michigan Alcoholism Screening Test), the AUDIT was considered superior, as the MAST failed to identify recent problems brought on by heavy alcohol consumption. The AUDIT has been found to be a very promising instrument for the identification of alcohol abuse and dependence among patients in diverse medical settings. [16][17][18] It is estimated that 30% of ...

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O estudo objetivou avaliar a prevalência de abuso físico e exposição à violência parental na infância, segundo características sócio-demográficas. Um procedimento de amostragem de múltiplos estágios foi usado para selecionar 3.007 indivíduos de 14 anos de idade ou mais, entre 2005/2006, incluindo sujeitos de todas as regiões do país, assim, os resultados são nacionalmente representativos. Foram acessadas experiências de abuso físico (bater, bater com alguma coisa, queimar/escaldar, ameaçar/usar faca ou arma) e exposição à violência parental (testemunhou ameaça e/ou agressão física parental) na infância. Realizaram-se as análises através do teste qui-quadrado de Pearson. A prevalência de história de abuso físico na infância foi de 44,1%, sendo que 33,8% relataram história de abuso físico moderado e 10,3% abuso físico severo. A prevalência de exposição à violência parental foi de 26,1%, sendo que 7,5% testemunharam violência parental moderada e 18,6% testemunharam violência parental severa na infância. Análises combinadas entre estes dois tipos de violência demonstraram significativas associações entre elas. Estes resultados podem ajudar na implementação de estratégias de intervenção alertando profissionais de saúde para alta prevalência deste tipo de violência na população.

Medir o nível de Qualidade de Vida e Desesperança em um grupo de mulheres residentes na periferia de São Paulo atendidas em um centro de intervenção e apoio que convivem com um dependente químico em seus lares. Participaram desta amostra 56 mulheres. A entrevista foi realizada individualmente no início do tratamento no serviço, sendo investigados os transtornos psiquiátricos na amostra, segundo critérios diagnósticos do CID-10. Os instrumentos de avaliação aplicados foram: entrevista para obtenção de dados demográficos; o levantamento do CCEB; WHOQOL-bref que mede Qualidade de Vida e BHS (Beck Hopelessness Scale) que mede nível de desesperança, acrescido de avaliação psiquiátrica. Foi constatado que 39% das mulheres apresentam desesperança mínima; 44% leve; 16% moderada/grave. Na Qualidade de Vida destacou-se o domínio Físico (x=14,45), seguido pelo domínio Social (x=13,26), Psicológico (x=12,57) e Meio Ambiente (x=10,68). No tocante aos transtornos psiquiátricos, 23% (n=13) apresentaram depressão e 5%(n=3) apresentaram transtorno de ansiedade. A maioria dos familiares possui nível de desesperança satisfatório, porém o grupo com desesperança moderada/grave desperta preocupações e demonstra a necessidade de intervenção, principalmente quando os dados são analisados com a presença de transtornos psiquiátricos.

Prevalence of substance use among trauma patients treated in a Brazilian emergency room Prevalência do uso de substâncias em pacientes com traumas em um pronto socorro brasileiro A b s t r a c t Objective: Although there is a considerable amount of data in the literature regarding the association between alcohol consumption and injuries treated in emergency rooms, little is known about the relationship between such injury and the use of other substances. The objective of this study was to estimate the prevalence of substance use in patients admitted to the emergency room for non-fatal injuries. Method: A prospective cross-sectional study assessing all patients admitted to the emergency room within 6 hours after a non-fatal injury was conducted over a three-month period. The following were used as measures of alcohol and drug use: a standardized World Health Organization questionnaire; a self-administered questionnaire related to drug consumption within the 24 hours preceding contact; the Drug Abuse Screening Test; urine screens for cannabis, cocaine and benzodiazepines; and determination of blood alcohol concentration. Descriptive analyses were performed and the confidence interval used was 95%. Results: A total of 353 patients were included. Cannabis and cocaine screens were conducted for 242 patients and benzodiazepine screens were conducted for 166. Blood alcohol concentrations reached the level of positivity in 11% (n = 39), and 10% (n = 33) presented some degree of intoxication. Among the 242 patients screened, 13.6% (n = 33) tested positive for cannabis, and 3.3% (n = 8) tested positive for cocaine, whereas 4.2% (n = 7) of the 166 patients screened tested positive for benzodiazepines. Conclusions: Substance use was highly prevalent among these individuals. In this sample, the frequency for the use of cannabis (an illicit drug) was comparable to that of alcohol. More studies are needed in order to characterize such use among Brazilians and to develop proper approaches to such cases, with the aim of reducing substance use and its consequences.

Background: Alcohol dependents seeking specialized alcohol treatment present modest rates of success in treatment programs. Alcohol dependents with gastrointestinal diseases present a worse prognostic and increased mortality rate compared with other non-alcoholic gastroenterology outpatients and the general population. Objective: To present the results of a study verifying outcomes of alcohol dependents following their treatment in one of two

This article aims is to conceptualize and describe the main steps in case management applied to the treatment of alcohol dependence. It is important to note the case manager functions, the importance of the first appointment, check the motivation to the treatment, some goals and activities suggestions for adherence reinforcement.