A b s t r a c tRecently, several studies have focused on comorbity psychiatric disorders with alcohol and other substance dependence. The Brazilian Association of Studies on Alcohol and Other Drugs proposed the Brazilian Guidelines project. This study review diagnostic and therapeutic criteria to the most prevalent psychiatric comorbidities. Randomized clinical trials, epidemiological, animal studies and other forms of research are reviewed. The main psychiatric comorbidities are studied based on guidelines adopted by other countries and the literature data resumed. Epidemiological aspects, diagnoses, integrated treatment and service organization, as well as specific psychotherapic and pharmacological treatment are discussed. The Brazilian Association of Studies on Alcohol and Other Drugs Guidelines reassures the importance of adequate diagnoses and treatment regarding alcoholic and drug dependent patients suffering of comorbid psychiatric disorders.

No abstract

No abstract

ResumoContexto: Considerando-se que o álcool possui um valor energético, ele tem a habilidade de suprimir as necessidades calóricas diárias de um indivíduo, e/ou levá-lo ao sobrepeso, dependendo da quantidade, freqüência e modo de consumo. Objetivos: Revisar o efeito do álcool no metabolismo energético e suas conseqüências no peso corporal. Métodos: Revisão bibliográfica realizada no sistema MEDLINE (Index Medicus) cruzando os descritores "alcohol" e "weight gain". Resultados: O álcool tem prioridade no metabolismo alterando outras vias metabólicas, incluindo a oxidação lipídica, o que favorece o estoque de gorduras no organismo. Dependendo da forma que ele é metabolizado, sua participação como fonte calórica é diferente. Conclusões: O valor energético dos alimentos adicionados ao consumo alcoólico e o patamar de consumo devem ser observados na relação de ganho de peso. Respostas ao consumo de álcool são diferentes de um indivíduo para o outro e são determinadas por fatores individuais e por possíveis fatores genéticos desconhecidos.Kachani, A.T. et al. / Rev. Psiq. Clín 35, supl 1; 21-24, 2008 Palavras-chaves: Álcool, metabolismo, energia, calorias. AbstractBackground: Due to alcohol's energy content, its intake can meet an individual's daily energy requirements, and/or lead to an individual becoming overweight based on amount, frequency, and pattern of consumption. Objectives: To review alcohol's effect on energy metabolism and its consequences for body weight. Methods: A review of literature was conducted in MEDLINE (Index Medicus), searching with the keywords "alcohol" and "weight gain". Results: Alcohol takes priority in metabolism and affects other metabolic pathways, including lipid oxidation, which facilitates fat accumulation in the body. Depending on the metabolic pathway activated, alcohol can play a different role as an energy source. Conclusions: The energy content of foods consumed together with alcohol and the level of consumption should be monitored to prevent weight gain. Individuals have varying responses to alcohol consumption which are determined by their specific characteristics and possibly by other unknown genetic factors as well.

ResumoA associação entre transtornos alimentares e dependência de substâncias é freqüente na prática clínica. Apesar de já existirem dados sugestivos de que essa associação possa sinalizar maior severidade nos distúrbios psiquiátricos e clínicos das pacientes, poucas pesquisas avaliaram sua influência no tratamento. Oitenta mulheres dependentes de álcool e drogas que procuraram tratamento em um programa exclusivo para mulheres foram avaliadas por meio da Entrevista Clínica Estruturada para o DSM-IV (SCID), do ASI, e de um questionário padronizado para a coleta de dados sociodemográficos e relativos ao uso de substâncias psicoativas. As 27 (33,75%) pacientes que tinham transtornos alimentares presentes (grupo com TA) foram comparadas com as 53 (66,25%) que não tinham essa comorbidade (grupo sem TA). Os resultados mostraram que o grupo com TA teve problemas com drogas de maneira mais precoce, era significativamente mais jovem e tinha maior severidade no uso destas que o grupo sem TA. As diferenças encontradas, bem como a alta prevalência dos transtornos alimentares não formais, enfatizam a importância de uma avaliação detalhada dos transtornos alimentares em pacientes dependentes de substâncias psicoativas que buscam tratamento. A fim de planejar abordagens terapêuticas efetivas, essas diferenças e, principalmente, a influên-cia da comorbidade entre transtornos alimentares e dependência de substâncias psicoativas no tratamento da dependência química precisam ser investigadas no futuro.Palavras-chave: Mulheres, dependência de substâncias psicoativas, transtornos alimentares, comorbidade.

No abstract

This study compared baseline demographics, clinical characteristics and patterns of substance use of 99 substance misusing women seeking treatment in a Brazilian hospital who had been diagnosed with drug dependence (alcohol dependence, if present, was not the most important) against 162 women diagnosed with alcohol dependence. Most of the drug-dependent women in this study were dependent on cocaine (73.7%). It was found that drug-dependent women, at entry, were younger, with a higher educational level, single or lived alone, and had a job outside home more often than alcoholics; they also had less alcohol-use related problems in the family and more relatives with problems with other drugs. They sought treatment mainly by self-initiative and reported more past suicide attempts than their alcoholic counterparts. In addition, they began drug use at the same age but increased drug use, as well as seeking treatment, significantly earlier. Alcoholics had more psychiatric comorbidity. The findings point out heterogeneity among chemically-dependent Brazilian women.

The Brazilian Language version showed suitable internal consistency and external validation, and was easy to understand. The results were similar to the original version and its use is recommended for evaluation of body checking in the Brazilian population in subjects with or without eating disorders.