Analysis of the psychometric properties of ASI-6 both in outpatients and inpatients in Brazil indicate a good reliability and validity of this instrument for the Brazilian culture. The development of this instrument in Brazil is an important advancement, which will certainly have implications for the prevention, clinical research, and social rehabilitation fields.

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.

Objective: To assess the characteristics of alcohol and drug users who seek treatment at the Brazilian Unified Health System in Brazil. Method: A multicenter cross-sectional study involving five clinical and research centers located in four Brazilian state capitals was conducted with 740 in-and outpatients. The only exclusion criterion was the presence of neurological or severe psychiatric symptoms at the moment of the interview. The Addiction Severity Index (ASI-6) and the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) were used to assess the severity of substance use and the problems related. Results: There were significantly more men than women in the sample; mean age was 36 years. The drug most frequently used at all sites was alcohol (78%), followed by cocaine/crack (51%). Alcohol was the drug that most commonly motivated treatment seeking, at all centers. ASI-6 Summary Scores for Recent Functioning (SS-Rs) were quite similar among centers. SS-Rs were compared between users who had never received treatment for psychoactive substance abuse (n = 265, 36.1%) and those who had already been treated at one or more occasions (n = 470, 63.9%). This analysis revealed significant differences between the groups in the drug, psychiatric symptoms, legal, and family/ social problems areas (p < 0.05). Conclusion: Our findings confirm previous evidence suggesting that the management of patients seeking drug abuse treatment should take several different aspects into consideration, e.g., education, employment, and family relationships, which often appear as areas of concern for these individuals. Keywords: Substance abuse, treatment, multicenter, alcohol, drugs, public health. ResumoObjetivo: Avaliar as características dos usuários de álcool e drogas que procuram tratamento no Sistema Único de Saúde. Método: Estudo transversal multicêntrico envolvendo cinco centros clínicos/de pesquisa localizados em quatro capitais brasileiras foi realizado com 740 pacientes hospitalizados e ambulatoriais. O único critério de exclusão foi a presença de sintomas neurológicos ou psiquiátricos graves no momento da entrevista. A Escala de Gravidade de Dependência (Addiction Severity Index, ASI-6) e o teste ASSIST (Alcohol, Smoking and Substance Involvement Screening Test) foram utilizados para avaliar a severidade do uso de substância e problemas relacionados. Resultados: Houve significativamente mais homens do que mulheres na amostra; a idade média foi de 36 anos. A droga mais usada em todos os centros foi o álcool (78%), seguido de cocaína/ crack (51%). O álcool foi a droga que mais motivou procura por tratamento, em todos os centros. Os Escores Resumidos da ASI-6 para Funcionamento Recente (SS-Rs) foram bastante similares nos centros. SS-Rs foram comparados entre usuários que nunca haviam recebido tratamento para abuso de substâncias (n = 265, 36,1%) e aqueles que já haviam sido tratados uma ou mais vezes (n = 470, 63,9%). Foram observadas diferenças significativas entre os grupos nas áreas de droga, sintomas psiq...

No abstract

The aim of this study was to evaluate the psychiatric comorbidities and different areas of life functioning in substance abusers with attention deficit hyperactivity disorder symptoms. A cross-sectional, multi-center study involving 285 adult substance abusers from outpatient and inpatient clinics was performed. The Adult ADHD Self-Report Scale, the sixth version of the Addiction Severity Index, and the Mini International Neuropsychiatry Interview were used for data collection. Individuals with comorbid attention deficit hyperactivity disorder and substance use disorders showed increased addiction severity when compared with individuals without attention deficit hyperactivity disorder (53.3 ± 7.3 vs. 48.4 ± 8.4, respectively). Our results suggest that comorbid attention deficit hyperactivity disorder and substance use disorders is associated with a more severe course of substance use and with social and psychiatric impairment.