A pioneering experience in Brazil: the creation of a support network for alcohol and drug dependent physicians. A preliminary report

Palhares-Alves, Hamer Nastasy; Laranjeira, Ronaldo; Nogueira-Martins, Luiz Antônio

doi:10.1590/s1516-44462006005000038

Cited by 10 publications

(13 citation statements)

References 12 publications

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“…These results are similar to those found in a clinical study conducted in Toronto, Canada, in which the Diagnostic Interview Schedule was used to make the diagnosis of comorbidities (68.4%) 11 and to another performed in São Paulo, Brazil, in which authors used the same assessment tool adopted in this study (67.7%) 10 . Furthermore, in the latter study, the frequencies of the following diagnoses were also similar to those found in the present study: depressive disorders (33.9%), anxiety disorders (11.5%), personality disorders (16.1%) and schizophrenia (2.6%).…”

Section: Frequency Of Diagnosis Of Cmbd Associated With CDsupporting

confidence: 88%

Comorbidities of mental and behavioral disorders in chemically dependent patients in different periods of abstinence

Costa

Oliveira

2012

J. bras. psiquiatr.

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objective: To assess the frequency of comorbidities of mental and behavioral disorders (CMBD) in psychoactive substance (PAS)-dependent patients with different periods of abstinence cared for at Alcohol and Other Drug Psychosocial Care Centers (CAPS-ad). Method: All patients under treatment in the two CAPS-ad of the city of Uberlândia-MG, between April and September 2010, were consecutively assessed. The ICD-10 symptom checklist was used to diagnose CMBD; additional information was obtained from interviews and medical records. The patients were divided according to duration of abstinence: < 1 week (Group 1); 1-4 weeks (Group 2); and > 4 weeks (Group 3). results: Of all patients assessed, 62.8% were diagnosed with CMBD, which were more frequent (p < 0.05) in Group 1 (72%) than Group 3 (54.2%), and both groups were similar to Group 2 (61%). Depressive and anxiety disorders were more frequent among patients of Group 1. Mood disorders were more frequent (p < 0.05) in women [22/34 (65%) vs. 54/154 (35.1%)], whereas psychotic disorders were more frequent (p = 0.05) in men [16/154 (10.4%) vs. 0]. The presence of CMBD was associated with more severe clinical conditions. conclusions: The higher frequency of diagnosis of CMBD in patients of Group 1 may have resulted from the difficulties in distinguishing mental disorders that are due to PAS intoxication or withdrawal from those that are not. However, to make the diagnosis of CMBD, even during detoxification, can increase the likelihood of better response to treatment. CTMC, utilizou-se o Checklist de sintomas da CID-10; informações adicionais foram obtidas em entrevistas e em prontuários. Os pacientes foram divididos de acordo com o tempo de abstinência: < 1 semana (Grupo 1), 1-4 semanas (Grupo 2) e > 4 semanas (Grupo 3). Palavras-chaveComorbidade, diagnóstico duplo (psiquiatria), dependência (psicologia), alcoolismo.

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Section: Frequency Of Diagnosis Of Cmbd Associated With CDsupporting

confidence: 88%

Comorbidities of mental and behavioral disorders in chemically dependent patients in different periods of abstinence

Costa

Oliveira

2012

J. bras. psiquiatr.

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“…Mean age was 42 years at referral, with delay of 7.5 years before seeking treatment. Two thirds (130) had both substance dependence and mental disorder, 1:5 (40) had only dependence, <10% (15) had mental disorder and <5% (8) reported ‘burnout’ . Half reported marital problems consequent from psychiatric disorders or chemical dependence.…”

Section: Potential Interventionmentioning

confidence: 99%

“…Two thirds (130) had both substance dependence and mental disorder, 1:5 (40) had only dependence, <10% (15) had mental disorder and <5% (8) reported 'burnout'. 26 Half reported marital problems consequent from psychiatric disorders or chemical dependence. Two thirds (122) had problems with professional activities and 1:3 (60) had previous psychiatric admissions.…”

Section: Potential Interventionmentioning

confidence: 99%

Mandatory notification of impaired doctors

Beran

2014

Internal Medicine Journal

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Mandatory reporting of impaired doctors is compulsory in Australasia. Australian Health Practitioner Regulation Agency guidelines for notification claim high benchmark though the Royal Australasian College of Surgeons and the Royal Australasian College of Physicians suggest they still obstruct doctors seeking help. Western Australia excludes mandatory reporting of practitioner-patients. This study examines reporting, consequences and international experiences with notification. Depressed doctors avoid diagnosis and treatment, fearing consequences, yet are more prone to marital problems, substance dependence and needing psychotherapy. South African research confirms isolation of impaired doctors and delayed seeking help with definable characteristics of those at risk. New Zealand data acknowledge: errors occur; questionable contribution from mandatory reporting; issues concerning competence assessment; favouring reporting to senior colleagues or self-intervention to compliance with mandatory reporting. UK found an anaesthetist guilty of professional misconduct for not reporting and sanctioned doctors regarding Harold Shipman. Australians are reluctant to report, fearing legalistic intrusion into care. Australian research confirmed definable characteristics for doctors with psychiatric illness or alcohol abuse. Exposure to legal medicine evokes personal disenchantment for doctors involved. Medicine poses barriers for impaired doctors. Spanish and UK doctors do not use general practitioners and may have suboptimal care. US and European doctors self-medicate using samples. US drug-dependent doctors also prescribe for spouses. Junior doctors are losing empathy with the profession. UK doctors favour private care, avoiding public scrutiny. NZ and Brazil created specific services for doctors, which appear effective. Mandatory reporting may be counterproductive requiring reappraisal.

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“…The project is aimed at reducing the physician's inability due to mental disorders and chemical dependence. It is a comprehensive program that includes drug therapy, psychotherapy and other kinds of therapies 54 . Brazilian studies also suggest that anesthesiologists are the most affected physicians (about 15% of the physicians treated are anesthesiologists, and they only represent 3% of the doctors).…”

Section: Treatmentmentioning

confidence: 99%

Abuso de fármacos anestésicos pelos anestesiologistas

Jungerman¹,

Alves²,

Carmona³

et al. 2012

Rev. Bras. Anestesiol.

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Summary: Jungerman FS, Palhares-Alves NH, Carmona MJC, Conti NB, Malbergier A -Anesthetic Drug Abuse by Anesthesiologists. 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.

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A pioneering experience in Brazil: the creation of a support network for alcohol and drug dependent physicians. A preliminary report

Cited by 10 publications

References 12 publications

Comorbidities of mental and behavioral disorders in chemically dependent patients in different periods of abstinence

Comorbidities of mental and behavioral disorders in chemically dependent patients in different periods of abstinence

Mandatory notification of impaired doctors

Abuso de fármacos anestésicos pelos anestesiologistas

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