Cristina Lessa Horta

Perfil dos usuários de crack que buscam atendimento em Centros de Atenção Psicossocial

This paper describes the profile of 95 crack cocaine users attending three community mental health services (CAPS) in Greater Metropolitan Porto Alegre, Rio Grande do Sul State, Brazil, from August 2009 to March 2010. The instruments employed were questionnaires developed by the team, the Self-Reporting Questionnaire (SRQ-20), and inventories of criteria for dependence and abuse (SAMHSA). The data depict a group of users consisting predominantly of young males with elementary schooling, without regular employment but reporting individual income, none of whom living on the streets. They were currently addicted, with heavy daily use of crack for more than two years, and with high SRQ-20 score. This groups characteristics showed that the community mental health services are attended by crack users that suffer losses resulting from their addiction, but also some possible selection process in the supply of these health services (based mainly income, schooling, or primary support network).

Percepção de profissionais de saúde de CAPS I quanto a demandas relativas ao consumo de crack

Pesquisa qualitativa que analisa dois grupos focais realizados em 2009 com vinte trabalhadores de dois CAPS I da regiao de Porto Alegre, para verificar a sua percepcao diante do aumento de demandas que a expansao do crack tende a gerar sobre as redes locais de saude mental. Propos-se que debatessem o que lhes parecia fonte de sobrecarga e insatisfacao em geral e, especificamente, em funcao das demandas de usuarios de crack. Os resultados mostram forte preocupacao com a instabilidade dos contratos de trabalho, levando a falta de projecao no futuro. Alem disso, o acumulo de tarefas para suprir carencias das equipes, justificando-se o limitado interesse em planejar acoes de longo prazo e a opcao por tarefas menos complexas. Consideraram-se problemas na rotina de trabalho as ordens judiciais e a interferencia de agentes publicos, pedido expresso de hospitalizacao, familiares sem postura cooperativa, querelantes e usuarios desmotivados para o tratamento ou reingressando no servico. As equipes parecem estar no centro um conflito entre a impossibilidade de se evitar o surgimento de demandas da populacao usuaria das redes locais de saude, o que se evidencia no contexto do uso de crack, e os limites da gestao, ampliando o desgaste e a sobrecarga percebidos.This article analyzes different aspects of depression association with suicide among the elderly based on psychological autopsies. The retrospective method was used to study indeterminate deaths, based on interviews and reports, which analyze psychosocial circumstances related to suicide. The paper reveals the predominance of gender, social class and race - women, middle and upper class, white - and, in an unprecedented manner, contextualizes depression in a poorly studied population in Brazil and in the world with high risk of suicide. The physical and mental health, social circumstances and predominant biographical characteristics of the suicide victim were reconstructed in order to assess the impact of depression on suicide. Depression was presented in almost all cases, in primary or secondary diagnosis, as the symptom associated with other co-morbidities or as a reaction to social stressors, demanding different therapeutic approaches and procedures. The association between depression and multiple co-morbidity accentuates the case prognosis and cumulatively increases the risk of suicide. Depression followed by suicidal tendencies is a risk factor which justifies immediate preventive measures. Increasing assertive ways to diagnose and treat depression in old age is recommended.

Perception of health professionals from Psychosocial Care Centers (CAPS I) regarding the demands related to the use of crack

This paper presents qualitative research analyzing two focus groups with twenty workers in Psychosocial Care Centers (CAPS I) in Porto Alegre, southern Brazil, in 2009. They were invited to discuss overwork and dissatisfaction with work in general and also recent demands of crack cocaine users on the local mental health networks. Workers in both groups reported a strong concern about the instability of employment contracts, leading to limited ability to plan their futures. In addition, the accumulation of tasks to replace absenteeism in teams leads to a limited interest in long-term action planning and the option for less complex tasks. Court orders, the interference of public officials and requests of hospitalization, are considered unfavorable routine conditions in the perception of health workers, as well as uncooperative and quarrelsome family members and unmotivated users for resuming treatment. The teams seem to be the center of a conflict between the impossibility of avoiding the emergence of demands of crack users who apply to local health networks and the limits established by management, increasing dissatisfaction and perceived overwork.

Bullying e uso de substâncias psicoativas na adolescência: uma revisão sistemática

Resumo Bullying e uso de substâncias psicoativas sao fenomenos prevalentes entre adolescentes e apontados como problemas de saude que podem comprometer o desenvolvimento de todos os envolvidos. Esse estudo de revisao sistematica da literatura pretendeu identificar em que medida o envolvimento em situacoes de bullying e uso de substâncias psicoativas na adolescencia se associam, alem de verificar se ha diferencas em relacao ao papel social do bullying. A partir da busca de artigos empiricos publicados entre janeiro de 2009 e dezembro de 2014, em sete bases de dados eletronicas, foram identificados 585 registros. Aplicados os criterios de inclusao e de exclusao, restaram 40 estudos que foram analisados a partir do seu delineamento, caracteristicas da amostra e resultados obtidos sobre a relacao entre bullying e uso de substâncias psicoativas. A maioria dos estudos e de delineamento quantitativo transversal, com amostras mistas, de meninos e meninas, sendo a escola o local onde esses fenomenos tem sido preferencialmente estudados. Evidenciou-se associacao entre perpetracao de bullying e uso de substâncias para adolescentes de ambos os sexos. Em relacao a vitimizacao por bullying, nao foi possivel precisar a direcao e a caracterizacao da relacao com o uso de substâncias.Bullying and psychoactive substance abuse are prevalent phenomena among adolescents and identified as health problems that may jeopardise the development of all those involved. This systematic review of the literature aims to identify the extent to which involvement in bullying and psychoactive substance use during adolescence are associated, as well as check for differences regarding the social roles of bullying. From the search for empirical articles published between January 2009 and December 2014 in seven electronic databases, 585 records were identified. After the criteria for inclusion and exclusion were applied, the remaining 40 studies were analyzed based on the design, characteristics of the sample and results of the relationship between bullying and psychoactive substance use. Most studies are quantitative and cross-sectional, and they showed mixed samples of boys and girls in the school environment, which was the place where the phenomena are studied by preference. The association between the perpetration of bullying and psychoactive substance use for adolescents of both sexes is revealed. In relation to victimization by bullying, it was not possible to determine the direction and characterization of the relationship with psychoactive substance use.

Violence exposure and substance use among southern Brazilian schoolchildren

espanolEste estudio transversal con muestra probabilistica de 3.547 adolescentes, 54.2% ninas, media de edad 14 anos (SD=1.66), realizado en escuelas brasilenas del sur de Brasil, analizo la asociacion entre la exposicion a la violencia y el consumo de sustancias. El genero y la edad fueron controlados y la proporcion de la muestra fue asegurada. Una medida de autoinforme ha evaluado datos sociodemograficos, la violencia, el consumo de sustancias, trastornos psiquiatricos, rendimiento escolar, practicas parentales y la relacion de los jovenes con padres y profesores. Se realizo analisis descriptivo y la razon de prevalencia para el consumo de sustancias fue estimada por regresion de Poisson, precedida por el control para efecto de la variable escuela. El analisis fue ajustada por sexo y el consumo de alcohol y tabaco por los padres, asi como por los trastornos psiquiatricos. Asociaciones entre la exposicion a la violencia y el uso en el ano de todos las sustancias investigadas fueron encontradas: tabaco [PR=2.49 (IC 95%: 1.92 - 3.25) p EnglishCross-sectional study with probabilistic sample of 3,547 adolescents aged from 12 to 17 years old, 54.2% girls, from southern Brazilian schools that analysed the association between exposure to violence and substance use. Gender and age distribution in general population were controlled and sample proportions were assured. A self report measure was used to evaluate sociodemographic conditions, violence, substance use, psychiatric disorders, school performance, parental practices and relationship with parents and teachers. Descriptive analysis were hold, prevalence ratio for substance use were estimated by Poisson Regression, preceded by control for design effect by school variable. The analysis were adjusted by gender, alcohol and tobacco use by the parents and psychiatric disorders. Association between violence exposure and use in the year of all drugs investigated was found: tobacco [PR=2.49 (CI95%: 1.92-3.25) p