Marcos Romano

Adaptação transcultural para o português da escala Adult Self-Report Scale para avaliação do transtorno de déficit de atenção/hiperatividade (TDAH) em adultos

The criteria listed in the fourth edition of the Diagnostic and Statistical Manual (DSM-IV) from the American Psychiatric Association are the most used ones for the diagnosis of Attention-Deficit Hyperactivity Disorder (ADHD) being based on field studies with children and adolescents. The Adult Self-Report Scale (ASRS, version 1.1) was developed to adapt those symptoms to an adult life context. The present study consisted of a transcultural adaptation of the original instrument in English into a final version to be used in Brazil. Results indicated a satisfactory equivalence between versions, with some modifications being done after debriefing, supporting the importance of this step in studies like this.

Álcool e adolescentes: estudo para implementar políticas municipais

OBJETIVO: Tracar um perfil de estudantes em relacao ao consumo de alcool e comportamentos de risco. METODOS: Participaram do estudo 1.990 alunos, com idade entre 11 e 21 anos, de ambos os sexos, matriculados em escolas publicas e privadas de Paulinia, SP, 2004. Um questionario de auto-preenchimento foi respondido em sala de aula, sem a presenca do professor. Analisou-se a percepcao da disponibilidade e facilidade de acesso as bebidas alcoolicas, contexto do beber e consequencias do consumo. RESULTADOS: A prevalencia de uso de alcool na vida foi de 62,2%. Em relacao aos ultimos 30 dias, 17,3% dos alunos relataram pelo menos um episodio de abuso agudo. Os adolescentes reportaram que adquiram facilmente bebidas alcoolicas de estabelecimentos comerciais e tambem em contextos sociais com parentes e amigos. Apenas 1% dos menores de idade relatou que tentou, mas nao conseguiu comprar bebida alcoolica. Como consequencias negativas do consumo nos ultimos 12 meses, os estudantes relataram ter passado mal por ter bebido (17,9%), arrependimento por algo que fizeram sob o efeito do alcool (11%), blackout (9,8%) e ter brigado apos beber (5%). Mais da metade (55%) dos estudantes conhecia alguem que sofreu acidente de trânsito provocado por motorista embriagado. CONCLUSOES: Os dados revelaram alta prevalencia de consumo de alcool entre os adolescentes estudados e facil acesso as bebidas alcoolicas, inclusive por menores de idade. Os jovens se colocaram em risco e apresentaram consequencias negativas do consumo de alcool. Ha necessidade de acoes imediatas em relacao as politicas publicas para o consumo de alcool no Brasil.

Consenso brasileiro sobre políticas públicas do álcool

This is the summary of a meeting where a group of experts, representing several health organizations and academic departements from different parts of Brazil, created a consensus about the main alcohol policies which should be implemented by different levels of the brazilian government. The World Health Organization has been suggesting for 30 years the actions that should be implemented for the public good. Two important conclusions were reached: 1) The research establishes beyond doubt that public health measures of proven effectiveness are available to serve the public good by reducing the widespread costs and pain related to alcohol use; 2) To that end, it is appropriate to deploy responses that influence both the total amount of alcohol consumed by a population and the high-risk contexts and drinking behaviours that are so often associated with alcohol-related problems. To conceive of these intrinsically complementary approaches as contractory alternatives would be a mistake. The objectives of the consensus are: 1) To make the scientific evidences more available to the Brazilian policy makers; 2) To facilitate the evaluation of the available estrategies according their effectivity, scientific support, cost and cultural adaptability; 3) To make the brazilian health professionais familiar with the priorities of alcohol policies.

Pesquisa de compra de bebidas alcoólicas por adolescentes em duas cidades do Estado de São Paulo

OBJECTIVE Alcohol use is a public health problem. Commercial availability is an important factor that encourages the use of alcohol by young people. The aim of the study was to assess how often young people under 18 could buy alcohol in shops METHODS Adolescents from 13 to 17 attempted to purchase alcoholic beverages at a random sample of shops in the cities of Paulinia (n=108) and Diadema (n=426), Southeastern Brazil. The study was conducted from November to December 2003 in Paulínia, and July 2004 to August 2005 in Diadema. They were told not to lie about their ages when asked and to say that the beverage was for themselves. Statistical tests performed were two-tailed and the significance level considered was p<0.05. RESULTS Adolescents, under the minimum legal age, were successful in purchasing alcoholic beverages in the first attempt in 85.2% of the surveyed outlets in Paulinia, and 82.4% in Diadema. The adolescents bought alcoholic beverages just as easy in all shops researched. CONCLUSIONS The data showed almost unanimous easiness of teenagers to obtain alcoholic beverages, suggesting the relevance of this problem in these cities (and probably in Brazil). The urge to adopt specific alcohol policies to this age group is highlighted, in order to reduce alcohol consumption.OBJETIVO: O consumo de alcool e um problema de saude publica. A disponibilidade comercial e um importante fator no estimulo ao consumo de alcool por adolescentes. O objetivo do estudo foi verificar com que frequencia menores de 18 anos conseguem comprar bebidas alcoolicas em estabelecimentos comerciais. METODOS: Adolescentes com idades entre 13 e 17 anos tentaram comprar bebidas alcoolicas em uma amostra aleatoria de estabelecimentos comerciais em Paulinia (N=108) e Diadema (N=426), no Estado de Sao Paulo. O estudo foi realizado em novembro e dezembro de 2003 em Paulinia e de julho de 2004 a agosto de 2005 em Diadema. Eles foram orientados a nao mentir sobre sua idade quando questionados e a dizer que a bebida era para consumo proprio. Os testes estatisticos realizados foram bi-caudais e o nivel de significância considerado foi de p<0,05. RESULTADOS: Adolescentes abaixo da idade minima legal conseguiram comprar bebidas alcoolicas em uma primeira tentativa em 85,2% dos locais testados em Paulinia e em 82,4% em Diadema. Os adolescentes compraram bebidas alcoolicas com a mesma facilidade em todos os estabelecimentos pesquisados. CONCLUSOES: Os dados mostraram uma quase unânime facilidade de obtencao de bebidas alcoolicas, sugerindo a relevância do problema nestas cidades (e provavelmente no Brasil). Ressalta-se a importância da adocao de politicas especificas para esta faixa etaria, no sentido de reduzir o consumo de alcool.

Diretrizes da Associação Brasileira de Estudos do Álcool e outras Drogas (ABEAD) para o diagnóstico e tratamento de comorbidades psiquiátricas e dependência de álcool e outras substâncias

Recently, 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.

Painel brasileiro de especialistas sobre diagnóstico do transtorno de déficit de atenção/hiperatividade (TDAH) em adultos

Present difficulties in the diagnosis of attention-deficit/hyperactivity disorder in adults have prompted Brazilian specialists involved in research in this area to make a consensus to be used in the country. A non-systematic preliminary review was repeatedly evaluated by all authors, who added new material, commented and corrected parts of the text for 6 months through electronic mail and a further meeting sponsored by the Brazilian Association of Attention-Deficit Disorder. The preliminary version was publicly presented during the annual congress of the Associacao Brasileira de Psiquiatria (Brazilian Association for Psychiatry) for appraisal and suggestions from participants in order to prepare the final version.Considerando-se as dificuldades atuais do diagnostico do transtorno do deficit de atencao/hiperatividade em adultos, foram reunidos especialistas brasileiros que fazem pesquisas nesta area, de modo a produzir diretrizes de consenso para uso no pais. Foi realizada uma revisao nao-sistematica preliminar e concebido um texto inicial, que foi repetidamente avaliado e editado pelos autores, com acrescimos e correcoes ao longo de 6 meses, atraves de correio eletronico e de uma reuniao posterior, patrocinada pela Associacao Brasileira do Deficit de Atencao. A versao preliminar foi apresentada publicamente durante o congresso anual da Associacao Brasileira de Psiquiatria, com comentarios e sugestoes dos participantes, para a redacao da versao final.

Co-ocorrência entre transtorno de déficit de atenção/hiperatividade e uso de substâncias psicoativas

Attention deficit/hyperactivity disorder (ADHD) is highly associated with substance use disorders (SUDs), both in clinical and community studies. Approximately 30% of subjects with SUDs present with comorbid ADHD, a prevalence rate significantly higher than that seen in the general population. The effect of ADHD on the development of SUDs have been subject to extensive studies. This article reviews the existing literature regarding: a) the nature of the association between ADHD and SUDs; b) the impact of ADHD on SUDs; c) the treatment of ADHD which co-occurs with SUDs. Finally an overview, from a predominantly clinical perspective, an integration of those data is proposed.

Brazilian consensus of specialists on the diagnosis of attention-deficit/hyperactivity disorder in adults

Present difficulties in the diagnosis of attention-deficit/hyperactivity disorder in adults have prompted Brazilian specialists involved in research in this area to make a consensus to be used in the country. A non-systematic preliminary review was repeatedly evaluated by all authors, who added new material, commented and corrected parts of the text for 6 months through electronic mail and a further meeting sponsored by the Brazilian Association of Attention-Deficit Disorder. The preliminary version was publicly presented during the annual congress of the Associacao Brasileira de Psiquiatria (Brazilian Association for Psychiatry) for appraisal and suggestions from participants in order to prepare the final version.Considerando-se as dificuldades atuais do diagnostico do transtorno do deficit de atencao/hiperatividade em adultos, foram reunidos especialistas brasileiros que fazem pesquisas nesta area, de modo a produzir diretrizes de consenso para uso no pais. Foi realizada uma revisao nao-sistematica preliminar e concebido um texto inicial, que foi repetidamente avaliado e editado pelos autores, com acrescimos e correcoes ao longo de 6 meses, atraves de correio eletronico e de uma reuniao posterior, patrocinada pela Associacao Brasileira do Deficit de Atencao. A versao preliminar foi apresentada publicamente durante o congresso anual da Associacao Brasileira de Psiquiatria, com comentarios e sugestoes dos participantes, para a redacao da versao final.

Manual Clínico do Transtorno do Déficit de Atenção/Hiperatividade

Universidade Federal de Sao Paulo (UNIFESP) Unidade de Pesquisa em Alcool e Drogas Ambulatorio de TDAH

Guidelines of the Brazilian Association of Studies on Alcohol and Other Drugs (ABEAD) for diagnosis and treatment of psychiatric comorbidity with alcohol and other substance and dependence

Abstract In recent years, several studies have been focused on the comorbidity of psychiatric disorders with alcohol and other substance dependence. In this context, the Brazilian Association of Studies on Alcohol and Other Drugs initiated a project to establish Brazilian Guidelines. The aim of this study was to review diagnostic and therapeutic criteria for the most prevalent psychiatric comorbidities. Randomized clinical trials, epidemiological studies, animal testing and other forms of research are reviewed herein. The main psychiatric comorbidities are investigated and data published in the literature are reviewed, based on guidelines adopted by other countries. Epidemiological aspects, diagnostic criteria, integrated treatment and the organization of specialized service, as well as details regarding psychotherapy and pharmacological treatment are discussed. The guidelines of the Brazilian Association of Studies on Alcohol and Other Drugs reinforce the importance of adequate diagnosis and treatment regarding alcoholic and drug dependent patients suffering of comorbid psychiatric disorders.