Renata Brasil Araujo

Perfil do usuário de crack e fatores relacionados à criminalidade em unidade de internação para desintoxicação no Hospital Psiquiátrico São Pedro de Porto Alegre (RS)

INTRODUCTION: This cross-sectional study was carried out with 30 crack users admitted at the male detoxication ward at Hospital Psiquiatrico Sao Pedro, in Porto Alegre, Brazil, from March to December, 2007. The objective of the present study was to identify the sociodemographic and psychoactive consumption profile of crack users and presence of antisocial behavior, anxiety and depression symptoms in patients admitted at the male detoxication ward at Hospital Psiquiatrico Sao Pedro, in Porto Alegre, Brazil. METHOD: Thirty crack users participated in the study, and the instruments used were a 55-item sociodemographic questionnaire to evaluate psychoactive substance consumption and presence of criminal records, Mental State Mini Exam, Beck Anxiety Inventory, Beck Depression Inventory, Fagerstrom Test for Nicotine Dependence and Visual Analog Scales for Craving. RESULTS: The main results led to a population of Caucasian young adults, mean age of 27.3 years, underemployed or unemployed. Presence of criminal records was observed in 40% of the sample and was associated with greater craving (U = 58.00; p = 0.035), more anxiety symptoms (U = 56.50; p =0.028) and depression (U = 47.00; p = 0.009). CONCLUSIONS: Presence of criminal records was frequent for crack users and this variable was related to more anxiety, depression and craving. Studies of this kind can enhance knowledge of the study population, in order to design a more effective therapeutic plan for these patients.

Qualidade de vida e gravidade da dependência de tabaco

CONTEXTO: A qualidade de vida e um constructo que vem ganhando importância como uma forma de acessar o impacto tanto de uma patologia quanto de uma estrategia terapeutica na vida dos sujeitos. Este parâmetro tem sido pesquisado nas mais variadas areas, entre as quais o tabagismo. OBJETIVO: Avaliar a associacao entre a qualidade de vida e a gravidade da dependencia do tabaco. METODO: Foi realizado um estudo transversal, com uma amostra por conveniencia de 276 dependentes de tabaco da populacao geral, sem doencas tabaco-relacionadas. Os instrumentos utilizados foram: World Health Organization Quality of Life Instrument (WHOQOL-BREF), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Fagerstrom Test for Nicotine Dependence e ficha com dados sociodemograficos. RESULTADOS: Foi verificada associacao entre a gravidade da dependencia de tabaco e piores escores em todos os dominios da qualidade de vida, avaliada por WHOQOL-BREF, tendo sido esse resultado influenciado por sintomas de ansiedade e depressao. CONCLUSAO: Os tabagistas mais graves tem mais prejuizos na qualidade de vida, no entanto esse grupo e o que apresenta os escores mais elevados de sintomas depressivos e de ansiedade, sendo importante realizar mais estudos a esse respeito.

Craving e dependência química: conceito, avaliação e tratamento

O craving ou fissura, cuja definicao mais comum e o desejo intenso por uma substância, e um conceito controverso entre os pesquisadores da area da dependencia quimica. OBJETIVO: Realizar revisao teorica a respeito do craving nos bancos de dados PsycInfo, Medline, ProQuest e Science Direct. METODO: As palavras-chave utilizadas foram craving, dependence e drug e o periodo pesquisado foi entre 1995 e 2007. RESULTADOS: Os resultados demonstraram que sao encontrados diversos significados para o craving, alguns se restringindo a desejo, e outros, considerando-o nao so como desejo, mas como antecipacao do resultado positivo do uso da substância, alivio dos sintomas de abstinencia ou afeto negativo e intencao de fumar, o que reflete uma visao multidimensional deste construto. A etiologia do craving pode ser explicada por intermedio dos modelos: comportamental, cognitivo ou psicossocial e neurobiologico, porquanto a opcao por um destes influencia a avaliacao e o manejo. CONCLUSAO: Conclui-se quanto a multidimensionalidade do craving e quanto a necessidade de que seja utilizado um modelo biopsicossocial que integre os diversos modelos no tratamento de dependentes quimicos. Destaca-se a importância da realizacao de mais estudos para a compreensao do craving em funcao deste ser um dos principais riscos de recaida.Craving is usually defined as an intense desire for a substance. This is a rather controversial concept among the researchers on the chemical dependence area. OBJECTIVE: The objective of this study was to carry out a theoretical review concerning craving at PsycInfo, Medline, ProQuest, Portal Capes and Science Direct Data Bases. METHODS: The keywords used were craving, dependence and drug, and the searching period was between 1995 and 2007. RESULTS: The results showed that many different meanings can be found for craving, some relate it only to desire, while others consider it not only as desire, but also as the anticipation of the positive result from the use of the substance, the relief of abstinence symptoms or negative affect and intention to smoke, which reflects a multidimensional view of this construct. The ethimology of craving can be explained by the following Models: Behavioral, Cognitive or Psychosocial and Neurobiological, being the option for one of them a factor that influences evaluation and usage. CONCLUSION: As a conclusion, we are in favor of craving multidimensionality, as well as the need to use a Biopsychsocial Model that integrates the various models for treating chemical dependent patients. It is also necessary to highlight the importance of carrying out more studies in oder to understand craving, for it is one of the principal risks of relapse.

Estudo dos estágios motivacionais em sujeitos adultos dependentes do álcool

The general aim of this work was to trace the motivational stages of interned clients in specialized units, based on Prochaska and Diclementes Transtheorical Model. This work also examines if there is a correlation between the motivation stages of this group of alcohol-addicted patients and their level of drug dependence. The sample was composed of 120 alcoholics male patients, with dependence levels between moderate and critical. The instruments used were: Short-form Alcohol Dependence Data to identify the dependence level and the University of Rhode Island Change Assessment Questionnaire to evaluate the motivational stages. The results show positive and low-intensity correlation (r s = 0,197; p=0,031) between the level of drug dependence and the Maintenance stage. It is still under discussion the importance of the scales used in order discussion, in order to judge and choose better techniques to be adopted during the therapeutic process.

Validação da versão brasileira do Questionnaire of Smoking Urges-Brief

CONTEXTO: A avaliacao do craving (ou fissura) e muito importante no tratamento do tabagismo. OBJETIVO: O objetivo desta pesquisa foi validar a versao brasileira do Questionnaire of Smoking Urges-Brief (QSU-B). METODOS: O delineamento foi experimental, e seus participantes foram divididos, aleatoriamente, em grupos de zero, 30 e 60 minutos de abstinencia do tabaco. A amostra foi de 201 sujeitos (134 mulheres e 67 homens), entre 18 e 65 anos (M = 38,15), e os instrumentos aplicados, alem do QSU-B, foram: Ficha com Dados Sociodemograficos, Escala Analogico-Visual do Craving, Fagerstrom Test for Nicotine Dependence e Inventarios Beck de Ansiedade e de Depressao. RESULTADOS: A analise fatorial com dois fatores teve variância total de 78,46% e a correlacao entre esses fatores foi significativa e de alta intensidade (r = 0,636; p < 0,001). Todos os valores de alfa de Cronbach do QSU-B estavam acima de 0,70. Observou-se correlacao do total do QSU-B com a Escala Analogico-Visual (r = 0,656; p < 0,001) e com a questao 1 (r = 0,201; p = 0,004) e a 2 (r = 0,257; p < 0,001) de Fagerstrom. CONCLUSAO: A versao brasileira do QSU-B demonstrou ser adequada, psicometricamente, para o uso tanto em pesquisas como nos atendimentos aos dependentes de tabaco.

A validação brasileira do Questionnaire of Smoking Urges

This study was designed to validate the Brazilian version of the Questionnaire of Smoking Urges (QSU). The design was experimental, and participants were randomly distributed in groups of zero, 30, and 60 minutes of tobacco abstinence. The total sample was 201, with 67 males and 134 females, age ranging from 18 to 65 (M = 38.15). The instruments applied, besides QSU, were the Social and Demographic Data Form, Visual Analogue Scale to evaluate craving, Fagerström Test for Nicotine Dependence, and Beck Anxiety and Depression Inventories. Total variation in the two-factor factorial analysis was 57.76%, with a high inter-correlation (r = 0.726; p = 0.000). Factor 1 represented the anticipated relief of negative affect, nicotine abstinence symptoms, and urgent and overwhelming desire to smoke. Factor 2 represented the desire to smoke and the anticipation of smoking pleasure. Such results are contrary to those found in the original QSU. The Brazilian version proved to be an adequate and reliable instrument that can be used in both research and patient treatment.

Relação entre o craving por tabaco e o craving por crack em pacientes internados para desintoxicação

OBJECTIVE: Verify if there is a relationship between crack craving increase and tobacco craving increase in patients hospitalized for detoxification. METHOD: Quasi-experimental clinical trial using a quantitative analysis. Sample comprised 32 crack-cocaine and tobacco-dependent males, in 2 to 3 weeks of abstinence. A group intervention was conducted to which initially Cocaine Craving Questionnaire-Brief (CCQB), QSUB (Questionnaire of Smoking Urges-Brief) and BAI (Beck Anxiety Inventory) were applied. Next, crack related images were applied and CCQB, QSUB and BAI were reapplied. After that, an individual interview was conducted in which a form containing sociodemographic information and data related to the pattern of consumption of psychoactive substances (FSD) and Fagerstrom Test for Nicotine Dependence (FTND) were applied. RESULTS: Following the crack related images exposure, there was a significant increase of crack craving, tobacco craving and anxiety symptoms, being them positively correlated. CONCLUSION: Results show a significant association between crack craving and tobacco craving, suggesting that tobacco abstinence can help on effectiveness of cocaine dependence treatment.

Adaptação transcultural para o idioma português do Cocaine Craving Questionnaire - Brief

CONTEXTO: A avaliacao do craving (ou fissura) e muito importante no tratamento de dependentes de cocaina, sendo necessarias adaptacoes transculturais de escalas para aumentar a efetividade na avaliacao e no tratamento dessa clientela. OBJETIVO: O objetivo deste estudo foi traduzir, adaptar culturalmente e verificar a equivalencia semântica do Cocaine Craving Questionnaire - Brief (CCQ-Brief), o qual avalia o craving (fissura) por cocaina. METODO: O CCQ-Brief foi traduzido do ingles para o portugues, aplicado em 10 sujeitos e submetido ao brainstorming em um grupo de 4 sujeitos para reproducao individual e verbal, item a item. Realizou-se o backtranslation da primeira traducao e do brainstorming. Logo apos, traduziu-se novamente para o portugues. Todo o processo foi analisado por um comite de juizes especialistas, os quais emitiram pareceres com as observacoes pertinentes. RESULTADOS: Considerando-se os pareceres dos especialistas e um ultimo estudo piloto, construiu-se a versao final brasileira do CCQ-Brief e uma versao adaptada dessa escala para usuarios de crack. CONCLUSAO: Os resultados indicaram uma equivalencia semântica satisfatoria entre as versoes, podendo o CCQ-Brief ser util no tratamento de dependentes de cocaina.

WHOQOL-BREF psychometric properties in a sample of smokers

OBJECTIVE To study the World Health Organization Quality of Life Instrument Bref psychometric properties in a sample of smokers. It is a self-administered instrument to evaluate quality of life. It contains 26 questions allocated to 4 domains: Social, Psychological, Physical and Environmental, there are 2 questions related to the Global domain. METHOD The sample was formed by 276 tobacco users selected at random. The instruments applied were: World Health Organization Quality of Life Instrument Bref, Fagerström Test for Nicotine Dependence, and Medical Outcomes Study Short-Form 36-item. The statistical analysis was accomplished up by ANOVA, Cronbachs alpha, Pearsons Coefficient and Multiple Regression. RESULTS The World Health Organization Quality of Life Instrument Bref presented good reliability (Cronbachs alpha 0.9207), converging validation (0.382<r<0.753; p<0.001), discriminant validation and criterion validation (0.554<r<0.778; p<0.001). CONCLUSION The World Health Organization Quality of Life Instrument Bref proved to be an adequate instrument, with a good level of reliability, being easily and quickly administered.

O relaxamento respiratório no manejo do craving e dos sintomas de ansiedade em dependentes de crack

INTRODUCTION: The objective of this study was to verify the effectiveness of deep breathing in the management of craving and anxiety symptoms in crack-cocaine-dependent patients hospitalized for treatment in a detoxification unit. METHODS: This is a quasi-experimental clinical trial using a quantitative analysis. The convenience sample comprised 32 crack-cocaine-dependent males. These subjects had cocaine as their drug of choice, having used this substance between 2 and 3 weeks prior to the beginning of the treatment, and were able to adequately perform the deep breathing technique. The instruments used were: the Cocaine Craving Questionnaire-Brief (CCQB), the visual analogue scale (VAS), the Beck Anxiety Inventory (BAI), and a form containing sociodemographic information and data related to the pattern of consumption of psychoactive substances (SDF). A group intervention was conducted with the administration of the CCQB, the VAS, and the BAI. After that, images related to the use of crack-cocaine were shown to the subjects and the same instruments were administered again. Next, the participants performed the deep breathing technique for 10 minutes, and the instruments were administered one more time. Finally, an individual interview was done and the SDF was completed. RESULTS: Our findings demonstrated a decrease in the scores on the CCQB, the VAS and the BAI after the deep breathing technique was performed in a sample whose profile represents the general pattern of crack-cocaine users. CONCLUSION: In spite of some methodological limitations, the present study suggests that the deep breathing technique is effective in the management of craving and anxiety symptoms in crack-cocaine-dependent patients.