Prenatal tobacco exposure is related to neurobehavioral modifications in infants of adolescent mothers

INTRODUCTION: Prenatal tobacco exposure interferes with neonatal outcomes. OBJECTIVE: To determine the neonatal neurobehavioral effects of in utero tobacco exposure. METHODS: This prospective cross-sectional study included healthy, term, with birth weight appropriate for gestacional age neonates without exposure to alcohol, drugs, or infections, born to adolescent mothers without psychiatric disorders or post-traumatic stress. Infants were classified according to in utero tobacco exposure, as identified by the Composite International Diagnostic Interview administered to mothers. Neurobehavior was assessed by the Neonatal Intensive Care Unit Network Neurobehavioral Scale. Both tools were administered between 24 and 72 hours after birth. Neurobehavioral outcomes were compared between exposed and nonexposed infants by ANOVA. The associations between neurobehavioral scores and number of cigarettes smoked were studied by linear correlation. RESULTS: During the study, 928 newborns of adolescent mothers were born, and 388 were included in the study. Of these, 23 were exposed to tobacco, and 365 neonates were not exposed. There were no differences between the groups in gestational age, birth weight, post-natal age at the exam, or time between last feeding and exam. Exposed neonates showed higher scores on arousal (p = 0.004), excitability (p = 0.003), and stress/abstinence signals (p = 0.019) and a lower score on regulation (p = 0.025). After adjusting for the type of anesthesia, mode of delivery, gender, age at neurologic exam, exam duration and time between last feeding and exam, differences in arousal and excitability remained significant. The mean number of cigarettes consumed daily was positively correlated with lethargy (p = 0.013) and inversely with attention (p = 0.043). CONCLUSIONS: Neonates exposed in utero to tobacco showed worse neurobehavioral performance between 24 and 48 hours of life

Álcool e adolescentes: estudo para implementar políticas municipais

OBJECTIVE: To build students' profile regarding alcohol consumption and risk behavior. METHODS: A total of 1,990 students were included in the study, aged 11 to 21 years old, from both genders, enrolled in public and private schools, in Southeastern Brazil, in 2004. A self-administered questionnaire was answered in the classroom without the presence of the teacher. The questionnaire also assessed the perception of how easy it was to get alcoholic beverages, the contexts where they drunk, and the consequences of drinking. RESULTS: Prevalence of lifetime alcohol use was 62.2%. Regarding consumption in the last 30 days, 17.3% of students reported at least one episode of binge drinking (five or more drinks). Adolescents reported that they had gotten alcoholic drinks very easily from shops, and also in social contexts with relatives and friends. Only 1% of underaged reported that they had tried and could not buy alcoholic beverages. As negative consequences of alcohol use in the last 12 months, students reported feeling sick due to drinking (17.9%), regret for doing something under the influence of alcohol (11%), blackouts (9.8%), and getting involved in a fight after drinking (5%). Over half of the students (55%) reported knowing someone who had been involved in a car accident because of a drunk driver. CONCLUSIONS: Data showed high prevalence of alcohol use among adolescents studied and how easy access to alcoholic beverages is, including to underaged people. Youngsters put themselves at risk and presented negative consequences of alcohol consumption. Prompt actions regarding public alcohol policies in Brazil are needed.OBJETIVO: Traçar um perfil de estudantes em relação ao consumo de álcool e comportamentos de risco. MÉTODOS: Participaram do estudo 1.990 alunos, com idade entre 11 e 21 anos, de ambos os sexos, matriculados em escolas públicas e privadas de Paulínia, SP, 2004. Um questionário de auto-preenchimento foi respondido em sala de aula, sem a presença do professor. Analisou-se a percepção da disponibilidade e facilidade de acesso às bebidas alcoólicas, contexto do beber e conseqüências do consumo. RESULTADOS: A prevalência de uso de álcool na vida foi de 62,2%. Em relação aos últimos 30 dias, 17,3% dos alunos relataram pelo menos um episódio de abuso agudo. Os adolescentes reportaram que adquiram facilmente bebidas alcoólicas de estabelecimentos comerciais e também em contextos sociais com parentes e amigos. Apenas 1% dos menores de idade relatou que tentou, mas não conseguiu comprar bebida alcoólica. Como conseqüências negativas do consumo nos últimos 12 meses, os estudantes relataram ter passado mal por ter bebido (17,9%), arrependimento por algo que fizeram sob o efeito do álcool (11%), blackout (9,8%) e ter brigado após beber (5%). Mais da metade (55%) dos estudantes conhecia alguém que sofreu acidente de trânsito provocado por motorista embriagado. CONCLUSÕES: Os dados revelaram alta prevalência de consumo de álcool entre os adolescentes estudados e fácil acesso às bebidas alcoólicas, inclusive por menores de idade. Os jovens se colocaram em risco e apresentaram conseqüências negativas do consumo de álcool. Há necessidade de ações imediatas em relação às políticas públicas para o consumo de álcool no Brasil

Amphetamine-type stimulant use and conditional paths of consumption: data from the Second Brazilian National Alcohol and Drugs Survey

Objective: The aim of this study was to estimate nationally representative prevalence rates of amphetamine-type stimulant (ATS) use and to identify consumption-associated factors, proposing a conditional model of direct and indirect consumption paths. Method: Using data from the Second Brazilian National Alcohol and Drugs Survey, this cross-sectional study analyzed a subsample of 3,828 participants between 15 and 64 years old, gathering information on the use of psychoactive substances in a probabilistic sample of the Brazilian household population. Results: Rates of lifetime and last-year ATS use were, respectively, 4.1 and 1.6%. Economically privileged individuals and users of other substances were more at risk for using ATS. The results suggest that higher education decreases the chances of ATS consumption. The conditional model showed that higher income increased ATS use, higher education lowered the odds of such an increase, and cocaine use cancelled that associative effect. Conclusion: Brazil presents high rates of ATS use. Prevention and treatment strategies should focus on the protective effect of higher education levels and should target polydrug use. Knowledge of ATS-associated factors and user profiles is the starting point for developing effective treatments and tailored prevention strategies.Conselho Nacional de Desenvolvimento Cientifico e TecnologicoCoordenacao de Aperfeicoamento de Pessoal de Nivel SuperiorInst Nacl Ciencia & Tecnol Polit Publ Alcool & Ou, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, UNIFESP, Dept Psiquiatria, Sao Paulo, SP, BrazilPrevent Res Ctr, Oakland, CA USAUniv Fed Sao Paulo, UNIFESP, Dept Psiquiatria, Sao Paulo, SP, BrazilCNPqCAPESWeb of Scienc

Depressive symptoms and alcohol correlates among Brazilians aged 14 years and older: a cross-sectional study

Background: the associations between depressive symptoms and alcohol-related disorders, drinking patterns and other characteristics of alcohol use are important public health issues worldwide. This study aims to study these associations in an upper middle-income country, Brazil, and search for related socio-demographic correlations in men and women.Methods: A cross-sectional study was conducted between November 2005 and April 2006. the sample of 3,007 participants, selected using a multistage probabilistic sampling method, represents the Brazilian population aged 14 and older. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale and alcohol dependence was assessed using the Composite International Diagnostic Interview. Associations assessed using bi-variate analysis were tested using Rao-Scott measures. Gender specific multinomial logistic regression models were developed.Results: Among the participants with alcohol dependence, 46% had depressive symptoms (17.2% mild/moderate and 28.8% major/severe; p < 0.01); 35.8% (p = 0.08) of those with alcohol abuse and 23.9% (p < 0.01) of those with a binge-drinking pattern also had depressive symptoms. Alcohol abstainers and infrequent drinkers had the highest prevalence of major/severe depressive symptoms, whereas frequent heavy drinkers had the lowest prevalence of major/severe depressive symptoms. in women, alcohol dependence and the presence of one or more problems related to alcohol consumption were associated with higher risks of major/severe depressive symptoms. Among men, alcohol dependence and being = 45 years old were associated with higher risks of major/severe depressive symptoms.Conclusions: in Brazil, the prevalence of depressive symptoms is strongly related to alcohol dependence; the strongest association was between major/severe depressive symptoms and alcohol dependence in women. This survey supports the possible association of biopsychosocial distress, alcohol consumption and the prevalence of depressive symptoms in Brazil. Investing in education, social programs, and care for those with alcohol dependence and major/severe depressive symptoms, especially for such women, and the development of alcohol prevention policies may be components of a strategic plan to reduce the prevalence of depression and alcohol problems in Brazil. Such a plan may also promote the socio-economic development of Brazil and other middle-income countries.Universidade Federal de São Paulo UNIFESP, Department Psychiat, BR-15085420 Sao Jos Rio Preto, SP, BrazilUniv São Paulo FMRP, Ribeirao Preto Med Sch, Dept Social Med, BR-14049900 Ribeirao Preto, SP, BrazilUniv Fed Santa Catarina, Ctr Ciencias Saude, Dept Clin Med, BR-88040900 Florianopolis, SC, BrazilUniv Texas Dallas, Dallas Reg Campus, Sch Publ Hlth, Dallas, TX 75390 USAUniv São Paulo, FMRP USP, Ribeirao Preto Med Sch, Dept Neurosci & Behav, BR-14048900 Ribeirao Preto, SP, BrazilINCT Translat Med, São Paulo, BrazilUniversidade Federal de São Paulo UNIFESP, Department Psychiat, BR-15085420 Sao Jos Rio Preto, SP, BrazilWeb of Scienc

Measuring stress, coping, strain and hopefulness of Brazilian family members of substance misusers:Factor structure of a set of measures

Objectives: We evaluated the psychometric properties of the Brazilian version of a set of measures designed to assess four psychological constructs associated with having a substance misusing relative in the family: the Family Member Impact (FMI), the Symptom Rating Test (SRT), the Coping Questionnaire (COPE) Hopefulness-hopelessness scale (HOPE). Methods: Secondary data from 3056 affected family members (AFMs) was analyzed. Factor structure of the measures and group invariance across gender were assessed using confirmatory factor analysis. Results: The Brazilian version of COPE showed that a four-factor model with 24 items fit the data better than the original three-factor model with 30 items. The FMI measure showed that a three-factor model is more appropriated to the Brazilian version of the scale than the original two-factor model. HOPE and SRT (29 items) Brazilian’s version had the same two-factor model structure. This set of measures presented full measurement and structural invariance for both male and female. Conclusions: Findings provide support for the structural validity of the Brazilian version of a set of standard measures for the assessment of stress, coping, strain and hopefulness of AFMs by their relatives’ substance misuse. As this is the first study to explore the factorial model of the measures, it provides further support for the use of these instruments for future studies aiming to explore means on supporting AFMs in Brazil and elsewhere.</p