Depression during gestation in adolescent mothers interferes with neonatal neurobehavior

Objective: To compare the neurobehavior of neonates born to adolescent mothers with and without depression during gestation. Methods: This prospective cross-sectional study included healthy term neonates born to adolescent mothers with untreated depression during gestation, without exposure to legal or illicit drugs, and compared them with infants born to adolescent mothers without psychiatric disorders. Maternal psychiatric diagnoses were assessed by the Composite International Diagnostic Interview (CIDI 2.1) and neonatal neurobehavior by the Neonatal Intensive Care Unit Network Neurobehavioral Scale (NNNS) at 24 to 72 hours of life. Neurobehavioral outcomes were analyzed by ANOVA adjusted for confounders. Results: 37 infants born to mothers with depression during gestation were compared to 332 infants born to mothers without psychiatric disorders. Infants of mothers with depression had smaller head circumferences. Significant interactions of maternal depression and male gender, gestational age > 40 weeks, regional anesthesia during delivery, vaginal delivery, and infant head circumference ≥ 34 cm were found. Worse performance was noted in the following neonatal neurobehavioral parameters: arousal, excitability, lethargy, hypotonicity, and signs of stress and abstinence. Conclusion: Infants born to adolescent mothers with depression exhibit some behavioral changes in the first days of life. These changes are associated with infant sex, gestational age, type of anesthesia, mode of delivery, and head circumference.Universidade Federal de São Paulo (UNIFESP) - Escola Paulista de Medicina (UNIFESP-EPM) Department of Pediatrics Division of Neonatal MedicineUNIFESP and Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) National Science and Technology Institute for Policies on Alcohol and Drugs (INPAD)UNIFESP-EPM Research Unit on Alcohol and Other DrugsUNIFESP-EPM Department of PsychiatryUNIFESP, - Escola Paulista de Medicina (UNIFESP-EPM) Department of Pediatrics Division of Neonatal MedicineUNIFESP, and Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) National Science and Technology Institute for Policies on Alcohol and Drugs (INPAD)UNIFESP, EPM Research Unit on Alcohol and Other DrugsUNIFESP, EPM Department of PsychiatrySciEL

Uso de crack no Brasil e factores psicossociais que antecedem esta tomada de decisão

Introduction: Crack's consumption in Brazil grows and requires extensive discussion of the complexity of this phenomenon. Objective: To discuss the psychosocial factors that influence decision-making in consuming crack. Methodology: The present work used the literary information of books and scientific journals, made since January 2016, in the electronic bases of content SCIELO, LILACS and PUBMED through the key words crack, decision making, health policy in all indexes and sources, including only scientific articles published between 2007 and 2016 focusing on the legislative, cultural, economic, legal, clinical, psychiatric, illicit aspects and crack user identity. Results: There is no consensus in Brazilian legislation regarding the treatment for crack dependents; Crack users start to live with their own values and the consumption of the substance is most important than illegal aspects; Crack's market is self-regulating; Brazil does not have effective territorial control. Conclusion: It was concluded on the need to define what Brazilian society think about the consumption of psychoactive substance; control strengthening borders between Brazil, Bolivia, Peru and Colombia; to conduct intelligence activities between Brazil, Bolivia, Peru and Colombia in combating drug trafficking; and developing a national public health policy, geared specifically to crack user.Introdução: O consumo de crack cresce no Brasil e necessita de ampla discussão sobre a complexidade desse fenômeno. Objetivo: Discutir os fatores psicossociais que incidem na tomada de decisão em consumir crack. Metodologia: O presente trabalho utilizou informações literárias de livros e revistas científicas, realizado a partir de janeiro de 2016, nas bases eletrônicas de conteúdo SCIELO, LILACS e PUBMED através das palavras chaves crack, tomada de decisão, política de saúde em todos os índices e fontes, incluindo apenas artigos científicos publicados entre os anos 2007 e 2016 enfocando os aspectos legislativos, culturais, econômicos, jurídicos, clínicos, psiquiátricos, ilícitos e a identidade do usuário de crack. Resultados: Não há consenso na legislação brasileira no que tange ao tratamento para dependentes de crack; o usuário de crack passa a viver pautado em valores próprios e o consumo da substância se sobrepõe aos aspectos ilegais; o mercado do crack se autorregulamenta; o Brasil não possui efetivo controle territorial. Conclusão: Concluiu-se sobre a necessidade de se definir o que a sociedade brasileira pensa sobre o consumo de substância psicoativa; o reforço no controle das fronteiras entre Brasil, Bolívia, Peru e Colômbia; a realização de ações de inteligência entre Brasil, Bolívia, Peru e Colômbia no combate ao tráfico de drogas; e o desenvolvimento de uma política pública nacional de saúde, voltada especificamente ao usuário de crack

Brief report: Prevalence of psychiatric disorders in pregnant teenagers

Purpose: To evaluate the prevalence of ICD-10 psychiatric disorders in a population of pregnant teenage women from a Brazilian public hospital.Method: 1000 pregnant teenage women were evaluated using the Composite International Diagnostic Interview, a Structured interview which establishes diagnoses according to the International Classification of Diseases.Results: 325 of the 1000 patients were found to have at least one psychiatric disorder; 33.2% of them had a second psychiatric diagnosis. the most prevalent, disorders were depression (12.9%), post-traumatic stress disorder (10%), and tobacco dependence/harmful use (10.30%). the most prevalent co-morbidity was ICD-10 Affective Disorders versus Neurotic, Stress-related, and Somatoform Disorders. Substance-related disorders are significantly correlated with all of the ICD-10 psychiatric diagnoses but Psychotic Disorders.Conclusion: the prevalence of psychiatric disorders in this Population is high, and one third of them had co-morbidities, a condition usually associated with a more serious course of illness. This finding has important implications for clinical management and prognosis, and demands preventive public policies. (C) 2008 Published by Elsevier Ltd on behalf of the Association for Professionals in Services for Adolescents.Universidade Federal de São Paulo, Dept Psychiat, Alcohol & Drug Res Unit Uniad, BR-04023061 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Pediat, BR-04023061 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Psychiat, Alcohol & Drug Res Unit Uniad, BR-04023061 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Pediat, BR-04023061 São Paulo, BrazilWeb of Scienc

Prevalence of cocaine and marijuana use in the last trimester of adolescent pregnancy: Socio-demographic, psychosocial and behavioral characteristics

Objective: To evaluate the prevalence of cocaine and marijuana use during the third trimester of pregnancy in a population of 1000 teenage women of a public hospital in São Paulo, Brazil using hair analysis in order I to avoid underestimation of data that could happen by the use of self-report questionnaires and describe socio-demographic, psychosocial and behavioral characteristics of the drug users.Results: Hair analysis has detected use of cocaine and/or marijuana in the third trimester of pregnancy in 6% of the patients: 4.0% used marijuana, 1.7% used cocaine and 3% used both drugs. They were about 17 years old, from low-income, poorly educated, unemployed, financially dependent and they had not planned the pregnancy. 10% of miscarriages have occurred in this population.Conclusion: This study shows the psychosocial impairment associated to teenage pregnancy and use of cocaine and marijuana during gestation by this low-income population with reliable data of prevalence obtained through hair analysis. (c) 2006 Elsevier B.V. All rights reserved.Universidade Federal de São Paulo, Dept Psychiat, Alcohol & Drug Res Unit, BR-04023061 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Pediat, BR-04038001 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Psychiat, Alcohol & Drug Res Unit, BR-04023061 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Pediat, BR-04038001 São Paulo, BrazilWeb of Scienc

Family members affected by a relative's substance misuse looking for social support: Who are they?

Background: This study proposes to describe family members in the city of São Paulo who are seeking support in mutual self-help groups to deal with a substance misusing relative.Method: Five hundred participants (one participant per family) completed a structured questionnaire collecting socio-demographic information, length of time taken to seek help, and where they sought help. Participants were recruited from the mutual self-help group 'Amor Exigente' in the city of São Paulo, Brazil.Results: Parents of substance misusers counted as the largest group of family members. It took an average time of 3.7 years for the family members to discover their relatives' substance misuse. 42% had then sought help immediately; it took an average of 2.6 years for the remaining 58% of the sample to seek some form of support. A belief that the substance misuse of their relatives was just a transient problem or that they could cope with the situation by themselves were among the most indicated reasons for delay in seeking help.Discussion: Findings stress the importance of implementing services that take into account the difficulties families have in finding help to deal with the substance misusing relative. (C) 2014 Elsevier Ireland Ltd. All rights reserved.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Natl Inst Publ Policy Alcohol & Other Drugs, São Paulo, BrazilUniversidade Federal de São Paulo, São Paulo, BrazilUniv Roehampton, London, EnglandUniversidade Federal de São Paulo, São Paulo, BrazilCNPq: 573615/2008-0FAPESP: 08/57714-7 e 2011/50614-0Web of Scienc