Emotional and Behavioral Problems in Children Living With Addicted Family Members: Prevention Challenges in an Underprivileged Suburban Community

Los niños que viven con consumidores de drogas son más propensos a tener problemas. Nuestro objetivo fue comparar, a partir de los informes de los cuidadores en el Child Behavior Checklist (CBCL) y en una hoja de datos sociodemográficos y de factores de riesgo, aspectos psicológicos de niños expuestos al abuso de sustancias, con y sin la asistencia de un programa de intervención preventiva en una comunidad desfavorecida. Este estudio de intervención observacional fue realizado con 66 cuidadores de niños que pasaron por la intervención y 35 de la misma comunidad que no fueron atendidos. Las idades oscilaran entre seis y 11 años. Las pruebas de chi-cuadrado y regresión logística indicaron que los niños expuestos al abuso de sustancias tenían más problemas de salud mental en comparación con la población general y que aquellos que no participan del programa de prevención tuvieron peores resultados, con una puntuación más alta de problemas emocionales y de conducta y una mayor exposición al riesgo. Se sugiere que las acciones preventivas puedan contribuir a la promoción de la salud mental en los niños en situación de riesgo y se valida la necesidad de políticas y servicios públicos.Children living with substance abusers are more likely to experience negative outcomes. Our goal was to compare caregivers' reports on the Child Behavior Checklist (CBCL) and a socioeconomic and risk form of psychological aspects of children exposed to substance abuse assisted versus not assisted by a preventive intervention program in an underprivileged community. This observational intervention study was conducted with 66 caregivers of children who attended the program and 35 caregivers of children from the same community who did not attend. Ages ranged between six and 11 years old. Chi-square and logistic regression tests indicate that children exposed to substance abusers have more mental health problems than the general population and those who did not participate in the preventive intervention program presented worse outcomes, with higher rates of behavioral/emotional problems and exposure to risk situations. Results suggest that preventive actions might be helpful to promote the mental health of children at risk, validating the need for public policies and services.Crianças que convivem com usuários de substâncias psicoativas são mais propensas a apresentar problemas. O objetivo deste estudo foi comparar, a partir dos relatos dos cuidadores no Child Behavior Checklist (CBCL) e numa ficha de dados sociodemográficos e de fatores de risco, aspectos psicológicos de crianças expostas ao abuso de substâncias assistidas e não assistidas por um programa de intervenção preventiva, em uma comunidade desfavorecida. O estudo observacional de intervenção foi conduzido com 66 cuidadores de crianças que passaram pela intervenção e 35 da mesma comunidade que não foram atendidas. A faixa etária era de seis a 11 anos. Os testes qui-quadrado e regressão logística indicaram que as crianças expostas ao abuso de substâncias apresentaram mais problemas de saúde mental do que a população geral e que aquelas que não participaram do programa preventivo apresentaram desfechos piores, com escores mais elevados de problemas emocionais/comportamentais e maior exposição a situações de risco. Sugere-se que ações preventivas podem contribuir para a promoção de saúde mental em crianças em situação de risco, validando a necessidade de políticas e serviços públicos

Children of substance abusers: psychosocial profile of children and adolescents

Introduction: Psychoactive substance abuse problems in the family have an impact on the development of children and adolescents. This risk conditions can harm mental health and hinder healthy development in psychosocial areas. Objectives: This study investigated the psychosocial profile of children and adolescents assisted in a prevention service center for children of substance abusers in a deprived community located in the outskirts of Sao Paulo. Methods: Exploratory and descriptive study, based on cross-sectional methodology and a convenience sample of 791 children and adolescents assisted at the Intervention and Support Center for Children of Substance Abusers - CUIDA between January 2001 and December 2008. The sample was divided into groups according to discharge status: Active, Therapeutic Discharge (TD), Abandonment, Without Information about the Reason for Leaving and With Information about the Length of Treatment (WIRL), Without Information (WI), and Other Reasons for Leaving (OR). Results: In the Active group, 26% of mothers had completed high-school and 11% belonged to the A/B socioeconomic classes. The TD group showed the highest percentages of wage earning parents (52%) living together (64%). In the WIRL group, 17% of the mothers were illiterate or had not completed primary education, and 23% of the fathers were unemployed. In the WI group, 22% lived in houses that had been lent to them. Conclusions: Results indicate the impact of addiction and underprivileged conditions (such as housing status, fathers’ level of education, and socioeconomic status) on retention in the service and the importance of health prevention and promotion strategies aimed at this population

Triagem e intervenção breve em pacientes alcoolizados atendidos na emergência: perspectivas e desafios Screening and brief intervention for alcoholic patients treated at emergency rooms: prospects and challenges

Este artigo tem como objetivo apresentar os princípios gerais, conceitos e principais elementos da intervenção breve, com uma revisão da literatura sobre sua aplicação em pacientes alcoolizados atendidos na emergência. Aborda a aplicabilidade da triagem como primeiro passo para o processo da intervenção breve e a utilização de instrumentos padronizados e validados que proporcionam informações úteis para um feedback consistente. Finalmente, destaca os desafios associados com a triagem nas salas de emergência como falta de tempo, formação inadequada dos profissionais, medo de incomodar o paciente e crença de que os alcoolistas não respondem às intervenções. Enfatiza-se, contudo, a importância da Intervenção Breve na emergência, que é viável e eficaz e a necessidade de pesquisas para determinar os ajustamentos dos profissionais e dos serviços de saúde.<br>The purpose of this article was to present the general principles, concepts, and main elements of brief intervention, with a literature review on its use for alcoholic patients treated at emergency rooms. It also presents the applicability of screening as a first step to the brief intervention process and the use of validated standard instruments that allow useful information for consistent feedback. Finally, it highlights the challenges associated with screening in emergency rooms due to insufficient time, inadequate professional training, fear of annoying the patient, and common beliefs that alcoholics do not respond to such interventions. Meanwhile, it emphasizes the relevancy of brief emergency intervention, which is both feasible and efficient, and the need for research to define the relevant adjustments by professionals and the health care system