RESUMO

OBJECTIVE: This study aimed to quantify the health and economic impacts of alcohol consumption in Brazil for 2019. STUDY DESIGN: Ecological study using secondary data sources. METHODS: We calculated the disease burden using estimates from the Global Burden of Disease study, which incorporated data from health surveys and hospital records. Costs were estimated based on direct expenses recorded in the Hospital and Outpatient Information System of the Unified Health System, with data by sex, age group, cause, and Federative Units. RESULTS: Alcohol consumption was a necessary cause for 30,355 deaths and approximately 1.69 million disability-adjusted life years in Brazil, representing 2.2% and 2.6% of the national totals, respectively. The impact was more pronounced among men, in the Northeast region and within the 40- to 64-year-old age group. The total costs attributed to these outcomes reached approximately Int$43.1 million, with hospital admissions accounting for 94.16% of these expenses. CONCLUSION: In 2019, alcohol consumption had a significant impact on both the health of Brazilians and the expenses of the health system. As a preventable risk factor, alcohol consumption necessitates effective intersectoral strategies to mitigate its burden.

Assuntos

RESUMO

Abstract Objective: To analyze the trend in mortality from mental and behavioral disorders due to alcohol use in Brazil, 2010-2021. Methods: This was an time series study using Mortality Information System data. Annual percentage change (APC) and 95% confidence intervals (95% CI) were calculated using Prais-Winsten linear regression. Results: Mortality showed a stationary trend for Brazil as a whole (APC = 0.6; 95%CI -4.2;3.0), a falling trend in individuals aged 20-29 years in the South (APC = -7.4; 95%CI -10.0;-4.3) and Northeast (APC = -3.4; 95%CI -6.4;-0.4) regions, in people aged 30-39 in the Midwest region (APC = -3,8; 95%CI -7.4;-0.1) and 40-49 in the South (APC = -2.1; 95%CI -3.8;-0.4), North (APC = -3.1; 95%CI -5.7;-0.5) and Midwest (APC = -2.9; 95%CI -5.5;-0.3) regions. Conclusion: Mortality from mental and behavioral disorders due to alcohol use showed a stationary trend nationally and a falling trend in some age groups regionally.

Resumen Objetivo: Analizar la tendencia de mortalidad por trastornos mentales y del comportamiento en decorrencia del consumo de alcohol en Brasil en el período 2010-2021. Métodos: Estudio de series de tiempo ecológicas, con datos del Sistema de Información de Mortalidad; el cambio porcentual anual (APV) y los respectivos intervalos de confianza del 95% (IC95%) se calcularon mediante regresión lineal de Prais-Winsten. Resultados: Hubo una tendencia estacionaria en la mortalidad en Brasil en su conjunto (VPA = 0,6; IC95% -4,2;3,0), una tendencia decreciente en individuos de 20 a 29 años en las regiones del Sur (VPA = -7,4; IC95% -10,0;-4,3) y Noreste (VPA = -3,4; IC95% -6,4;-0,4), en personas de 30 a 39 años en el Centro-Oeste (VPA = -3,8; IC95% -7,4;-0,1) y en adultos de 40 a 49 años en el Sur (VPA = -2,1; IC95% -3,8;-0,4), Norte (VPA = -3,1; IC95% -5,7;-0,5) y Centro-Oeste (VPA = - 2,9; IC95% -5,5;-0,3). Conclusión: La mortalidad por trastornos mentales y del comportamiento a causa del consumo de alcohol presentó una tendencia estacionaria en Brasil y una tendencia decreciente en algunos grupos etarios.

Resumo Objetivo: Analisar a tendência da mortalidade por transtornos mentais e comportamentais devidos ao uso de álcool no Brasil em 2010-2021. Métodos: Estudo de séries temporais, com dados do Sistema de Informação sobre Mortalidade. A variação percentual anual (VPA) e respectivos intervalos de confiança de 95% (IC95%) foram calculados por regressão linear de Prais-Winsten. Resultados: Houve tendência estacionária na mortalidade no Brasil como um todo (VPA = 0,6; IC95% -4,2;3,0), tendência decrescente em indivíduos de 20-29 anos nas regiões Sul (VPA = -7,4; IC95% -10,0;-4,3) e Nordeste (VPA = -3,4; IC95% -6,4;-0,4), em pessoas de 30-39 anos no Centro-Oeste (VPA = -3,8; IC95% -7,4;-0,1) e naqueles com 40-49 anos nas regiões Sul (VPA = -2,1; IC95% -3,8;-0,4), Norte (VPA = -3,1; IC95% -5,7;-0,5) e Centro-Oeste (VPA = -2,9; IC95% -5,5;-0,3). Conclusão: A mortalidade por transtornos mentais e comportamentais devidos ao uso de álcool apresentou tendência estacionária no Brasil e decrescente em algumas faixas etárias.

RESUMO

Resumo O presente estudo objetivou investigar a associação entre o TEA e o uso materno e paterno de medicamentos, tabaco, álcool e drogas ilícitas. Trata-se de um estudo caso-controle realizado com crianças e adolescentes diagnosticados com TEA e indivíduos neurotípicos. Os dados foram colhidos por meio de entrevista com as mães ou responsáveis. Foram analisadas as variáveis sexo e idade das crianças/adolescentes; idade dos pais; uso de medicamentos antes e durante a gestação; classes de medicamentos usados na gestação; tabagismo materno e paterno; etilismo materno e paterno; uso de drogas ilícitas pelos pais. Para a análise das informações, utilizou-se o modelo de regressão logística, além da razão de chances (OR) bruta e ajustada. Os resultados mostraram que, após os ajustes, foi encontrada associação entre o uso materno na gestação de antitérmicos/analgésicos (OR = 2,26; IC95% 1,29-3,95; p < 0,040) com o TEA. Já o uso de tabaco, álcool e drogas ilícitas materno e paterno, antes e durante a gestação, não apontou relação com o TEA. Os dados encontrados sugerem que existe influência de fatores ambientais no desenvolvimento do TEA.

Abstract The aim of this study was to investigate the association between maternal and paternal licit and illicit drug use, smoking and drinking and autism spectrum disorder (ASD). We conducted a case-control study with children and adolescents diagnosed with ASD and neurotypical individuals. The data were collected using a semi-structured questionnaire administered during interviews with the children's mothers or guardians. The following variables were analyzed: child sex and age; maternal and parental age; use of medicines before and during pregnancy; classes of medicines used during pregnancy; maternal and paternal smoking; maternal and paternal drinking; maternal and paternal illicit drug use. The data were analyzed using logistic regression and crude and adjusted odds ratios (OR). After adjustment, the results showed an association between maternal use of antipyretics/pain killers during pregnancy (OR = 2.26; 95%CI 1.29-3.95; p < 0.040) and ASD. No association was found between maternal and paternal smoking, drinking and illicit drug use before and during pregnancy and ASD. The findings suggest that the development of ASD is influenced by environmental factors.

RESUMO

INTRODUCTION: Consumption of substances has been associated with cognitive impairment. The Mini Mental State Examination (MMSE) is an easy-to-apply screening tool used to assess cognitive functions. OBJECTIVES: To evaluate the cognitive performance of individuals with alcohol (AUD) and/or crack cocaine use disorder (CUD) and polysubstance use using the MMSE and to investigate the impact of substance use profile and the moderation effect of educational level on MMSE performance. METHODS: Cross-sectional study with 508 adult male inpatients diagnosed with substance use disorders (245 with AUD, 85 with CUD, and 178 with polysubstance use). Cognitive performance was assessed using the MMSE scale (total and composite scores). RESULTS: Individuals with AUD had worse total MMSE scores and scored worse for all three MMSE components compared to individuals with polysubstance use (p < 0.001, oral/written language comprehension, p < 0.001, attention/memory, and p = 0.007, motor functions). MMSE scores were positively correlated with educational level (p < 0.017), but were not associated with age, recent drug use, or years of drug use. Educational level moderated the impact of substance use on MMSE performance, especially total score and composite language comprehension score. Individuals with a low educational level (≤ 8 years) had worse performance than those with a high educational level (≥ 9 years), mainly in individuals with AUD (p < 0.001). DISCUSSION: Individuals with a low educational level and alcohol use are more prone to present cognitive impairment than crack cocaine users, especially involving language aspects. Better-preserved cognitive function could impact treatment adherence and might guide the decision of therapeutic strategies.

Assuntos

RESUMO

ABSTRACT Objective: Substance misuse can lead to several consequences for physical and mental health. Physical exercise is an important ally to pharmacological and psychotherapeutic treatment for substance use. However, the literature is still scarce regarding long-term interventions. Thus, this study aims to describe the acceptability and effects of combined physical training intervention (aerobic and strength). Methods: This study comprises an n-of-1 clinical trial that was performed with a 64-year-old male individual with alcohol use disorder. The treatment lasted 12 weeks and evaluated the association of multidisciplinary interventions on quality of life, depressive symptoms, cognitive impairment, and anxiety. Results: The participant improved general quality of life (12.5%), no alterations were found for depressive symptoms, there was an improvement in cognition (20%), as well a reduction in the trait (16.2%) and state (14.7%) anxiety symptoms of the participant. Conclusions: These findings allude to the importance of non-drug therapeutic resources such as structured physical exercise, associated with other offers in the treatment of alcohol use disorder.

RESUMO Objetivo: O uso de substâncias psicoativas pode levar a diversas consequências à saúde física e mental. O exercício físico é um importante aliado ao tratamento farmacológico e psicoterápico para o uso de substâncias. No entanto, a literatura ainda é escassa em relação às intervenções de longa duração. Dessa forma, este estudo objetiva descrever a aceitabilidade e os efeitos de uma intervenção de treinamento físico combinado (aeróbico e força). Métodos: Este estudo compreende um n-of-1 clinical trial que foi realizado com um indivíduo do sexo masculino, de 64 anos de idade, com transtorno por uso de álcool. O tratamento teve a duração de 12 semanas e avaliou a associação de intervenções multiprofissionais sobre a qualidade de vida, sintomas depressivos, comprometimento cognitivo e ansiedade. Resultados: O participante melhorou a qualidade de vida geral (12,5%), não foram encontradas alterações para sintomas depressivos, houve melhora na cognição (20%), bem como redução nos sintomas de ansiedade traço (16,2%) e estado (14,7%) do participante. Conclusões: Esses achados aludem à importância de recursos terapêuticos não medicamentosos como o exercício físico estruturado, associados às demais ofertas no tratamento para o transtorno por uso de álcool.

RESUMO

Abstract Introduction Consumption of substances has been associated with cognitive impairment. The Mini Mental State Examination (MMSE) is an easy-to-apply screening tool used to assess cognitive functions. Objectives To evaluate the cognitive performance of individuals with alcohol (AUD) and/or crack cocaine use disorder (CUD) and polysubstance use using the MMSE and to investigate the impact of substance use profile and the moderation effect of educational level on MMSE performance. Methods Cross-sectional study with 508 adult male inpatients diagnosed with substance use disorders (245 with AUD, 85 with CUD, and 178 with polysubstance use). Cognitive performance was assessed using the MMSE scale (total and composite scores). Results Individuals with AUD had worse total MMSE scores and scored worse for all three MMSE components compared to individuals with polysubstance use (p < 0.001, oral/written language comprehension, p < 0.001, attention/memory, and p = 0.007, motor functions). MMSE scores were positively correlated with educational level (p < 0.017), but were not associated with age, recent drug use, or years of drug use. Educational level moderated the impact of substance use on MMSE performance, especially total score and composite language comprehension score. Individuals with a low educational level (≤ 8 years) had worse performance than those with a high educational level (≥ 9 years), mainly in individuals with AUD (p < 0.001). Discussion Individuals with a low educational level and alcohol use are more prone to present cognitive impairment than crack cocaine users, especially involving language aspects. Better-preserved cognitive function could impact treatment adherence and might guide the decision of therapeutic strategies.

RESUMO

ABSTRACT Objectives: to perform content validity and verify the psychometric properties of the adapted version of an alcohol knowledge questionnaire and associated questions. Methods: a methodological study, in which a committee of judges analyzed the questionnaire item representativeness, clarity and relevance. Item response theory was used to assess the instrument psychometric properties applied to a sample of 240 health professionals. Results: the questions were adjusted according to judges' assessment, obtaining a satisfactory Content Validity Index (0.98). High discrimination ability and adequate difficulty levels were observed in 75% of multiple-choice questions and in 25% of statements. Conclusions: the instrument presented content validity with satisfactory indices. However, it is recommended that the questionnaire adapted in this study be used in different samples of health professionals from other parts of Brazil, in order to provide greater robustness to its reliability.

RESUMEN Objetivos: realizar la validación de contenido y verificar las cualidades psicométricas de la versión adaptada del cuestionario de conocimientos sobre alcohol y preguntas asociadas. Métodos: estudio metodológico, en el que un comité de jueces analizó la representatividad, claridad y pertinencia de los ítems del cuestionario. Se utilizó la teoría de respuesta al ítem para evaluar las cualidades psicométricas del instrumento aplicado a una muestra de 240 profesionales de la salud. Resultados: las preguntas fueron ajustadas de acuerdo a la evaluación de los jueces, obteniendo un Índice de Validez de Contenido satisfactorio (0,98). Se observó una alta capacidad de discriminación y niveles de dificultad adecuados en el 75% de las preguntas de opción múltiple y en el 25% de las afirmativas. Conclusiones: el instrumento presentó validez de contenido con índices satisfactorios. Sin embargo, se recomienda que el cuestionario adaptado en este estudio sea utilizado en diferentes muestras de profesionales de la salud de otras partes del país, con el fin de darle mayor robustez a su confiabilidad.

RESUMO Objetivos: realizar a validação de conteúdo e verificar as qualidades psicométricas da versão adaptada do questionário de conhecimentos frente ao álcool e questões associadas. Métodos: estudo do tipo metodológico, em que um comitê de juízes analisou a representatividade, clareza e pertinência dos itens do questionário. Utilizou-se a teoria da resposta ao item para avaliar as qualidades psicométricas do instrumento aplicado em uma amostra de 240 profissionais de saúde. Resultados: as questões foram ajustadas conforme avaliação dos juízes, obtendo um Índice de Validade de Conteúdo satisfatório (0,98). Observou-se alta capacidade de discriminação e níveis de dificuldade adequados em 75% das questões de múltipla escolha e em 25% das afirmativas. Conclusões: o instrumento apresentou validade de conteúdo com índices satisfatórios. Entretanto, recomenda-se que o questionário adaptado neste estudo seja utilizado em amostras diversas de profissionais de saúde, de outros locais do país, com o intuito de oferecer maior robustez à sua confiabilidade.

RESUMO

Alcohol use disorder (AUD) is a worldwide public health problem, being an important aggravating factor of comorbidities found in the elderly, with the potential to increase mortality indicators for this age group. OBJECTIVE: To analyze alcohol-induced deaths in elderly people with alcohol-related disorder in Brazil between 1996 and 2019. METHODS: An ecological study was conducted with secondary data obtained from the Brazilian Unified Health System (SIM) Mortality Information System from 1996 to 2019. TabNet/DATASUS, Excel® 2016 and SPSS 21® were used to prepare the results. RESULTS: Between 1996 and 2019, 85,928 alcohol-induced deaths were recorded among the elderly (>60 years); in 1996, the lowest number of deaths was recorded (n = 1396), and in 2018, there were the highest number of deaths (n = 5667). In the profile of the elderly, there was a predominance of men (88%). Mortality from AUD was due to alcoholic liver disease (62.2%), followed by mental disorders due to alcohol use (37.3%). CONCLUSIONS: Coping with AUD is a public health problem that aims to reduce the number of deaths from diseases, conditions and injuries in which alcohol consumption is the causative agent, in addition to preventing deaths to which alcohol contributes.

Assuntos

RESUMO

Alcohol drinking and risk factors for problematic drinking may vary across a lifespan. The objective of this study was to identify risk factors for problematic drinking in men and women in their thirties and forties. Alcohol drinking and potential risk factors for problematic drinking were assessed at ages 30, 34, 42, and 46 in the 1970 British Cohort Study. Multilevel models included 10,079 observations in 3880 men and 9241 observations in 3716 women. In men, formerly smoking, currently smoking, having a degree, having malaise, and having a mother who drank while pregnant were independently associated with increased risk of problematic drinking. In women, formerly smoking, currently smoking, being physically active in one's leisure time, having a degree, having a managerial or professional occupation, having malaise, and having a mother who drank while pregnant were independently associated with increased risk of problematic drinking. In men and women, cohabiting as a couple was associated with decreased risk of problematic drinking. This study suggests that several risk factors may be associated with problematic drinking in men and women in their thirties and forties. Policy makers should consider the role of modifiable risk factors in the prevention of problematic drinking.

Assuntos

RESUMO

ISSUES: Alcohol use disorder (AUD) causes the highest harms around the world. Many people use alcohol to reduce stress and anxiety, considered as risk factors for AUD. Chronic alcohol use leads to changes in the reward system and the high level of stress may exacerbate neuroendocrine responses. Electroencephalographic (EEG) neurofeedback shows reduction of stress, anxiety and alcohol abuse and it could be an important tool for reducing harm and risk associated with AUD. The aim of this paper is to review the studies that investigated the effects of EEG neurofeedback in subjects with AUD and it proposes to discuss this intervention as a tool for reducing harm and risk in AUD. APPROACH: Medline, PsycINFO and LILACS databases were searched and appropriated terms were used. Inclusion criterion was adopted. The year of publication was not limited because of the scarce number of studies. Eighty-two papers returned and eight were included. A critical review was conducted. KEY FINDINGS: Most of the papers analysed used the alpha/theta protocol to reduce the 'hyperexcitation' of the nervous system. This protocol provides relaxation, decreases anxiety or stress, prevents alcohol relapse, maintains abstinence and increases the feeling of well-being. IMPLICATIONS: EEG neurofeedback has important effects on AUD and anxiety or stress. Studies reinforce the use of EEG neurofeedback as an alternative tool for reducing harm and risk in AUD. CONCLUSION: EEG neurofeedback is an intervention to treat AUD, specifically, to reduce harm and risk. However, more randomised studies are necessary to consolidate the effectiveness of the technique.

Assuntos