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Objective: To explore the contribution of a mindfulness-based intervention as an adjuvant to outpatient substance use disorder treatment. Outcomes included substance use behavior, depression and anxiety symptoms, and anger expression. Methods: This preliminary study for a pragmatic randomized controlled trial with stratified random allocation included three months of follow-up. In two outpatient clinics linked to public universities, a mindfulness-based intervention plus treatment as usual (experimental group n=22) was compared to treatment as usual (control group n=20). The study included data from self-report measurements and the patients' records, which were evaluated according to intention-to-treat analysis through generalized estimating equations and generalized method of moments estimation. Results: The experimental group had lower symptoms of depression (b=-6.82; 95%CI -12.45 to -1.18) and anxiety (b=-0.25; 95%CI -0.42 to -0.09), and anger expression (b=-9.76; 95%CI -18.98 to -0.54) three months after the intervention. We detected no effect on substance use behavior. Conclusion: The mindfulness-based intervention yielded promising results as an adjuvant to outpatient substance use disorder treatment, since it reduced levels of highly prevalent symptoms in this population. However, further studies with longer follow-up periods and larger samples are required.

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OBJECTIVE: To explore the contribution of a mindfulness-based intervention as an adjuvant to outpatient substance use disorder treatment. Outcomes included substance use behavior, depression and anxiety symptoms, and anger expression. METHODS: This preliminary study for a pragmatic randomized controlled trial with stratified random allocation included three months of follow-up. In two outpatient clinics linked to public universities, a mindfulness-based intervention plus treatment as usual (experimental group n=22) was compared to treatment as usual (control group n=20). The study included data from self-report measurements and the patients' records, which were evaluated according to intention-to-treat analysis through generalized estimating equations and generalized method of moments estimation. RESULTS: The experimental group had lower symptoms of depression (b=-6.82; 95%CI -12.45 to -1.18) and anxiety (b=-0.25; 95%CI -0.42 to -0.09), and anger expression (b=-9.76; 95%CI -18.98 to -0.54) three months after the intervention. We detected no effect on substance use behavior. CONCLUSION: The mindfulness-based intervention yielded promising results as an adjuvant to outpatient substance use disorder treatment, since it reduced levels of highly prevalent symptoms in this population. However, further studies with longer follow-up periods and larger samples are required.

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In recent years, several studies have been focused on the comorbidity of psychiatric disorders with alcohol and other substance dependence. In this context, the Brazilian Association of Studies on Alcohol and Other Drugs initiated a project to establish Brazilian Guidelines. The aim of this study was to review diagnostic and therapeutic criteria for the most prevalent psychiatric comorbidities. Randomized clinical trials, epidemiological studies, animal testing and other forms of research are reviewed herein. The main psychiatric comorbidities are investigated and data published in the literature are reviewed, based on guidelines adopted by other countries. Epidemiological aspects, diagnostic criteria, integrated treatment and the organization of specialized service, as well as details regarding psychotherapy and pharmacological treatment are discussed. The guidelines of the Brazilian Association of Studies on Alcohol and Other Drugs reinforce the importance of adequate diagnosis and treatment regarding alcoholic and drug dependent patients suffering of comorbid psychiatric disorders.

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OBJECTIVE: Compare inadequate eating behaviors and their relationship to body checking in three groups: patients with anorexia nervosa (AN), patients with bulimia nervosa (BN) and a control group (C). METHODS: Eighty three outpatients with eating disorders (ED) and 40 controls completed eating attitudes and body checking questionnaires. RESULTS: The overall relationship between the eating attitude and body checking was statistically significant in all three groups. The worse the eating attitude, the greater the body checking behavior. However, when we look at each group individually, the relationship was only statistically significant in the AN group (r=.354, p=0.020). DISCUSSION: The lower the desired weight and the worse the eating attitude, the more people check themselves, although in the presence of an ED the relationship between body checking and food restrictions is greater. In patients displaying the AN subgroup, body checking is also related to continued dietary control.

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OBJECTIVE: To assess the characteristics of alcohol and drug users who seek treatment at the Brazilian Unified Health System in Brazil. METHOD: A multicenter cross-sectional study involving five clinical and research centers located in four Brazilian state capitals was conducted with 740 in- and outpatients. The only exclusion criterion was the presence of neurological or severe psychiatric symptoms at the moment of the interview. The Addiction Severity Index (ASI-6) and the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) were used to assess the severity of substance use and the problems related. RESULTS: There were significantly more men than women in the sample; mean age was 36 years. The drug most frequently used at all sites was alcohol (78%), followed by cocaine/crack (51%). Alcohol was the drug that most commonly motivated treatment seeking, at all centers. ASI-6 Summary Scores for Recent Functioning (SS-Rs) were quite similar among centers. SS-Rs were compared between users who had never received treatment for psychoactive substance abuse (n = 265, 36.1%) and those who had already been treated at one or more occasions (n = 470, 63.9%). This analysis revealed significant differences between the groups in the drug, psychiatric symptoms, legal, and family/social problems areas (p < 0.05). CONCLUSION: Our findings confirm previous evidence suggesting that the management of patients seeking drug abuse treatment should take several different aspects into consideration, e.g., education, employment, and family relationships, which often appear as areas of concern for these individuals (AU)

OBJETIVO: Avaliar as características dos usuários de álcool e drogas que procuram tratamento no Sistema Único de Saúde. MÉTODO: Estudo transversal multicêntrico envolvendo cinco centros clínicos/de pesquisa localizados em quatro capitais brasileiras foi realizado com 740 pacientes hospitalizados e ambulatoriais. O único critério de exclusão foi a presença de sintomas neurológicos ou psiquiátricos graves no momento da entrevista. A Escala de Gravidade de Dependência (Addiction Severity Index, ASI-6) e o teste ASSIST (Alcohol, Smoking and Substance Involvement Screening Test) foram utilizados para avaliar a severidade do uso de substância e problemas relacionados. RESULTADOS: Houve significativamente mais homens do que mulheres na amostra; a idade média foi de 36 anos. A droga mais usada em todos os centros foi o álcool (78%), seguido de cocaína/crack (51%). O álcool foi a droga que mais motivou procura por tratamento, em todos os centros. Os Escores Resumidos da ASI-6 para Funcionamento Recente (SS-Rs) foram bastante similares nos centros. SS-Rs foram comparados entre usuários que nunca haviam recebido tratamento para abuso de substâncias (n = 265, 36,1%) e aqueles que já haviam sido tratados uma ou mais vezes (n = 470, 63,9%). Foram observadas diferenças significativas entre os grupos nas áreas de droga, sintomas psiquiátricos e problemas legais e familiares/sociais (p < 0,05). CONCLUSÕES: Nossos dados confirmam evidências prévias de que o manejo de pacientes que procuram tratamento para abuso de substância deve levar em conta vários aspectos, como educação, emprego e relações familiares, que normalmente geram preocupação nesses indivíduos (AU)

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OBJECTIVE: Compare obsessive-compulsive symptoms in patients with anorexia nervosa (AN) and bulimia nervosa (BN), and assess the association of these symptoms and body checking in each of these groups of patients. METHODS: Eighty-five female outpatients with eating disorders (ED) completed body checking and obsessive-compulsive questionnaires. RESULTS: Body checking was more prevalent in the BN group. Among patients with AN, the highest mean body-checking scores were found in patients with somatic obsessions related to body areas and eating rituals (p = 0.003 and 0.018, respectively). DISCUSSION: Patients with eating disorders are believed to be included in the obsessive-compulsive spectrum, and may experience intrusive thoughts about behavior. The results of our work suggest that obsessive symptoms and body checking should be further investigated and properly managed in patients with ED.

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OBJECTIVE: To assess the characteristics of alcohol and drug users who seek treatment at the Brazilian Unified Health System in Brazil. METHOD: A multicenter cross-sectional study involving five clinical and research centers located in four Brazilian state capitals was conducted with 740 in- and outpatients. The only exclusion criterion was the presence of neurological or severe psychiatric symptoms at the moment of the interview. The Addiction Severity Index (ASI-6) and the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) were used to assess the severity of substance use and the problems related. RESULTS: There were significantly more men than women in the sample; mean age was 36 years. The drug most frequently used at all sites was alcohol (78%), followed by cocaine/crack (51%). Alcohol was the drug that most commonly motivated treatment seeking, at all centers. ASI-6 Summary Scores for Recent Functioning (SS-Rs) were quite similar among centers. SS-Rs were compared between users who had never received treatment for psychoactive substance abuse (n = 265, 36.1%) and those who had already been treated at one or more occasions (n = 470, 63.9%). This analysis revealed significant differences between the groups in the drug, psychiatric symptoms, legal, and family/social problems areas (p < 0.05). CONCLUSION: Our findings confirm previous evidence suggesting that the management of patients seeking drug abuse treatment should take several different aspects into consideration, e.g., education, employment, and family relationships, which often appear as areas of concern for these individuals.

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The aim of this study was to evaluate the psychiatric comorbidities and different areas of life functioning in substance abusers with attention deficit hyperactivity disorder symptoms. A cross-sectional, multi-center study involving 285 adult substance abusers from outpatient and inpatient clinics was performed. The Adult ADHD Self-Report Scale, the sixth version of the Addiction Severity Index, and the Mini International Neuropsychiatry Interview were used for data collection. Individuals with comorbid attention deficit hyperactivity disorder and substance use disorders showed increased addiction severity when compared with individuals without attention deficit hyperactivity disorder (53.3 ± 7.3 vs. 48.4 ± 8.4, respectively). Our results suggest that comorbid attention deficit hyperactivity disorder and substance use disorders is associated with a more severe course of substance use and with social and psychiatric impairment.

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The aim of this study is evaluate the psychometric results and validity of the Brazilian Portuguese language version of the Body Checking Cognitions Scale (BCCS). Factor analysis and concurrent validity were checked on assessments from participants with and without eating disorders. The scale had good internal consistency. Factor analysis confirmed four components. Control and Eating Disorders groups were discriminated, and results correlated well with the Eating Attitudes Test and Body Shape Questionnaire. The results for the Portuguese version of the BCCS were similar to the original version, and its use is recommended for evaluation of body-checking cognitions in the Brazilian population with or without eating disorders.

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Diferentes autores têm colocado a drogadição entre os quadros clínicos caracterizados por falhas nas bases de constituição da subjetividade, como expressão da falta de capacidade simbólica. Esta ausência de simbolização aparece sob a forma de atuações, nas quais incorporações antropofágicas substituem processos de elaboração. Neste sentido, o grande desafio do tratamento de pessoas dependentes de substâncias psicoativas é dar a possibilidade para o sujeito de formar um discurso que possa mediar, através da simbolização, a relação entre o ele e sua antropofagia. Nesse sentido, é fundamental, criar condições para a construção de vínculos sustentáveis, que permitam a emergência da angústia para o trabalho de elaboração psíquica. O objetivo deste trabalho é refletir sobre as possibilidades e limites encontrados por uma equipe multidisciplinar de um programa ambulatorial específico para mulheres dependentes químicas, que trabalha para construir vínculos que promovam elaboração psíquica. A partir da análise da transferência, questiona-se a natureza dos vínculos e a própria direção do processo terapêutico...

Different authors have described addiction among clinical casescharacterized byimpairments on the basis of constitution of subjectivity, as an expression of lack of symbolic capacity. This lack of symbolization appears in the form of acting-outs, in which anthropophagicincorporations replace the elaboration process. In this sense, the great challenge of treating people with substance use disorders is giving them the possibility of formation of a discourse that may mediate, through symbolization, the relationship between the person and heranthropophagi. Thus, it is essential to create conditions for building sustainable bonds, enabling the emergence of anguish to the work of psychic elaboration. The aim of this paper is to discuss the possibilities and limits found by a multidisciplinary team in an outpatient women-only substance abuse treatment working to build bonds that promote psychic elaboration. From the analysis of the transference, the question is the nature of the bonds and the actual direction of the therapeutic process...

Diferentes autores han ubicado la adicción entre los cuadros clínicos caracterizados por fracasos en la base de la constitución de la subjetividad como expresión de la falta de capacidad simbólica. Esta falta de simbolización aparece en forma de actuaciones, en que las incorporaciones antropofágicas sustituyen procesos de elaboración. En este sentido, el acto de tratar a las personas con trastornos por consumo de sustancias es brindar la posibilidad al sujeto de articular un discurso que puede mediar, a través de la simbolización, la relación entre el yo y su antropofagia. Por lo tanto, es fundamental crear las condiciones para la construcción de vínculos sostenibles, lo que permite la aparición de la angustia para el trabajo de la elaboración psíquica. El objetivo de este trabajo es discutir las posibilidades y limitaciones encontradas por un programa ambulatorio multidisciplinario específico para mujeres con dependencia química, que trabaja para crear vínculos que promuevan la elaboración psíquica. A partir del análisis de la transferencia, se pone en juego la cuestión de la naturaleza de los vínculos y la propia dirección del proceso terapéutico...

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Diferentes autores têm colocado a drogadição entre os quadros clínicos caracterizados por falhas nas bases de constituição da subjetividade, como expressão da falta de capacidade simbólica. Esta ausência de simbolização aparece sob a forma de atuações, nas quais incorporações antropofágicas substituem processos de elaboração. Neste sentido, o grande desafio do tratamento de pessoas dependentes de substâncias psicoativas é dar a possibilidade para o sujeito de formar um discurso que possa mediar, através da simbolização, a relação entre o ele e sua antropofagia. Nesse sentido, é fundamental, criar condições para a construção de vínculos sustentáveis, que permitam a emergência da angústia para o trabalho de elaboração psíquica. O objetivo deste trabalho é refletir sobre as possibilidades e limites encontrados por uma equipe multidisciplinar de um programa ambulatorial específico para mulheres dependentes químicas, que trabalha para construir vínculos que promovam elaboração psíquica. A partir da análise da transferência, questiona-se a natureza dos vínculos e a própria direção do processo terapêutico.(AU)

Different authors have described addiction among clinical casescharacterized byimpairments on the basis of constitution of subjectivity, as an expression of lack of symbolic capacity. This lack of symbolization appears in the form of acting-outs, in which anthropophagicincorporations replace the elaboration process. In this sense, the great challenge of treating people with substance use disorders is giving them the possibility of formation of a discourse that may mediate, through symbolization, the relationship between the person and heranthropophagi. Thus, it is essential to create conditions for building sustainable bonds, enabling the emergence of anguish to the work of psychic elaboration. The aim of this paper is to discuss the possibilities and limits found by a multidisciplinary team in an outpatient women-only substance abuse treatment working to build bonds that promote psychic elaboration. From the analysis of the transference, the question is the nature of the bonds and the actual direction of the therapeutic process.(AU)

Diferentes autores han ubicado la adicción entre los cuadros clínicos caracterizados por fracasos en la base de la constitución de la subjetividad como expresión de la falta de capacidad simbólica. Esta falta de simbolización aparece en forma de actuaciones, en que las incorporaciones antropofágicas sustituyen procesos de elaboración. En este sentido, el acto de tratar a las personas con trastornos por consumo de sustancias es brindar la posibilidad al sujeto de articular un discurso que puede mediar, a través de la simbolización, la relación entre el yo y su antropofagia. Por lo tanto, es fundamental crear las condiciones para la construcción de vínculos sostenibles, lo que permite la aparición de la angustia para el trabajo de la elaboración psíquica. El objetivo de este trabajo es discutir las posibilidades y limitaciones encontradas por un programa ambulatorio multidisciplinario específico para mujeres con dependencia química, que trabaja para crear vínculos que promuevan la elaboración psíquica. A partir del análisis de la transferencia, se pone en juego la cuestión de la naturaleza de los vínculos y la propia dirección del proceso terapéutico.(AU)

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This work aims to compare in patients with anorexia nervosa, bulimia nervosa, and control subjects: (a) body checking types, frequency, and parts; (b) prevalence of body avoidance and the most checked body parts; (c) body checking cognitions. Eighty-five outpatients with eating disorders (ED) and 40 controls filled out validated body checking and cognition questionnaires. ED patients, especially bulimia nervosa, check their bodies more than do the control subjects. The most checked area was the belly. The most frequent means of body checking was mirror checking, while the most avoided was weighing. The reasons that participants in the various study groups check their bodies seem to differ. Given the importance of body checking in the etiology and maintenance of EDs, it is important that clinicians consider this behavior, as well as the factors that lead to checking/avoidance in the different eating disorder subtypes, so that treatment may be more specific.

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BACKGROUND: There are few research tools in Brazil to assess more broadly the alcohol and other drug related problems. OBJECTIVE: To test the psychometric properties of ASI in its sixth version (ASI-6). METHODS: A multicenter cross-sectional study was conducted in four Brazilian state capitals. Four research centers interviewed 150 adult inpatients or outpatients, and one research center interviewed 140 patients. A total of 740 substance abusers were selected. Training and supervision of interviewers were performed to assure the quality of dada collected. RESULTS: Most areas of the ASI showed good reliability between the instrument and the interviewers, with no statistically significant differences between the ASI-6 Summary Scores for Recent Functioning (SS-Rs) of both interviews. Cronbach's alpha for ASI-6 subscales ranged from 0.64 to 0.95. Correlations between the ASI-6 Alcohol and Drug scores and the concurrent instrument (ASSIST) were high (0.72 and 0.89, respectively). There was a significant negative correlation between the scores in psychiatric, medical and drug areas and the scores of WHOQOL. CONCLUSION: Analysis of the psychometric properties of ASI-6 both in outpatients and inpatients in Brazil indicate a good reliability and validity of this instrument for the Brazilian culture. The development of this instrument in Brazil is an important advancement, which will certainly have implications for the prevention, clinical research, and social rehabilitation fields.

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BACKGROUND: There are few research tools in Brazil to assess more broadly the alcohol and other drug related problems. OBJECTIVE: To test the psychometric properties of ASI in its sixth version (ASI-6). METHODS: A multicenter cross-sectional study was conducted in four Brazilian state capitals. Four research centers interviewed 150 adult inpatients or outpatients, and one research center interviewed 140 patients. A total of 740 substance abusers were selected. Training and supervision of interviewers were performed to assure the quality of dada collected. RESULTS: Most areas of the ASI showed good reliability between the instrument and the interviewers, with no statistically significant differences between the ASI-6 Summary Scores for Recent Functioning (SS-Rs) of both interviews. Cronbach's alpha for ASI-6 subscales ranged from 0.64 to 0.95. Correlations between the ASI-6 Alcohol and Drug scores and the concurrent instrument (ASSIST) were high (0.72 and 0.89, respectively). There was a significant negative correlation between the scores in psychiatric, medical and drug areas and the scores of WHOQOL. CONCLUSION: Analysis of the psychometric properties of ASI-6 both in outpatients and inpatients in Brazil indicate a good reliability and validity of this instrument for the Brazilian culture. The development of this instrument in Brazil is an important advancement, which will certainly have implications for the prevention, clinical research, and social rehabilitation fields.

INTRODUÇÃO: Existem poucos instrumentos de pesquisa no Brasil que avaliam de forma mais ampla os problemas relacionados ao álcool e a outras drogas. OBJETIVO: Testar as propriedades psicométricas da ASI, em sua sexta versão (ASI-6). MÉTODOS: Um estudo transversal e multicêntrico foi conduzido em quatro capitais de estados brasileiros. Quatro centros de pesquisa entrevistaram 150 pacientes adultos internados ou em tratamento ambulatorial. Foram selecionados um total de 740 abusadores de substâncias. A qualidade dos dados coletados foi assegurada pelo treinamento e supervisão aos entrevistadores. RESULTADOS: A maioria das áreas da ASI mostraram boa confiabilidade entre o instrumento e os entrevistadores, sem diferenças estatisticamente significativas entre os Escores Sumários de Funcionamento Recente da ASI-6. O alfa de Cronbach para as subescalas da ASI-6 variou de 0,64 a 0,95. Correlações entre os escores da área Álcool e Drogas da ASI-6 e o instrumento concorrente (ASSIST) foram altas (0,72 e 0,89, respectivamente). Existiu uma correlação negativa estatisticamente significativa entre os escores nas áreas psiquiátrica, médica e drogas, e os escores da WHOQOL. CONCLUSÃO: A análise das propriedades psicométricas da ASI-6 tanto em sujeitos internados quanto em tratamento ambulatorial no Brasil apontam para uma boa confiabilidade e validade deste instrumento para a cultura brasileira.

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CONTEXTO: A Body Checking Cognitions Scale (BCCS) avalia cognições relacionadas à checagem do peso, comportamento comum e de importância clínica em pacientes com transtornos alimentares (TA). OBJETIVO: Tradução, adaptação transcultural da BCCS para o idioma português, validação de conteúdo e análise da consistência interna. MÉTODOS: Envolveu cinco etapas: (1) tradução; (2) retrotradução; (3) revisão técnica e avaliação das equivalências semântica e conceitual (4) validação de conteúdo por profissionais da área - juízes; (5) avaliação do instrumento por uma amostra de estudantes do sexo feminino. RESULTADOS: O instrumento foi traduzido e adaptado para o idioma português. Foram realizadas algumas adaptações de palavras, expressões e conjugação verbal. Demonstrou ser de fácil compreensão (valores médios superiores a 4,22 - valor máximo 5,0) e excelente concordância (alfa de Cronbach: 0,80 a 0,95). Os construtos verificação objetiva, segurança sobre o corpo, consequências de não checar e controle da dieta e do peso foram identificados pelos especialistas, e o nível de concordância correspondeu a 48,6 por cento. CONCLUSÃO: A escala encontra-se traduzida e adaptada para o idioma português, demonstrando resultados satisfatórios no processo de tradução, adaptação transcultural e análise de consistência interna. São necessárias ainda análises de validade externa, equivalência de mensuração e reprodutibilidade.

BACKGROUND: The Body Checking Cognitions Scale (BCCS) measures cognitions associated with weight checking, which is a medically relevant common behavior among patients with eating disorders (ED). OBJECTIVE: To translate and cross-culturally adapt BCCS into Brazilian Portuguese, to validate its content and analyze it for internal consistency. METHODS: The study included five steps: (1) translation; (2) back translation; (3) technical review and assessment of semantic and conceptual equivalences; (4) content validation by experts - arbiters; and (5) instrument evaluation in a sample of female students. RESULTS: The instrument was translated and adapted into Brazilian Portuguese. Some adjustments were made of words, phrases and verb conjugation. The version was found to be easily understandable (mean values higher than 4.22; maximum value: 5.0) and showed excellent concordance (Cronbach's a: 0.80 to 0.95). The constructs (objective verification, reassurance, safety beliefs and body control) were identified by experts and the level of agreement was 48.6 percent. DISCUSSION: BCCS was translated and adapted into Brazilian Portuguese and showed adequate translation, cross-cultural adaptation, and internal consistency. BCCS external validation, measurement equivalence and reproducibility analyses are still required.

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INTRODUÇÃO: Antes de iniciar um tratamento para abuso de substâncias psicoativas (SPA), é primordial avaliar os prejuízos que estas acarretam na vida dos usuários. Considerando a complexidade dessa avaliação, o instrumento atualmente mais utilizado no mundo para a abordagem multidimensional de problemas relacionados ao abuso de SPA é a Escala de Gravidade de Dependência (Addiction Severity Index, ASI). OBJETIVO: Através da revisão da literatura sobre o tema, da apresentação de um caso clínico, de aspectos da ASI e da discussão de tópicos contemplados na avaliação de usuários de drogas, este trabalho tem como finalidade auxiliar o profissional de saúde a sistematizar a avaliação desses pacientes. MÉTODO: A revisão da literatura foi realizada nas bases de dados MEDLINE, LILACS e PsycINFO, utilizando os descritores assessment e evaluation, cruzados com o termo substance-related disorders dos Medical Subject Headings e subexpressões nele incluídas. RESULTADOS E CONCLUSÃO: Na literatura, há uma carência de artigos sobre o tema, e, no Brasil, ainda não existem instrumentos que se proponham a avaliar os usuários de drogas de forma tão ampla como a ASI. A utilização de uma escala com essas características pode ser útil para o sistema de saúde brasileiro, favorecendo a identificação precoce de problemas e propiciando melhora na qualidade da assistência prestada.

INTRODUCTION: Before initiating any treatment for substance abuse, the assessment of problems related to the consumption of those substances is of paramount importance. Considering the complexity of this evaluation, the instrument most widely used in the present days for a multidimensional approach to these patients is the Addiction Severity Index (ASI). OBJECTIVE: The present study presents a literature review, a clinical case vignette, comments on different aspects of the scale, and the discussion of topics covered in the evaluation process, and aims at providing support to health professionals in the sense of systematizing the assessment of these patients. METHOD: The literature review was conducted on MEDLINE, LILACS, and PsycINFO databases, using the keywords assessment and evaluation together with substance-related disorders and other terms presented as synonyms in the Medical Subject Headings. RESULTS AND CONCLUSION: There is a paucity of articles in the literature focusing on the topic, and no other instruments designed to provide a general overview of substance users (as is the case with the ASI) are available in Brazil. The use of a scale with these characteristics may be useful for the Brazilian public health system, allowing for the early identification of problems and promoting an improvement in the quality of treatment provided to these patients.

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CONTEXTO: O consumo de drogas entre adolescentes tem sido alvo de várias pesquisas nos últimos anos. Sabe-se que a família pode ser um fator tanto de proteção quanto de risco para o uso de substâncias nessa fase. OBJETIVO: O presente artigo é uma revisão da literatura sobre o tema família de adolescentes abusadoras e/ou dependentes de substâncias psicoativas, a fim de levantar quais dados a literatura já dispõe sobre esse assunto com o intuito de capacitar profissionais da área da saúde na atuação clínica bem como na prevenção desta síndrome. MÉTODOS:Revisão bibliográfica no sistema MedLine (Index Medicus), ScieLO, PubMed, a partir das seguintes palavras-chave: adição, abuso de drogas, meninas, adolescência e família. RESULTADOS:Observou-se que essas famílias em sua maioria possuem características disfuncionais como laços familiares conflitivos, pouca proximidade entre os membros, falta de uma hierarquia bem definida e pais que não dão exemplo positivo quanto ao uso de drogas. Diferenças entre gêneros também são apontadas: meninas necessitam maior apoio familiar que os meninos como fator protetor do envolvimento com grupo de pares desviantes. As meninas também são tão sensíveis ao abuso psicológico quanto ao físico, diferentemente dos meninos que consideram pior o abuso físico. Destaca-se ainda que a presença de relações de apoio com irmãs mais velhas é fator protetor para o abuso de substâncias em meninas. Outros temas, como transmissão transgeracional e estilo parental, também são abordados. CONCLUSÕES:Conclui-se que este tema é pouco explorado na literatura, principalmente no que se refere a estudos que abordem isoladamente a relação entre meninas e dependência.

BACKGROUND: Drug use among adolescents has been investigated in several recent studies. Family is recognizably both a protective and a risk factor for substance use during adolescence. OBJECTIVE:This present article is a literature review on family aspects of female adolescents who are drug abusers and/or psychoactive drug dependents to gather information available on this issue for capacitating heath providers in clinical care and prevention of this syndrome. METHODS:A literature review was conducted in MedLine (Index Medicus), SciELO, PubMed using the following key words: addiction, drug abuse, girls, adolescence and family. RESULTS:The families of these adolescents were found to be mostly dysfunctional characterized by conflictive family relationships, poor family cohesion, ill-defined hierarchy, and negative parental role modeling for drug use. Gender differences were also remarkable: girls need more family support than boys to protect them against deviant peer group involvement; they are also more vulnerable to psychological rather than physical abuse while boys suffer more from physical abuse. Notably, support from older female siblings is a protective factor against substance abuse in girls. Transgenerational transmission and parental style are also addressed. DISCUSSION: Drug abuse in girls has been little investigated and there have been few studies specifically focusing on the association between dependence and girls.

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RESUMO: A origem da psicoterapia analítica de grupo com drogadictos pode ser remetida ao trabalho dos Álcoolatras Anônimos e seus dois pressupostos: a importância da dinâmica grupal e a centralidade da abstinência. Embora o primeiro possa ter sido amplamente favorável a instalação da psicanálise de grupo, a questão da direção para a cura do sintoma parece ter constituido uma marca que dificultou a sua expansão. O percurso desta terapêutica parece ter sido dificultado também pelas resistências da instituição psicanalítica clássica ao desenvolvimento de concepções não restritas a prática ortodoxa. O marco com que a clínica psicanalítica com drogadictos pode operar e definido a partir da construção de novos dispositivos, que, fundamentalmente respeitem a escuta do funcionamento psíquico dos drogadictos. (AU)

ABSTRACT: Analytic group psychotherapy for drug addicts has its origin in the Alcoholic Anonymous initiative and its two premises: the importance of group dynamic approach and withdrawal as a core element. While the former may has favored group psychoanalysis, focusing on symptom cure seems to have prevented its widespread application. The advance of this therapy apparently has also been hindered by resistance from classic psychoanalysis institution against the development of conceptions unrestrained by traditional practice. The framework of psychoanalysis in drug addicts is based on the construction of new resources that essentially respect the listening to drug addicts' psychic functioning. (AU)

RESUMEN: El origen de la psicoterapia de grupo con drogadictos puede ser relacionada al trabajo de los Alcoholicos Anonimos y sus dos postulados: la importancia de la dinamica grupal y el papel central de la abstinencia. Aunque el primero pueda haber sido muy favorable a la instalacion del psicoanalisis de grupo, la problematica de la direccion de la cura del sintoma parece haber constituido una marca que dificulto su expansion. El camino de esta terapeutica parece tambien haber sido dificultado por las resistencias de la institucion psicoanalitica clasica, al desarrollo de conceptos no restrictos a la practica ortodoxa. El marco con que la clinica psicoanalitica con drogadictos puede trabajar es definido a partir de la construccion de nuevos dispositivos, que, fundamentalmente respeten la escucha del funcionamiento psiquico de los drogadictos. (AU)

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RESUMEN

A origem da psicoterapia analítica de grupo com drogadictos pode ser remetida ao trabalho dos Álcoolatras Anônimos e seus dois pressupostos: a importância da dinâmica grupal e a centralidade da abstinência. Embora o primeiro possa ter sido amplamente favorável a instalação da psicanálise de grupo, a questão da direção para a cura do sintoma parece ter constituido uma marca que dificultou a sua expansão. O percurso desta terapêutica parece ter sido dificultado também pelas resistências da instituição psicanalítica clássica ao desenvolvimento de concepções não restritas a prática ortodoxa. O marco com que a clínica psicanalítica com drogadictos pode operar e definido a partir da construção de novos dispositivos, que, fundamentalmente respeitem a escuta do funcionamento psíquico dos drogadictos.

Analytic group psychotherapy for drug addicts has its origin in the Alcoholic Anonymous initiative and its two premises: the importance of group dynamic approach and withdrawal as a core element. While the former may has favored group psychoanalysis, focusing on symptom cure seems to have prevented its widespread application. The advance of this therapy apparently has also been hindered by resistance from classic psychoanalysis institution against the development of conceptions unrestrained by traditional practice. The framework of psychoanalysis in drug addicts is based on the construction of new resources that essentially respect the listening to drug addicts' psychic functioning.

El origen de la psicoterapia de grupo con drogadictos puede ser relacionada al trabajo de los Alcoholicos Anonimos y sus dos postulados: la importancia de la dinamica grupal y el papel central de la abstinencia. Aunque el primero pueda haber sido muy favorable a la instalacion del psicoanalisis de grupo, la problematica de la direccion de la cura del sintoma parece haber constituido una marca que dificulto su expansion. El camino de esta terapeutica parece tambien haber sido dificultado por las resistencias de la institucion psicoanalitica clasica, al desarrollo de conceptos no restrictos a la practica ortodoxa. El marco con que la clinica psicoanalitica con drogadictos puede trabajar es definido a partir de la construccion de nuevos dispositivos, que, fundamentalmente respeten la escucha del funcionamiento psiquico de los drogadictos.

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CONTEXTO: Considerando-se que o álcool possui um valor energético, ele tem a habilidade de suprimir as necessidades calóricas diárias de um indivíduo, e/ou levá-lo ao sobrepeso, dependendo da quantidade, freqüência e modo de consumo. OBJETIVOS: Revisar o efeito do álcool no metabolismo energético e suas conseqüências no peso corporal. MÉTODOS: Revisão bibliográfica realizada no sistema MEDLINE (Index Medicus) cruzando os descritores "alcohol" e "weight gain". RESULTADOS: O álcool tem prioridade no metabolismo alterando outras vias metabólicas, incluindo a oxidação lipídica, o que favorece o estoque de gorduras no organismo. Dependendo da forma que ele é metabolizado, sua participação como fonte calórica é diferente. CONCLUSÕES: O valor energético dos alimentos adicionados ao consumo alcoólico e o patamar de consumo devem ser observados na relação de ganho de peso. Respostas ao consumo de álcool são diferentes de um indivíduo para o outro e são determinadas por fatores individuais e por possíveis fatores genéticos desconhecidos.

BACKGROUND: Due to alcoholÆs energy content, its intake can meet an individualÆs daily energy requirements, and/or lead to an individual becoming overweight based on amount, frequency, and pattern of consumption. OBJECTIVES:To review alcoholÆs effect on energy metabolism and its consequences for body weight. METHODS: A review of literature was conducted in MEDLINE (Index Medicus), searching with the keywords "alcohol" and "weight gain". RESULTS: Alcohol takes priority in metabolism and affects other metabolic pathways, including lipid oxidation, which facilitates fat accumulation in the body. Depending on the metabolic pathway activated, alcohol can play a different role as an energy source. CONCLUSIONS: The energy content of foods consumed together with alcohol and the level of consumption should be monitored to prevent weight gain. Individuals have varying responses to alcohol consumption which are determined by their specific characteristics and possibly by other unknown genetic factors as well.

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