RESUMO
AIM: To provide information on the possible influence of cultural practices in perpetuating child sexual abuse and to examine documented examples of these cultural influences. METHODS: A computer literature search was done of Medline, Science Direct, PSYCInfo, Embase and PubMed for keywords. There were also manual searches in the library of journals that are not accessible online. Keywords for searches included: sexual abuse, child abuse, psychopathology, name of countries (eg Jordan, China and Morocco), culture and cultural practices. RESULTS: There is documented evidence of cultural practices that continue to fuel the persistently high level of child sexual abuse across the globe. The definition has evolved to now include simple genital-genital and non-genital contact such as oral-genital contacts, exhibitionism and pornography. CONCLUSIONS: Cultural practices are no longer restricted to one geographical collection of people due to migratory influence, as these practices may also spread to different groups who intermingle. There are few empirical studies of child sexual abuse in the Caribbean, but one factor that could be used as a proxy is age of first sexual activity. The World Bank reports that this age is youngest in the Caribbean and is likely to be significantly influenced by child sexual abuse.
RESUMO
The present study sought to determine whether an association exists between alcohol dependence and select affective and anxiety disorders in patients presenting at substance abuse centres in Trinidad and Tobago (TT). The participants in this study were 143 alcohol dependents, of either East Indian ancestry (Indo-TT) or African ancestry (Afro-TT) and 109 controls matched by age, gender and ethnicity. A structured interview was used to gather information on demographics, psychiatric diagnoses and personal drinking and drug use. A blood sample was obtained and used to genotype for the presence of ADH and ALDH1 polymorphisms and serum levels of hepatic enzymes. Forty-one per cent of Indo-TT and 37% of Afro-TT with alcohol dependence had co-morbid major depressive disorders independent of alcohol and/or drug use. Thirty-nine per cent of Indo-TT and 37% of Afro-TT with alcohol dependence had co-morbid major depression induced by alcohol or drug use. The severity of depression was significantly associated with severity of alcohol dependence. Neither major depression nor the severity of depressive episodes was associated with values of any liver function test or the presence of ALDH1*2 or ADH1C*2 alleles. However, in participants of African descent elevated alanine transaminase ALT was associated (p = 0.038) with not having substance-induced major depression. Co-morbidity of major depressive disorder with alcohol dependence is common in the two major ethnic groups in Trinidad and Tobago and appears to be as likely the consequence of drinking and/or drug use, as the cause. Clinicians should solicit a history of depression from patients with alcohol dependence.
El presente estudio busca determinar si existe una asociación entre la dependencia del alcohol y trastornos particulares afectivos y de ansiedad en pacientes que acuden a centros de abuso de sustancia en Trinidad Tobago (TT). Los participantes en este estudio fueron 143 personas dependientes del alcohol, quienes eran bien de ascendencia indo-oriental (indo-trinitenses), o bien de ascendencia africana (afro-trinitenses), y 109 controles apareados por edad, género y etnicidad. Se usó una entrevista estructurada a fin de recoger información sobre demografía, diagnóstico psiquiátrico, así como el consumo personal de drogas y alcohol. Una muestra de sangre fue obtenida y usada para un genotipado en busca de la presencia de polimorfismos ADH y ALDH1 así como de los niveles de sueros de las enzimas hepáticas. El cuarenta y uno por ciento de los indotrinitenses y el 37% de los afrotrinitenses con dependencia de alcohol presentaban serios trastornos depresivos comórbidos, independientes del alcohol y/o uso de drogas. La severidad de la depresión estuvo asociada de manera significativa con la severidad del uso del alcohol. Ni la depresión seria ni la severidad de los episodios depresivos estuvieron asociadas con los valores de ninguna de las pruebas del funcionamiento del hígado o la presencia de alelos de ALDH1*2 o ADH1C*2. Sin embargo, en participantes de ascendencia africana, la elevada alanina transaminasa (ALT), estuvo asociada (p = 0.038) con el no tener una depresión seria inducida por sustancia. La comorbilidad del trastorno depresivo severo con dependencia del alcohol, es común en los dos grupos étnicos principales de Trinidad y Tobago, y parece ser probablemente tanto la causa como la consecuencia de darse a la bebida y/o al uso de drogas. Los clínicos debían pedir a sus pacientes con dependencia de alcohol, una historia de su depresión.
Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Alcoolismo/epidemiologia , Transtornos de Ansiedade/epidemiologia , Transtornos do Humor/epidemiologia , População Negra/estatística & dados numéricos , Alanina Desidrogenase/genética , Alcoolismo/psicologia , Comorbidade , Depressão/epidemiologia , Genótipo , Índia/etnologia , Trinidad e Tobago/epidemiologiaRESUMO
The present study sought to determine whether an association exists between alcohol dependence and select affective and anxiety disorders in patients presenting at substance abuse centres in Trinidad and Tobago (TT). The participants in this study were 143 alcohol dependents, of either East Indian ancestry (Indo-TT) or African ancestry (Afro-TT) and 109 controls matched by age, gender and ethnicity. A structured interview was used to gather information on demographics, psychiatric diagnoses and personal drinking and drug use. A blood sample was obtained and used to genotype for the presence of ADH and ALDH1 polymorphisms and serum levels of hepatic enzymes. Forty-one per cent of Indo-TT and 37% of Afro-TT with alcohol dependence had co-morbid major depressive disorders independent of alcohol and/or drug use. Thirty-nine per cent of Indo-TT and 37% of Afro-TT with alcohol dependence had co-morbid major depression induced by alcohol or drug use. The severity of depression was significantly associated with severity of alcohol dependence. Neither major depression nor the severity of depressive episodes was associated with values of any liver function test or the presence of ALDH1*2 or ADH1C*2 alleles. However in participants of African descent elevated alanine transaminase ALT was associated (p = 0.038) with not having substance-induced major depression. Co-morbidity of major depressive disorder with alcohol dependence is common in the two major ethnic groups in Trinidad and Tobago and appears to be as likely the consequence of drinking and/or drug use, as the cause. Clinicians should solicit a history of depression from patients with alcohol dependence.