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ABSTRACT: To examine sex differences in alcohol consumption according to age groups, and to assess gender and age effects on several aspects of alcohol consumption patterns.
Based on a Brazilian nationwide representative sample (n = 3,007), we analysed the differences in drinking patterns between genders. We also assessed the effects of gender, age, and gender by age interaction for alcohol consumption dimensions (frequent drinking, usual intake, binge drinking, and frequent binge drinking), using logistic and negative binomial regression models.
Gender, age, and gender by age interaction had significant effects on the predictive models for all studied drinking patterns, except for the 'usual' dosage. The effect of gender on drinking patterns varies with age. While gender has a greater effect in older age groups, the difference between men and women decreased in the younger age groups.
Gender convergence regarding alcohol use is a trend that might be influenced by environmental factors and should be addressed in prevention and treatment programs, as well as in public health policies.
Revista Brasileira de Psiquiatria 12/2011; 33(4):367-73. · 1.20 Impact Factor
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ABSTRACT: Obsessive-compulsive disorder (OCD) is a heterogeneous condition, in which subtypes have been proposed. Previous studies suggested that gender plays a relevant role in OCD phenotypic expression. This study aimed to review the literature on gender differences in clinical, genetic or familial aspects of OCD.
A conventional review was conducted, including all papers that investigated demographic, clinical, and genetic aspects of OCD according to gender. The search was based on data available in Medline and PsycINFO databases in the last 20 years, using as keywords: obsessive-compulsive disorder; and: gender, sex, male, female, demographic characteristics, clinical features, clinical characteristics, genetic, genes, genetics gender OCD, genes OCD, genes OCD males, genes OCD females.
Sixty three of 487 phenotypical and genetics studies were selected. Most studies indicate that male patients are more likely than females to be single, present early onset of symptoms and chronic course of the disorder, greater social impairment, more sexual-religious and aggressive symptoms, and greater comorbidity with tic and substance use disorders. Female patients present more contamination/cleaning symptoms and greater comorbidity with eating and impulse-control disorders. Genetic and family studies are inconclusive, but suggest that gender may play a role in the disease expression.
Gender is a relevant factor that should be taken into account when evaluating OCD patients. More studies are necessary to determine whether in fact it defines a homogeneous and particular group in OCD.
Revista Brasileira de Psiquiatria 12/2011; 33(4):390-9. · 1.20 Impact Factor
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01/2010: pages 179 - 188; , ISBN: 9780470749180
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ABSTRACT: Pathological love (PL)--behavior characterized by providing repetitive and uncontrolled care and attention to the partner in a romantic relationship--is a rarely studied condition, despite not being rare and causing suffering. This study aims at investigating impulsivity, personality, and characteristics related to the romantic relationship in this population.
Eighty-nine individuals (50 with PL; 39 individuals with no psychiatric disorder) were compared regarding impulsivity, personality, type of attachment, satisfaction with romantic relationship, and love style.
Individuals with PL have higher levels of impulsivity (P<.001; Barratt Impulsiveness Scale), higher self-transcendence, that is, are more unconventional and hold sense of communion with a wider reality (P<.001; Temperament and Character Inventory) and keep dissatisfactory romantic relationships (P<.001; Adapted Relationship Assessment Scale).
Individuals with PL present personality traits and relationship aspects that must be taken into account in devising assessment and therapeutic strategies for this population.
CNS spectrums 05/2009; 14(5):268-74. · 2.20 Impact Factor
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Revista Brasileira de Psiquiatria 04/2009; 31(1):76. · 1.20 Impact Factor
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Revista Brasileira de Psiquiatria 10/2008; 30(3):292-3. · 1.20 Impact Factor
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ABSTRACT: To test a reliable and easily administered frustration-induction procedure for experimental research.
One hundred volunteers (81 women, mean age +/- SD 34.2 +/- 8 years) physically and psychiatrically healthy submitted to the frustration induction procedure were prevented from reaching reward level scores. Subjective aggressiveness feelings related to frustration were self-rated in a 13-item visual analogue scale before and after the procedure.
Significant increases in aggressiveness-related feelings were detected in 12 of the 13 items. This was consistent with the observed overt behavior of the subjects during the task.
The frustration-induction procedure is a simple, easy to administer frustration-induction procedure that can be used in experimental studies in normal subjects.
Revista Brasileira de Psiquiatria 04/2008; 30(1):47-9. · 1.20 Impact Factor
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Journal of Clinical Psychopharmacology 07/2007; 27(3):314-5. · 4.10 Impact Factor
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ABSTRACT: This study compared the pattern of alcohol, legal and illegal drugs use among students of the Universidade de São Paulo (Brazil) in 1996 and 2001.
Samples of 2.564 (1996) and 2.837 (2001) students answered a questionnaire proposed by the World Health Organization, which characterizes the consumption of alcohol, legal and illegal drugs in lifetime, in the last 12 months and in the last 30 days.
Men showed a significant increase in lifetime use of tobacco (44.8% to 50.9%), marijuana (33.7% to 39.5%) and hallucinogens (6.6% to 14.1%) between 1996 and 2001. No significant change was observed among women between 1996 and 2001 in tranquilizer use. Concerning the consumption reported in the last 12 months, both genders displayed significant increases in the consumption of marijuana (22.3% to 27.1% for men and 12.9% to 16.9% for women), amphetamines (1.9% to 5.0% for men and 3.4% to 5.6% for women), and inhalants (9.8% to 15.7% for men and 5.4% to 10.6% for women). The greatest gender difference was observed in consumption reported in the last 30 days with significant increases in male use of tobacco (19.6% to 23.5%), marijuana (15.8% to 20.5%), amphetamines (1.1% to 3.2%), and inhalants (4.0% to 7.9%). Substance use reported in the last 30 days remained stable among women between the 2 surveys.
Rates of substance use among university students increased. These gender differences in substance consumption should be taken into account in the development of preventive and treatment strategies for undergraduate university students.
Revista Brasileira de Psiquiatria 07/2007; 29(2):123-9. · 1.20 Impact Factor
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ABSTRACT: The pathological love is characterized by being a behavior of taking care and paying attention to the beloved partner in a way which is repetitive and careless of control in an amorous relationship. Although the available data is comprised of case studies, such condition (which is distinguished itself from erotomania or delusional love) seems not to be rare.
We reviewed the available literature on the clinical characteristics of pathological love (PL), using the Medline, Lilacs and PsychoINFO databases.
It was verified that low self-esteem, feelings of anger and affectionate deprivation, and emotional distress can be important psychological factors in the evolvement of such clinical diagnosis. Similarly, some family factors could be associated with it, such as substance abuse, and history of physical and/or emotional negligence during childhood.
The progress of research may bring broader precision on the clinical, etiologic and comorbid features. Thus, this woud be favoring an effetive approach to the bearer, adding a potential repercussion on the affective life of a significant number of people.
Revista Brasileira de Psiquiatria 03/2007; 29(1):55-62. · 1.20 Impact Factor
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ABSTRACT: Craving plays an important role in the addictive behavior process. The impact of gender, emotional state and personality on craving, however, has been understudied. Ninety-six women and 86 men seeking treatment for substance dependence were investigated regarding the association between personality factors (assessed by the Temperament and Character Inventory), depressive/anxiety symptomatology (assessed by the Beck Depression Inventory and the Beck Anxiety Inventory), and craving intensity (rated in the 7-day and the 24-hour periods prior to assessment). Recency of substance use and impulsivity were significantly associated with craving intensity for both women and men. Regression analyses revealed that depression best predicted craving for women, but not for men. These results suggest that while recent substance use and impulsivity can be important predictors of craving across gender, depression plays a critical role in craving among women. This finding underscores the need for vigorous assessment and treatment of comorbid symptomatology in women entering addiction treatment.
Journal of Addictive Diseases 02/2007; 26(1):79-84. · 1.46 Impact Factor
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ABSTRACT: The present study explored the potential for change in personality in women in recovery. Dimensions of the Temperament and Character Model and the five-factor model of personality were examined at baseline and at follow-up after treatment for addiction. Within both models of personality, the factors which have been found to be the best predictors of the presence of a personality disorder (Self-Directedness within the Temperament and Character Model; Neuroticism within the five-factor model) showed significant change at follow-up which suggests the flexibility of personality and the potential for change of personality disorders within women seeking treatment for addiction.
Journal of Addictive Diseases 02/2006; 25(4):59-66. · 1.46 Impact Factor
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ABSTRACT: Domestic violence and substance abuse are common in primary care patients. Although these problems are associated with severe physical and psychological sequelae, they are often undiagnosed. This article provides an overview of the prevalence of these problems, the health-related consequences for adults, children and elderly, as well as the challenges for clinicians in screening, assessment and referral.
Revista Brasileira de Psiquiatria 11/2005; 27 Suppl 2:S51-5. · 1.20 Impact Factor
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ABSTRACT: Craving is a central phenomenon in addiction. Temperament factors are also important for pathologic gambling and other addictions. The aim of this study was to compare craving between pathologic gamblers (PG) and alcohol-dependent subjects (ADS), correlating craving with personality.
Forty-nine PG and 101 ADS willing to start treatment were recruited. A trained psychiatrist diagnosed them according to DSM-IV criteria. To be included in this study, subjects had to be abstinent for at least five days and no longer than 21 days. Alcoholics should have no significant physical withdrawal symptoms by the time of craving assessment. Subjects with current comorbidity with other addictions were excluded, except nicotine. ADS rated craving for alcohol and PG rated craving for gambling on the same questions, respectively. Both answered a semistructured interview, the Temperament and Character Inventory and the Beck Scales for anxiety and depression.
Pathologic gamblers scored higher than ADS on craving measures (p<0.001) and novelty seeking (p=0.01). ADS scored higher in harm avoidance (p=0.01). Alcohol craving correlated positively with anxiety and novelty seeking and negatively with length of abstinence and persistence. Gambling craving correlated positively with depression and negatively with length of abstinence and reward dependence
Pathologic gamblers experienced stronger cravings than did ADS. This may be a disturbing experience for PG and a potential cause for relapse. The higher scores on novelty seeking concur with previous studies that associate PG and impulsivity. ADS higher scores on harm avoidance suggest anxiety vulnerability. The positive relation between alcohol craving, anxiety, and harm avoidance suggests that ADS rely on alcohol to deal with a proclivity to negative emotions. The positive relation of gambling craving to depression and negative relation to reward dependence suggests that individuals who have a lesser susceptibility to experience positive emotions are the ones who most miss gambling when abstaining.
Alcoholism Clinical and Experimental Research 08/2005; 29(8):1427-31. · 3.34 Impact Factor
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ABSTRACT: Among the different possible genes involved in the alcoholism etiology, the X-linked monoamine oxidase A gene is a good candidate. The aim of this study was to assess whether a functional VNTR polymorphism in the promoter region of the monoamine oxidase A gene is associated with alcoholism, comparing patients of both sexes. Ninety-three alcohol-dependent patients (51 males, 42 females) and 93 sex-matched normal controls were engaged. In the total sample, the genotype containing at least one three-repeat allele was significantly more frequent among alcohol-dependent patients than controls (P=0.01). However, when the two sexes were analyzed separately, the difference was statistically significant only for females. This is of particular interest as rates of alcoholism in Brazil are markedly lower in females. Our results suggest that this monoamine oxidase A polymorphism could play a role in susceptibility to alcoholism, which may differ across sexes.
Psychiatric Genetics 07/2005; 15(2):141-4. · 2.58 Impact Factor
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ABSTRACT: Meeting the needs of women manifesting substance-use disorders is a goal in developing treatment programs for this population. As retention in treatment is positively related to treatment outcome, the length of stay in outpatient treatment of alcohol- and other drug-dependent women in Brazil was compared between two programs. Data were analyzed from 181 women entering a Mixed-Gender Program from 1986 to 1996 and from 80 women entering a Women-Only Program from 1997 to 1998. A greater 3-month retention rate was observed in the Women-Only as opposed to the Mixed-Gender Program. Moreover, the impact was more significant among the alcohol-dependent women. This finding suggests that the heterogeneity of women with substance-use disorders has to be taken into account when developing appropriate treatment strategies.
Substance Use & Misuse 01/2004; 38(14):2109-24. · 1.10 Impact Factor
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ABSTRACT: The authors compared 99 drug-dependent women to 162 alcoholic women and 66 drug-dependent men entering an outpatient treatment program. They were assessed by a semistructured interview for demography, progression of dependence prior to entering treatment, prior suicidal behavior, and baseline functioning in different areas (alcohol/drug use, occupation, family relationships, and leisure activities). Discriminant analysis techniques were good at predicting group membership for all groups, with an overall correct classification of 69%; though at a lesser degree for the group of drug-dependent women (55%). Among those drug-dependent women misclassified, two-thirds were reclassified into the drug-dependent men group and the remaining third into the alcoholic women group. Taken together, these findings suggest that the drug-dependent women are a distinct group of substance users, who show more heterogeneous characteristics, as well as sharing more features with the drug-dependent men. This should be taken into account when devising treatment strategies for this specific population.
Addictive Behaviors 10/2003; 28(7):1343-9. · 2.09 Impact Factor
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ABSTRACT: The authors compared 66 women and 66 men entering an outpatient treatment for drug dependence, focussing on demographics, progression of dependence, and other associated clinical features. Most of the subjects were dependent on cocaine (75%). Women, as compared with men, had a higher level of education, were more likely to have migrated from other places to the city of Sao Paulo, to report past suicide attempts, and to have first-degree relatives with alcohol problems. There were no gender differences regarding the total time of drug use, baseline severity of dependence, and rates of concurrent psychiatric comorbidity. Clinicians working with drug-dependent women should note the high rates of suicidal behavior in this population, and should explore, besides psychiatric status, risk factors such as impulsive temperament traits. It should also be noted that higher rates of alcohol problems in women's family background pose challenges for the development of effective preventive and treatment strategies.
Substance Abuse 04/2003; 24(1):17-25. · 1.33 Impact Factor
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ABSTRACT: This article reviews sex differences in psychiatric comorbidity among individuals with substance use disorders and, in particular, the clinical significance of these differences for treatment outcome among women.
We undertook a computerized search of major health care databases. To enhance the search, we drew prior relevant articles from the reference list.
Women with alcohol and other drug use disorders present higher rates of psychiatric comorbidity, particularly mood and anxiety disorders, than do men. Moreover, the comorbid diagnosis, particularly of depression, is more often primary in women, while in men the comorbidity is more often secondary to the substance abuse diagnosis. In addition, there is evidence that psychiatric comorbidity is associated with distinct, sex-specific outcomes for substance use treatment.
Sex differences in the clinical presentation of substance-dependent individuals with psychiatric comorbidity present specific treatment challenges and opportunities.
Canadian journal of psychiatry. Revue canadienne de psychiatrie 03/2003; 48(1):5-13. · 2.42 Impact Factor
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ABSTRACT: Treatment approaches for pathological gambling have been modelled after preexisting substance addiction models. This paper reviews cognitive-behavioural models in a search for original insights that are specific to gambling treatment.
A computerized search of major health care databases (Medline and PsycINFO) was performed.
New cognitive-behavioural approaches to the treatment of pathological gambling provide 3 original additions to the traditional multimodal treatment of addictions: cognitive restructuring, in vivo exposure, and imaginal desensitization. Other cognitive-behavioural techniques, such as relapse prevention, problem solving, and social skill training, are shared by gambling treatment and addictions treatment.
When treating pathological gamblers, clinicians must consider introducing techniques to address cognitive distortions related to gambling. Also, cue exposure--whether in vivo or imaginal--may help deal with urges prompted by such cues. The blending of these new techniques into a multimodal addiction treatment potentially balances the rational and external orientation of the cognitive-behavioural approach with interpersonal and introspective components of the traditional addiction treatment.
Canadian journal of psychiatry. Revue canadienne de psychiatrie 03/2003; 48(1):22-7. · 2.42 Impact Factor
