Biomedical subjects
Publications and source records attributed to Miguel Roberto Jorge.
The Cocaine Craving Questionnaire was administered to 205 cocaine addicts. A 6/5 cut-off corresponded to the scale's best performance. Reliability was 0.803. Receiver Operating Characteristic analysis resulted in an area under the curve of 0.7199 +/- 0.0384, and dimensionality resulted in a three-factor solution. The scale is a reliable and valid instrument in identifying craving.
INTRODUCTION: Craving for cocaine seems to play an important role in the continued use of and dependence on the substance. AIMS: to describe characteristics of the craving phenomenon in a sample of cocaine users and to identify those that could predict the appearance of the phenomenon. METHOD: 205 cocaine users attending an outpatient clinic were interviewed to assess patterns of drug consumption and characteristics of craving for the drug. FINDINGS: Subjects were mostly young (24.8+/-12.8 years) and male (86.2%). One hundred and two subjects (49.8%) were addicted to cocaine and the remainders (50.2%) were non-addicted occasional cocaine users. The majority of subjects (60.5%) reported having had craving episodes during the previous week. Frequency of cocaine use during the previous month correlated with the number of reported craving fits (r=0.425; p<0.001) and with the duration of the craving fits (r=0.351; p<0.001). Users of crack reported more craving episodes than did the users of snorted cocaine (p<0.001) and the frequency of craving fits was inversely proportional to the duration of abstinence from the drug (r=-0.405; p<0.001). CONCLUSION: Both the method of drug consumption and the abstinence period elapsed since previous drug intake were identified as predictive parameters of craving.
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Cultural variations in the expression of emotions have been described. Consequently, there are cross-cultural influences on the diagnosis and management of bipolar disorder. This article provides a review of the evidence regarding the main aspects of transcultural psychiatry and bipolar disorder.
Both substance dependence and depressive mood seem to be associated with increased suicide risk. Clinical information on suicide attempts and depressive symptoms were obtained from a sample of 211 psychoactive substance dependents attending a university clinic program for addicts in Brazil. 49 subjects (23.4%) had attempted suicide at least once, and the frequency of reporting attempts was 4.32 times greater among women than among men. Male addicts also tended to engage in potentially more dangerous attempt methods than women. Depressive male addicts were 2.17 times more likely to have attempted suicide than nondepressive addicted men. Among women, no association could be established between having attempted suicide and the presence of depression. Substance addicts have a relatively high risk of attempting suicide and the co-occurrence of depression seems to increase prevalence of suicidal behavior among men.
The Center for Epidemiologic Studies-Depression scale is a screening test designed by the National Institute of Mental Health (USA) to screen for 'depressed' individuals in the community. It has been widely used in different settings and cultures displaying variable psychometric properties. The present article describes coefficients of internal consistency and factor analysis of the CES-Depression version adapted for use in Brazil. In a sample of 523 college students internal consistency measured by Cronbach alpha was .85. Structure analysis evidenced that two questions were poorly correlated with the remaining questions. Factor analysis resulted in a four-dimension solution accounting for 53.8% of the total item variance. The scale is adequate for use in this different cultural setting.
Culturally competent diagnostic systems are necessary for an effective and ethical clinical practice, as cultural diversity of patients increase around the world. Latin American psychiatrists hold a long-standing commitment to this enterprise. Recently, two main Latin American adaptations to the international psychiatric classification have emerged: the Cuban Glossary of Psychiatry, and the project of the Latin American Guide for Psychiatric Diagnosis (GLADP). Keeping ICD-10 as the basis for nosological organization, GLADP is being developed with contributions by mental health professionals from Latin American countries. GLADP comprises 4 parts: (1) historical and cultural framework, (2) comprehensive diagnosis and formulation, (3) psychiatric nosology and (4) appendixes.