OBJETIVOS: O presente estudo visou estimar a prevalência da comorbidade entre transtornos mentais graves e o abuso de substâncias psicoativas, e estudar os fatores associados a essa comorbidade, em pacientes com transtornos mentais graves residentes em São Paulo. MÉTODO: O estudo teve desenho de corte transversal. Vinte serviços de saúde mental (emergências, hospitais psiquiátricos e ambulatórios) foram pesquisados, a fim de identificar todos os pacientes com idade entre 18 e 65 anos, com diagnóstico clínico de transtorno mental grave, que fossem residentes em um dos 7 distritos administrativos escolhidos para o estudo e que tiveram ao menos um contato com o serviço de saúde no período entre 1/9/1997 e 30/11/1997. Os pacientes incluídos foram avaliados quanto a sintomas psiquiátricos, ajustamento social, uso de álcool e uso de substâncias psicoativas, utilizando-se instrumentos padronizados. RESULTADOS: Dos 620 pacientes identificados, 404 foram aleatoriamente selecionados para serem entrevistados. Foi possível entrevistar diretamente 192 (47,9%) indivíduos. A prevalência de comorbidade nos últimos 12 meses foi de 10,4% (I.C. 95%: 6.5 a 15.6), sendo 7,3% para abuso de álcool e 4,7% para abuso de drogas ilícitas, e mostrou-se maior entre homens, entre migrantes, entre indivíduos separados/divorciados, em indivíduos com 12 ou mais anos de escolaridade, e em indivíduos com o diagnóstico de transtornos do espectro da esquizofrenia. A presença de sintomas negativos de esquizofrenia foi significativamente menor entre os indivíduos que receberam o diagnóstico de abuso de substâncias psicoativas. CONCLUSÃO: Os resultados deste estudo sugerem que na população estudada a prevalência de transtornos decorrentes do uso de álcool e outras drogas é mais baixa do que as prevalências encontradas em outros estudos, realizados nos EUA e Europa. Essa discrepância de resultados pode ser devida a diversos fatores, incluindo o consumo de substâncias pela população geral na qual estão os sujeitos investigados, o ambiente social onde esses sujeito vivem e aspectos culturais relacionados ao consumo de substâncias. / OBJECTIVES: To investigate the prevalence of substance use disorders among patients with severe mental illnesses in São Paulo, Brazil, and to study factors associated with such comorbidity. METHOD: The study had a cross-sectional design. Twenty mental health services (emergency, inpatient and outpatient services) were scrutinized to identify all patients aged 18 to 65 years old, with a clinical diagnosis of severe mental illness, who were resident in one of 7 administrative districts chosen for the study, and had had at least one contact with such services between 1stSeptember and 30th November 1997. Assessments included psychiatric symptoms, social adjustment, and patterns of alcohol and drug use, using standardized instruments. RESULTS: Out of 620 patients identified, 404 were randomly selected to be interviewed. One hundred and ninety two patients (47.9%) were directly interviewed. The prevalence of comorbidity was 10,4% (95%CI: 6.5 to 15.6), being 7,3% for alcohol abuse and 4,7% for drug abuse, and was higher among male subjects migrants, single or separated individuals, those with 12 or more years of education, and among those with schizophrenia-like disorders. Presence of negative symptoms was associated with lower prevalence of comorbidity. CONCLUSIONS: Results of the present study suggest that the prevalence of dual diagnosis in São Paulo is lower than those found in previous studies, carried out in the USA and Europe. Such discrepancy may be due to several factors, including population patterns of substance use, the social environment where patients live, and cultural issues related to the use of alcohol.

OBJETIVOS: O presente estudo visou estimar a prevalência da comorbidade entre transtornos mentais graves e o abuso de substâncias psicoativas, e estudar os fatores associados a essa comorbidade, em pacientes com transtornos mentais graves residentes em São Paulo. MÉTODO: O estudo teve desenho de corte transversal. Vinte serviços de saúde mental (emergências, hospitais psiquiátricos e ambulatórios) foram pesquisados, a fim de identificar todos os pacientes com idade entre 18 e 65 anos, com diagnóstico clínico de transtorno mental grave, que fossem residentes em um dos 7 distritos administrativos escolhidos para o estudo e que tiveram ao menos um contato com o serviço de saúde no período entre 1/9/1997 e 30/11/1997. Os pacientes incluídos foram avaliados quanto a sintomas psiquiátricos, ajustamento social, uso de álcool e uso de substâncias psicoativas, utilizando-se instrumentos padronizados. RESULTADOS: Dos 620 pacientes identificados, 404 foram aleatoriamente selecionados para serem entrevistados. Foi possível entrevistar diretamente 192 (47,9%) indivíduos. A prevalência de comorbidade nos últimos 12 meses foi de 10,4% (I.C. 95%: 6.5 a 15.6), sendo 7,3% para abuso de álcool e 4,7% para abuso de drogas ilícitas, e mostrou-se maior entre homens, entre migrantes, entre indivíduos separados/divorciados, em indivíduos com 12 ou mais anos de escolaridade, e em indivíduos com o diagnóstico de transtornos do espectro da esquizofrenia. A presença de sintomas negativos de esquizofrenia foi significativamente menor entre os indivíduos que receberam o diagnóstico de abuso de substâncias psicoativas. CONCLUSÃO: Os resultados deste estudo sugerem que na população estudada a prevalência de transtornos decorrentes do uso de álcool e outras drogas é mais baixa do que as prevalências encontradas em outros estudos, realizados nos EUA e Europa. Essa discrepância de resultados pode ser devida a diversos fatores, incluindo o consumo de substâncias pela população geral na qual estão os sujeitos investigados, o ambiente social onde esses sujeito vivem e aspectos culturais relacionados ao consumo de substâncias. / OBJECTIVES: To investigate the prevalence of substance use disorders among patients with severe mental illnesses in São Paulo, Brazil, and to study factors associated with such comorbidity. METHOD: The study had a cross-sectional design. Twenty mental health services (emergency, inpatient and outpatient services) were scrutinized to identify all patients aged 18 to 65 years old, with a clinical diagnosis of severe mental illness, who were resident in one of 7 administrative districts chosen for the study, and had had at least one contact with such services between 1stSeptember and 30th November 1997. Assessments included psychiatric symptoms, social adjustment, and patterns of alcohol and drug use, using standardized instruments. RESULTS: Out of 620 patients identified, 404 were randomly selected to be interviewed. One hundred and ninety two patients (47.9%) were directly interviewed. The prevalence of comorbidity was 10,4% (95%CI: 6.5 to 15.6), being 7,3% for alcohol abuse and 4,7% for drug abuse, and was higher among male subjects migrants, single or separated individuals, those with 12 or more years of education, and among those with schizophrenia-like disorders. Presence of negative symptoms was associated with lower prevalence of comorbidity. CONCLUSIONS: Results of the present study suggest that the prevalence of dual diagnosis in São Paulo is lower than those found in previous studies, carried out in the USA and Europe. Such discrepancy may be due to several factors, including population patterns of substance use, the social environment where patients live, and cultural issues related to the use of alcohol.

The present study compared the suicidal behaviour and related measures of adolescents in high school in Germany (N=318) and South Africa (N=299). Participants completed a series of self-report measures of the SPS (Suicide Probability Scale), PSS-Fa (Perceived Social Support From Family Scale), PSS-Fr (Perceived Social Support From Friends Scale), SIB (Scale Of Interpersonal Behaviour) and a number of demographic questions. Analyses were conducted using content analysis, correlation coefficients and logistic regression to determine variables related to previous suicide attempts, stepwise multiple regression to account for variables predicting currents suicidal risk; and multivariate analysis of variance (MANOVA) to examine differences among the groups and among suicide attempters and non-attempters. 36 German (11.3%) and 48 South African (16.1%) adolescents reported that they had made previous suicide attempts. German adolescents reported 45 (14.2%) suicide attempts in the family and 82 (25.8%) suicide attempts by friends. South African adolescents reported 43 (14.4%) suicide attempts in the family and 92 (30.7%) suicide attempts by friends. The following variables were associated with previous suicide attempts in the German sample: attempted suicide by friends, a life-threatening event, previous psychiatric contact, the death of a friend, low perceived family support, female gender, attempted suicide in the family, suicide of a friend, and low perceived friend support. The following variables were associated with previous suicide attempts in the South African sample: low perceived family support, death of a friend, attempted suicide by friends, female gender, a life-threatening event, previous psychiatric contact, suicide of friends, and attempted suicide in the family. The following variables for the German sample were found to be significant predictors of current suicidal risk: low perceived family and friend support, previous suicide attempts, suicide attempts in the family, a life-threatening event, suicide attempts of friends, suicide of friends, female gender, and previous psychiatric contact. The following variables for the South African sample were found to be significant predictors of current suicidal risk: previous suicide attempts, low perceived family and friend support, death of a friend, a life-threatening event, previous psychiatric contact, suicide attempts in the family, suicide of friends, and suicide attempts of friends. These findings show that suicidal behaviour is frequent in both countries. Suicidal deaths of friends and family is more prevalent in Germany, whereas religion or belief in god does not protect against suicide attempts in both countries. Results indicate that perceived support from family is a strong protective factor against suicide attempts. / Psychology / M.A. (Psychology)

The present study compared the suicidal behaviour and related measures of adolescents in high school in Germany (N=318) and South Africa (N=299). Participants completed a series of self-report measures of the SPS (Suicide Probability Scale), PSS-Fa (Perceived Social Support From Family Scale), PSS-Fr (Perceived Social Support From Friends Scale), SIB (Scale Of Interpersonal Behaviour) and a number of demographic questions. Analyses were conducted using content analysis, correlation coefficients and logistic regression to determine variables related to previous suicide attempts, stepwise multiple regression to account for variables predicting currents suicidal risk; and multivariate analysis of variance (MANOVA) to examine differences among the groups and among suicide attempters and non-attempters. 36 German (11.3%) and 48 South African (16.1%) adolescents reported that they had made previous suicide attempts. German adolescents reported 45 (14.2%) suicide attempts in the family and 82 (25.8%) suicide attempts by friends. South African adolescents reported 43 (14.4%) suicide attempts in the family and 92 (30.7%) suicide attempts by friends. The following variables were associated with previous suicide attempts in the German sample: attempted suicide by friends, a life-threatening event, previous psychiatric contact, the death of a friend, low perceived family support, female gender, attempted suicide in the family, suicide of a friend, and low perceived friend support. The following variables were associated with previous suicide attempts in the South African sample: low perceived family support, death of a friend, attempted suicide by friends, female gender, a life-threatening event, previous psychiatric contact, suicide of friends, and attempted suicide in the family. The following variables for the German sample were found to be significant predictors of current suicidal risk: low perceived family and friend support, previous suicide attempts, suicide attempts in the family, a life-threatening event, suicide attempts of friends, suicide of friends, female gender, and previous psychiatric contact. The following variables for the South African sample were found to be significant predictors of current suicidal risk: previous suicide attempts, low perceived family and friend support, death of a friend, a life-threatening event, previous psychiatric contact, suicide attempts in the family, suicide of friends, and suicide attempts of friends. These findings show that suicidal behaviour is frequent in both countries. Suicidal deaths of friends and family is more prevalent in Germany, whereas religion or belief in god does not protect against suicide attempts in both countries. Results indicate that perceived support from family is a strong protective factor against suicide attempts. / Psychology / M.A. (Psychology)

The study sought to explore the influence of gastrointestinal symptoms in female respondents with emetophobia disorder, panic disorder with agoraphobia and obsessive compulsive disorder. The research assessed a sample of sixty respondents which formed part of three groups which were recruited from clinical and online support groups. The age ranged from twenty to forty-five years. Non-probability quota sampling was employed. A non-experimental research design was implemented in order to make comparisons between these groups’ association of gastrointestinal symptoms and the occurrence of possible vomiting. The differential research strategy determined whether a statistically significant difference existed. The groups were assessed on the Gastrointestinal Symptom Score (2005) and the Patient Assessment of Upper Gastrointestinal Symptom Severity Index (2004). The research aimed to determine whether empirical support exists for the Cognitive Behavioural Model of Emetophobia by Boschen (2007). / Psychology / M.A. (Psychology)

The study sought to explore the influence of gastrointestinal symptoms in female respondents with emetophobia disorder, panic disorder with agoraphobia and obsessive compulsive disorder. The research assessed a sample of sixty respondents which formed part of three groups which were recruited from clinical and online support groups. The age ranged from twenty to forty-five years. Non-probability quota sampling was employed. A non-experimental research design was implemented in order to make comparisons between these groups’ association of gastrointestinal symptoms and the occurrence of possible vomiting. The differential research strategy determined whether a statistically significant difference existed. The groups were assessed on the Gastrointestinal Symptom Score (2005) and the Patient Assessment of Upper Gastrointestinal Symptom Severity Index (2004). The research aimed to determine whether empirical support exists for the Cognitive Behavioural Model of Emetophobia by Boschen (2007). / Psychology / M.A. (Psychology)

Indiana University-Purdue University Indianapolis (IUPUI) / This study investigates differences between Veterans and non-Veterans with severe mental illness (SMI) regarding perceptions of their illness, themselves, and treatment. I compare patient interviews (using the Indiana Psychiatric Illness Interview, IPII) of Veterans (N=20) and non-Veterans (N=26). Modified grounded theory and qualitative coding software Atlas-TI were used to develop codebooks for each group, and these were compared for differences. I examined differences in both code frequency and meaning. Statistically, more Veterans were male, employed, married, had higher income, and had higher education. Statistical differences in code frequency included: more Veterans discussing boredom, regret/guilt/loss, and wanting to be “normal.” More non-Veterans had codes of pessimism and religion/spirituality, wanting a different future, bringing up mental health, family, future: no change, life goals, and relapse. Key differences in narrative themes included: (1) Veterans’ “military mindset”/discussion of anger as part of mental illness, (2) non-Veterans’ focus on mental-illness, (3) differing attitudes regarding stigma, (4) active versus passive attitudes toward treatment, and (5) degree of optimism regarding the future. Differences are described and then potential relationships and interactions are proposed. Veterans appear to have several protective factors (i.e., finances, employment, marriage). Additionally, Veterans’ military-mindset seems to encourage greater stigma-resistance, and thereby also facilitate Veterans being more active and optimistic toward treatment and recovery. By contrast, non-Veteran focus on mental illness may be related to increased self-stigma, passive and pessimistic attitudes. I propose that Veteran identity can serve as an additional protective factor against stigma, pessimism, and passivity. Veteran-identity may also be a useful framework clinically, to help promote active approaches to treatment (e.g., “fighting symptoms”). Further, Veterans emphasized issues relating to anger as important and part of their mental health. It may be that Veterans are more comfortable discussing mental health in the language of “anger,” given stigma. Finally, findings suggest that helping individuals in both groups engage in meaningful, non-mental illness-related life activities may help shape self-perception, and thereby responses to stigma, attitudes toward treatment, and hope for the future.