L'objectif principal de ce mémoire est d'évaluer le rôle modérateur de trois traits de personnalité, soit l'estime de soi, le sentiment de cohésion, ainsi que le centre de contrôle interne sur la relation entre les conditions de l'organisation du travail et la consommation d'alcool à risque, ainsi que la consommation de médicaments psychotropes des travailleurs canadiens. Les données sur lesquelles nous nous sommes basés proviennent de l'Enquête Nationale sur la Santé de la Population (ENSP) de Statistique Canada. Celle-ci a été conduite à des intervalles de deux ans, de l’année 1994 jusqu'à l’année 2003, et comprend ainsi cinq cycles longitudinaux. Les analyses multiniveaux que nous avons effectuées nous ont permises d’identifier cinq variables des conditions de l'organisation du travail qui s’associent de manière significative à la consommation d'alcool à risque, soit l’utilisation des compétences qui augmente de 7% le risque de faire partie du groupe de consommation d’alcool à risque par un travailleur, les demandes psychologiques qui augmentent ce risque de 69%, et les travailleurs confrontés à un horaire de travail irrégulier qui consomment 61% plus d’alcool à risque que les travailleurs qui ont un horaire de travail régulier. Inversement, l’insécurité d’emploi réduit de 12% le risque de faire partie du groupe de consommation d’alcool à risque, et les travailleurs bénéficiant d’un soutien social au travail courent 5% moins de risque de consommation d’alcool à risque. Pour ce qui est des médicaments psychotropes, nos analyses multiniveaux nous ont permises d’identifier deux variables des conditions de l’organisation du travail qui y sont associées de manière significative. Il s’agit de l’utilisation des compétences qui augmente de 8% le risque de faire partie du groupe de consommation de médicaments psychotropes, alors que le nombre d’heures travaillées diminue de 1% ce risque. En ce qui concerne les traits de personnalité, l’estime de soi augmente de 17% le risque de consommation d’alcool à risque, alors que le sentiment de cohésion diminue de 1% ce risque. L’estime de soi joue un rôle modérateur faible entre les conditions de l’organisation du travail et la consommation d’alcool à risque, puisque celle-ci diminue de 3% l’effet pathogène des demandes physiques imposées sur les travailleurs sur leur consommation d’alcool à risque. Pour ce qui est des médicaments psychotropes, nos résultats indiquent que l’estime de soi diminue de 4% le risque de consommation de médicaments psychotropes, le centre de contrôle interne diminue de 9% ce risque, et le sentiment de cohésion quant à lui, diminue ce risque de 3%. D’ailleurs, aucun trait de personnalité ne joue un rôle modérateur entre les conditions de l’organisation du travail et la consommation de médicaments psychotropes. / The main objective of this master's thesis is to determine the moderator effect of personality traits (self esteem, sens of cohesion, sens of control) on the relationship between work organization conditions, and risky alcohol consumption, as well as psychotropic medication consumption by canadian workers. In order to conduct our project, we relied on data that came from five cycles of the National Population Health Survey (NPHS). This survery was conducted at a two year interval, spanning from the year 1994 until 2003, and includes five longitudinal cycles. The multilevel analyis we performed, allowed us to identify five work organization conditions that increase the risk of risky alcohol consumption.Skill utilisation increases by 7% the risk of being part of a risky alcohol consumption group, while psychological demands increase risky alcohol consumption by 69%, and workers confronted to an irregular work schedule consume 61% more risky alcohol. However, job insecurity decerases by 12% the risk of being part of a risky alcohol consumption group, and workers that enjoy social support at work have a 5% lesser risk of being part of a risky alcohol consumption group. As for psychotropic medications consumption, our multilevel analysis allowed us to identify two work organization conditions that are associated in a significant manner to the psychotropic medication consumption. Skill utilisation at work increases by 8% the risk of being part of a pscyhotropic medication consumption group, while the number of hours worked decreases by 1% the risk of being part of a psychotropic medication consumption group. As for personnality traits, our results indicate that self esteem increases by 17% the risk of risky alcohol consumption, while sense of cohesion decreases by 1% this risk. In addition, self esteem plays a moderator role by diminuishing by 3% the pathologic impact of physical demands at work on risky alcohol consumption. Concerning psychotropic medications consumption, our results indicate that self esteem diminuishes by 4% the risk of psychotropic medications consumption, sense of control diminuishes by 9% the risk of psychotropic medications consumption, and sense of cohesion diminuishes by 3% this risk. In addition, none of the personnality traits plays a moderator role between work’s organization’s conditions and psychotropic medications consumption.

Many studies have reported that women consume approximately twice the amount of psychotropic drugs as men. In an attempt to explain this ratio, a conceptual model of psychotropic drug was developed, focusing on questions of initial problem recognition and definition; problem-solving ability; and the perception of control. These factors were explored with 179 women chosen to reflect varying frequencies of drug use. In addition, patient-physician interaction was evaluated by psychiatrists' diagnostic and prescriptive reactions to differing patient attributes. / Multidimensional scaling interpretations across drug frequency groups indicated that external causal attribution and lack of control were concomitants of drug use. Deficient problem-solving, particularly at the definitional stage, accounted for 21% of drug use variance, discriminating 73% of drug users. Physicians were found to prescribe according to factors additional to diagnosis and symptomatology. This research was seen as providing theoretical coherence to the increasingly complex gestalt of drug use.

Aim: The overall aim of this thesis was to study mental distress, health and lifestyle habits, social factors and psychotropic drug use by young people, and how PHNs conceive their roles in relation to this. Methods: Quantitative and qualitative methods were used. Study I included data  from the Norwegian Youth Health Study (NYHS, 11 620 participants, aged 15-16 years) (2000–2003) linked to the Norwegian Prescription Database (NorPD) (2004–2009). Study II included prescription data on psychotropic drugs among 15-16 year olds from the NorPD (2006–2010). Eight young people were interviewed and qualitative content analysis was used to analyse the data (III). Study IV included interviews with 20 Public Health Nurses (PHN), and was analysed using a phenomenographic approach. Main results: Mental distress was reported among 15.5% of the adolescents non-users of psychotropic drugs, 75% of whom were girls. In both genders reporting mental distress, incident psychotropic use was higher one to nine years, up to 27.7% among girls, as compared with the rest of the participants. In addition, health, lifestyle habits and social factors were associated with incident use (I). Psychotropic drug use increased during 2006–2010, hypnotics and melatonin accounted for most of the increase. In total, 16.4% of all incident psychotropic drug users in 2007 were still having prescriptions dispensed in 2010 (II). Young people experience both beneficial and undesired effects from psychotropic drugs. Access to professional support and follow-up was experienced as insufficient. Life with family, friends, school and work was influenced by psychotropic drug use, and they were afraid of being lonely and stigmatized (III). The PHNs conceived their roles in relation to young people as; the discovering PHNs who became aware of psychotropic drug use in the health dialogues and chose either to act or not to act in relation to this. Those PHNs who took action continued to be the cooperating PHNs who cooperated with the young people, their families, schools, and others. If cooperation was established, the supporting PHNs teach and support the young people in relation to psychotropic drug use (IV). Conclusions: Attention must be paid to poor mental health and increasing psychotropic drug use by young people. Advances in knowledge, treatment and follow-up are needed. The prevalence of mental distress among young people, with differences between the genders, as well as between socioeconomic groups, should have consequences for health promotion strategies. PHNs in Norway, working in health centres and schools, have responsibility and opportunity to identify and follow-up young people with mental health problems. / Baksidestext International studies indicate an increase in mental distress and psychotropic drug use among young people. In this thesis mental distress is reported among 15.5 % of the young people. Of those reporting mental distress 75 % were girls. One quarter of the girls reporting mental distress at 15-16 years of age was incident users of psychotropic drugs one to nine years later. Psychotropic drug use, increase among young people, particularly hypnotic drugs. The young people experience beneficial and undesired effects of the psychotropic drugs. They miss out on professional availability and follow-up, and experience negative reactions related to their psychotropic drug use by their significant others. The public health nurse who discovers psychotropic drug use among young people chooses either to act or not to act in relation to this. Those who choose to act continue to cooperate with the young people and others. An established cooperation was followed by a public health nurse who supports and teaches the young people. The prevalence of mental distress, with a high frequency of initiation of psychotropic drug use among young people should have consequences for health promotion in the school health service. Public health nurses, working in health centers and schools, have a responsibility to promote health and prevent health problems. They have the responsibility and opportunity to identify young people struggling with mental health problems and psychotropic drug use as well as teach and support significant others.

Narcotic and psychotropic substances are all chemicals that affect a person&rsquo / s mental activities, perceptual abilities, behavior and level of consciousness / they may cause physical and/or psychological dependence. For determination of narcotic and psychotropic substances, chromatographic techniques are usually preferred which are aimed to identify the target chemicals and require several extraction steps. In this study, an Infrared Spectrometric method has been developed for qualitative determination of most widely encountered substances (morphine, heroin, cocaine, MDMA (3,4-methylenedioxymethamhetamine) and amphetamine) and additives (caffeine, paracetamol and lactose). Standard reference materials and illicit samples have been analyzed in powdered form by using Fourier Transform Infrared-Attenuated Total Reflectance (FTIR-ATR) technique. In the first part, a spectral FTIR database was constituted from the standard references. Illicit samples containing drugs and additives in varying percentages were analyzed using the same method and their database forecast results were compared with results from Gas Chromatography and High Pressure Liquid Chromatography. In the second part of the study, the possibility of finding a similarity between two samples just by comparing their spectra was investigated. For this purpose, all illicit sample spectra were collected in a new database, and then randomly selected samples were searched using this database. Most of the search attempts resulted in a correct match. Consequently, it has been observed that FTIR-ATR can be used as a priory detection step for classification studies / moreover with this technique pre-determination of narcotic and psychotropic substances can be done simply and rapidly.

Thesis (M.A.)--University of Toronto, 2006. / Source: Masters Abstracts International, Volume: 44-06, page: 2503.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2002. / Härtill 5 uppsatser.

Thesis (Ph. D.)--University of Wisconsin, 1954. / Typescript (carbon copy). eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves [53]-[60]).

Pharmacological magnetic resonance imaging (phMRI) is the use of functional MRI techniques to elucidate the effects that psychotropic drugs have on neural activity within the brain; it is an emerging field of research that holds great potential for the investigation of drugs that act on the central nervous system by revealing the changes in neural activity that mediate observable changes in behavior, cognition, and perception. However, the realization of this potential is hampered by several unanswered questions: Are the MRI measurements reliable surrogates of changing neural activity in the presence of pharmacological agents? Is it relevant to investigate psychiatric phenomena such as reward or anxiolysis in anesthetized, rather than conscious animals? What are the methods that yield reproducible and meaningful results from phMRI experiments, and are they consistent in the investigations of different drugs? The research presented herein addresses many of these questions with the specific aims of 1) Developing pharmacological MRI methodologies that can be used in the conscious animal, 2) Validating these methodologies with the investigation of a non-stimulant, psychoactive compound, and 3) Applying these methodologies to the investigation of typical and atypical antipsychotic drugs, classes of compounds with unknown mechanisms of therapeutic action Building on recent developments in the field of functional MRI research, we developed new techniques that enable the investigator to measure localized changes in metabolism commensurate with changing neural activity. We tested the hypothesis that metabolic changes are a more reliable surrogate of changes in neural activity in response to a cocaine challenge, than changes observed in the blood-oxygen-level-dependent (BOLD) signal alone. We developed a system capable of multi-modal imaging in the conscious rat, and we tested the hypothesis that the conscious brain exhibits a markedly different response to systemic morphine challenge than the anesthetized brain. We identified and elucidated several fundamental limitations of the imaging and analysis protocols used in phMRI investigations, and developed new tools that enable the investigator to avoid common pitfalls. Finally, we applied these phMRI techniques to the investigation of neuroleptic compounds by asking the question: does treatment with typical or atypical antipsychotic drugs modulate the systems in the brain which are direct or indirect (i.e. downstream) substrates for a dopaminergic agonist? The execution of this research has generated several new tools for the neuroscience and drug discovery communities that can be used in neuropsychiatric investigations into the action of psychotropic drugs, while the results of this research provide evidence that supports several answers to the questions that currently limit the utility of phMRI investigations. Specifically, we observed that metabolic change can be measured to resolve discrepancies between anomalous BOLD signal changes and underlying changes in neural activity in the case of systemically administered cocaine. We found clear differences in the response to systemically administered morphine between conscious and anesthetized rats, and observed that only conscious animals exhibit a phMRI response that can be explained by the pharmacodynamics of morphine and corroborated by behavioral observations. We identified fundamental and drug-dependent limitations in the protocols used to perform phMRI investigations, and designed tools and alternate methods to facilitate protocol development. By applying these techniques to the investigation of neuroleptic compounds, we have gained a new perspective of the alterations in dopaminergic signaling induced by treatment with antipsychotic medications, and have found effects in many nuclei outside of the pathways that act as direct substrates for dopamine. A clearer picture of how neuroleptics alter the intercommunication of brain nuclei would be an invaluable resource for the classification of investigational antipsychotic drugs, and would provide the basis for future studies that examine the neuroplastic changes that confer therapeutic efficacy following chronic treatment with antipsychotic medications.

Introdução: Os Benzodiazepínicos estão entre as drogas mais prescritas no mundo. Possuem características ansiolíticas, hipnóticas, miorelaxantes e anticonvulsivantes. Estudos prévios evidenciam inadequações nas prescrições de benzodiazepínicos, como uso equivocado para quadros inespecíficos, tratamento prolongado e abuso por idosos. Benzodiazepínicos podem trazer sérios efeitos adversos, sobretudo em idosos, como sonolência diurna, deterioro da memória e funções cognitivas, desequilíbrio e quedas. Objetivos: Analisar a prevalência do uso de benzodiazepínicos nos pacientes do Centro de Atenção Psicossocial (CAPS) de Campo Bom-RS em um período de 24 meses (Junho de 2013 a Maio de 2015), faixa etária, frequência de dispensações, dosagens, CIDs e especialidades dos médicos prescritores; bem como possíveis relações com a função cognitiva, afetiva, e quedas em idosos. Métodos: Estudo transversal, com informações coletadas e tabuladas a partir dos prontuários e prescrições médicas do CAPS Campo Bom, bem como do seu sistema informatizado de gerenciamento (Software Multi 24 Horas). Foram obtidos dados como idade, gênero, identificação dos CIDs; bem como informações sobre prescrições de Benzodiazepínicos, como frequência, quantidade, tipo de medicamento, posologia, profissional prescritor e demais medicamentos utilizados. Critério de inclusão: utilização de qualquer benzodiazepínico disponível na rede SUS: Clonazepam 0,5mg, Clonazepam 2,5 mg/ml, Clonazepam 2mg e Diazepam 5mg. Foram aplicados os testes MEEM e GDS nos pacientes idosos, em entrevistas individuais, nas quais também se avaliou a escolaridade, ocorrência e frequência de quedas, além das comorbidades auto relatadas. Para construção do banco de dados foi utilizado o Software Microsoft® Office Excel® 2007, e para análise estatística o Software PASW V18 (SPSS®). Resultados: O número total de pacientes ativos identificados no CAPS foi de 855 indivíduos, sendo 543 (63,5%) mulheres e 84 idosos (9,8%). A prevalência de utilização de BZD nesta população representou 47,2% (n=404 indivíduos). Foram identificadas 12.680 prescrições médicas dispensadas e, deste total, a prevalência de prescrições de benzodiazepínicos foi de 21,7% (n=2.748). Dentre os pacientes que receberam BZD, 297 (73,5%) eram mulheres e 59 idosos (14,6%), dos quais 56 foram entrevistados. Dentre os idosos entrevistados, 42 (75,0%) possuíram significativa sintomatologia depressiva (GDS≥5) e 32 (57,1%) apresentaram duas ou mais quedas no período de 1 ano. Dezoito pacientes idosos demonstraram fazer uso de dois ou mais BZDs. Houve correlação linear negativa entre os escores do MEEM e do GDS (r = - ,416; p=,002). Houve também uma correlação linear negativa entre o escore do MEEM e número de quedas em idosos (r = -,327 p=,016). Conclusões: Os benzodiazepínicos corresponderam a 21,7 % do total de prescrições do CAPS e do total dos indivíduos 47,2% receberam benzodiazepínicos. Proporcionalmente aos homens, as mulheres tenderam a receber mais prescrições de benzodiazepínicos (p<.001). A prevalência de significativa sintomatologia depressiva nos idosos usuários do CAPS foi alta (75,0%), assim como a incidência de quedas, sendo que mais da metade dos idosos caiu 2 ou mais vezes no período. Identificou-se uma correlação linear negativa entre a função cognitiva como avaliada pelo MEEM e a sintomatologia depressiva avaliada pelo GDS; bem como houve uma correlação linear negativa entre o MEEM e o número de quedas em idosos. / Introduction: Benzodiazepines are among the most prescribed drugs in the world, they have characteristics such as anxiolytic, hypnotic, muscle relaxants and anticonvulsants. Studies have pointed out distortions in benzodiazepines’ prescriptions, such as misuse for unspecific cases, prolonged treatment and use by elderly. Such medications may cause serious damage, particularly in the elderly, and its continued use causes side effects such as daytime somnolence, imbalance, memory and cognitive function loss, increased incidence of falls. Objectives: To assess the prevalence of benzodiazepine use among patients of the Center for Psychosocial Care in Campo Bom-RS within the period of June 2013 to May 2015. The variables analyzed were: age, frequency of dispensations, dosages, ICDs and specialties of prescribing doctors; as well as possible correlations between cognitive function, emotional function and falls in the elderly. Methods: Cross-sectional study, with data collected and tabulated from medical records and prescriptions, as well as from the management system from CAPS (Software Multi 24 hours). Data obtained was age, gender, ICDs identification; as well as frequency of prescriptions, quantity and type of medication, dosage, prescribing professional, others used drugs. Inclusion criteria: Use of any benzodiazepine available in the Health Unic System: Clonazepam 0,5 mg, Clonazepam 2,5 mg/ml, Clonazepam 2 mg and Diazepam 5mg. MMSE and GDS tests have been applied in the elderly, through individual interviews, in which we found about educational level, occurrence and frequency of falls and other self-reported comorbidities. The software Microsoft® Excel® 2007 was used to build database, and for statistical analysis the software PASW V18 (SPSS) was used. Results: The total number of active patients identified at CAPS was 855 individuals, of these 543 were women (63.5%) and 84 elderly (9.8%). The prevalence of benzodiazepines’ use in this population was 47.2 % (n = 404). We have found 12.680 prescriptions dispensed and the prevalence of benzodiazepines’ prescriptions was 21.7 % (n = 2.748). Among patients who received benzodiazepines, 297 (73.5%) were women and 59 elderly (14.6%), of these 56 were interviewed. From the interviewed patients, 42 (75.0%) had significant depressive symptomatology (GDS≥5) and 32 (57.1%) have suffered two or more falls. Eighteen elderly patients demonstrated to use two or more benzodiazepines. There was a negative linear correlation between MMSE and GDS scores (r = -.416, p =.002). There was also a negative linear correlation between MMSE scores and number of falls in elderly (r = -.327 p =. 016). Conclusions: Benzodiazepines accounted for 21.7% of the total CAPS’ prescriptions, and 47.2% individuals treated at CAPS received benzodiazepines. Women tended to receive more prescriptions of benzodiazepines (p <.001) than men. The prevalence of significant depressive symptomatology in the elderly was very high (75.0%). As well as the incidence of falls, since more than half of the elderly patients presented two or more falls in the period. We identified a negative linear correlation between cognitive function as assessed by MMSE and depressive symptoms assessed by the GDS; and there was a negative linear correlation between MMSE and the number of falls in the elderly.

Apesar de amplamente prescritos, os psicofármacos são ainda controversos quanto a sua utilização. O uso em larga escala remete a outras dimensões do problema, que extrapolam à psiquiatria e permeiam as áreas da psicologia e das ciências sociais. Entender o uso destes medicamentos é entender as características da população que os utiliza. Assim, esta dissertação objetivou descrever a prevalência autorreferida de uso de psicofármacos pela população urbana brasileira, focando nas diferenças entre homens e mulheres. Para isso, foi avaliada a prevalência global, e estratificada por sexo, do uso de medicamentos psicotrópicos valendo-se dos dados da Pesquisa Nacional Sobre o Acesso, Utilização e Promoção do Uso Racional de Medicamentos (Pnaum). Os psicofármacos foram agrupados em 4 classes terapêuticas: antidepressivos; ansiolíticos; antipsicóticos e estabilizadores do humor. Foram calculadas as prevalências e razões de prevalência e seus intervalos de confiança de 95% [IC95%] e foram aplicados testes do qui-quadrado de Pearson para avaliação da significância estatística das diferenças entre os grupos, considerando o nível de significância de 5%. Entre os entrevistados, 8,0% declararam utilizar ao menos um psicofármaco. Esta prevalência sobe para 10,9% quando considerado apenas o sexo feminino, que chega a apresentar prevalência de uso 2 vezes maior do que os homens na faixa etária dos 35 aos 46 anos de idade. As prevalências de uso de psicofármacos para homens, mulheres e amostra sem distinção de sexo aumentam com o aumento da idade, número de doenças crônicas e número de medicamentos utilizados para o tratamento destas doenças. Os antidepressivos e ansiolíticos figuram como as classes terapêuticas mais utilizadas, sendo estas mesmas classes mais prevalentes entre as mulheres, em todas as faixas etárias, enquanto os antipsicóticos e 8 estabilizadores do humor foram mais prevalentes entre os indivíduos do sexo masculino. Os resultados indicam um maior uso destes medicamentos por parte das mulheres, e um padrão diferenciado entre elas e os homens no que se refere às classes terapêuticas. Buscando compreender estas diferenças, esta dissertação percorre aspectos relacionados às especificidades biológicas dos sexos e aos papéis sociais exercidos por homens e mulheres, incluindo suas implicações no modelo de saúde. / Although widely prescribed, psychotropic drugs are still controversial as to their use. Large-scale use refers to other dimensions of the problem, which go beyond psychiatry and permeate areas of psychology and social sciences. Understanding the use of these drugs is, therefore, understanding the characteristics of the population that uses them. Thus, this dissertation aimed to describe the selfrefered prevalence of psychotropic medication use by the Brazilian urban population, focusing on the differences between men and women. For this, the overall prevalence and stratified by sex prevalence of the psychotropic drugs use were evaluated using data from the National Survey on Access, Use and Promotion of Rational Use of Medicines (Pnaum). The psychotropic drugs were grouped into four therapeutic classes: antidepressants; anxiolytics; antipsychotics and mood stabilizers. Prevalence, prevalence estimates and their 95% confidence intervals [95% CI] were calculated and Pearson's qui-square tests were used to assess the statistical significance of the differences between the groups, considering a significance level of 5%. Among those interviewed, 8.0% reported using at least one psychotropic drug. This prevalence rises to 10.9% when considered only female, which has a prevalence of use 2 times higher than men in the age group of 35 to 46 years of age. The prevalences of psychoactive drugs use for men, women and non-gender sample increases with increasing age, number of chronic diseases and number of drugs used to treat diseases. Antidepressants and anxiolytics appear as the most commonly used therapeutic classes, the same classes being more prevalent among women in all age groups, while antipsychotics and mood stabilizers were more prevalent among males. The results indicate a greater use of these drugs by women, and a differentiated 10 pattern between them and the men regarding the therapeutic classes. Seeking to understand these differences, this dissertation covers aspects related to the biological specificities of the sexes and to the social roles played by men and women, including its implications in the health model.