交互式统计网站的设计与实现--《计算机工程与应用》2003年01期
交互式统计网站的设计与实现
【摘要】：采用网络技术是当今发布统计信息的一种最好的方式。文章较详细地介绍了一个比较实用的统计网站的设计,并通过实例讲述网站最新技术ASP的应用。
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【分类号】：TP393.09【正文快照】：
１引言作为深圳市统计局各类统计信息的发布窗口，“深圳统计业务专网”必须及时、准确、快速地发布最新最全面的统计信息，为各级政府和社会公众提供完善周到的统计信息服务。为建立便于管理、交互式的统计网站，采用了数据库管理方式，利用当今网页设计和网站建设的主流工
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【引证文献】
中国期刊全文数据库
陈伟,邵文渊,刘建;[J];武汉理工大学学报(信息与管理工程版);2004年02期
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黄维平,吴淦国,何明跃,高金汉,苏尚国,付宗堂;[J];吉林大学学报(信息科学版);2005年03期
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谢幼如,尹睿;[J];电化教育研究;2003年01期
魏亚栋;郭英;;[J];北京体育大学学报;2005年12期
邢苗条;[J];现代电子技术;2002年04期
熊伟,张丽静,王振旗;[J];中国电力教育;2004年04期
贾文峰,白琳,黄雄;[J];洛阳大学学报;2003年02期
【二级引证文献】
中国硕士学位论文全文数据库
邵文渊;[D];武汉理工大学;2004年
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J. bras. psiquiatr. vol.61 no.3 Rio de Janeiro
http://dx.doi.org/10.-00004
ARTIGO ORIGINAL
Comorbidities of mental and behavioral disorders in chemically
dependent patients in different periods of abstinence
Comorbidades de transtorno mental e
comportamental em pacientes dependentes qu&micos em diferentes per&odos de
abstin&ncia
Maria de Lourdes Pereira CostaI;
Luiz Carlos Marques de OliveiraII
IUniversidade Federal de Uberl&ndia
(UFU), Centro de Aten&&o Psicossocial de &Alcool e Outras Drogas (CAPS-ad) David
Capistrano da Costa Filho e Programa de Aten&&o & Pessoa com Depend&ncia
IIUFU, Faculdade de Medicina, CAPS-ad,
Departamento de Cl&nica M&dica
OBJECTIVE: To assess the frequency of comorbidities of mental and behavioral disorders
(CMBD) in psychoactive substance (PAS)-dependent patients with different
periods of abstinence cared for at Alcohol and Other Drug Psychosocial Care
Centers (CAPS-ad).
METHOD: All patients under treatment in the two CAPS-ad of the city of Uberl&ndia-MG,
between April and September 2010, were consecutively assessed. The ICD-10
symptom checklist was used to diagnose CMBD; additional information was
obtained from interviews and medical records. The patients were divided
according to duration of abstinence: & 1 week (Group 1); 1-4 weeks (Group
2); and & 4 weeks (Group 3).
RESULTS: Of all patients assessed, 62.8% were diagnosed with CMBD, which were more
frequent (p & 0.05) in Group 1 (72%) than Group 3 (54.2%), and both groups
were similar to Group 2 (61%). Depressive and anxiety disorders were more
frequent among patients of Group 1. Mood disorders were more frequent (p &
0.05) in women [22/34 (65%) vs.
54/154 (35.1%)], whereas psychotic disorders were more frequent (p = 0.05) in
men [16/154 (10.4%) vs.
0]. The presence of CMBD was associated with more severe clinical conditions.
CONCLUSIONS: The higher
frequency of diagnosis of CMBD in patients of Group 1 may have resulted from
the difficulties in distinguishing mental disorders that are due to PAS
intoxication or withdrawal from those that are not. However, to make the
diagnosis of CMBD, even during detoxification, can increase the likelihood of
better response to treatment.
Keywords: Comorbidity, diagnosis, dual (psychiatry), dependency
(psychology), alcoholism.
OBJETIVO: Avaliar a frequ&ncia de comorbidades de transtorno mental e comportamental
(CTMC) em pacientes dependentes de subst&ncias psicoativas (SPA) em Centros de
Aten&&o Psicossocial de &Alcool e outras Drogas (CAPS-ad), com diferentes
per&odos de abstin&ncia.
M&ETODO: Avaliaram-se, consecutivamente, todos os pacientes que estavam em tratamento
nos dois CAPS-ad de Uberl&ndia-MG, entre abril e setembro de 2010. Para o
diagn&stico de CTMC, utilizou-se o Checklist de sintomas da CID-10; informa&&es adicionais foram obtidas em entrevistas e em
prontu&rios. Os pacientes foram divididos de acordo com o tempo de abstin&ncia:
& 1 semana (Grupo 1), 1-4 semanas (Grupo 2) e & 4 semanas (Grupo 3).
RESULTADOS: Dentre todos,
62,8% tiveram diagn&stico de CTMC, que foi mais frequente (p & 0,05) no
Grupo 1 (72%) do que no Grupo 3 (54,2%); ambos os grupos foram semelhantes ao
Grupo 2 (61%). Transtornos depressivos e de ansiedade foram mais frequentes
entre pacientes do Grupo 1. Transtornos de humor foram mais frequentes (p &
0,05) em mulheres [22/34 (65%) vs.
54/154 (35,1%)], enquanto transtornos psic&ticos foram mais frequentes (p =
0,05) em homens [16/154 (10,4%) vs.
0]. CTMC associou-se a piores condi&&es cl&nicas.
CONCLUS&OES: Maior frequ&ncia de diagn&stico de
CTMC entre pacientes do Grupo 1 pode ser decorrente das dificuldades de se
diferenciar transtornos mentais que s&o decorrentes ou independentes da
intoxica&&o ou suspens&o da SPA. Por&m, fazer o diagn&stico de CTMC, mesmo
durante a desintoxica&&o, pode aumentar as chances de resposta ao tratamento.
Palavras-chave: Comorbidade, diagn&stico duplo
(psiquiatria), depend&ncia (psicologia), alcoolismo.
INTRODUCTION
Substance use disorders (SUD), i.e., dependence on or abuse
of a PAS, can be associated with other mental and behavioral disorders (MBD),
which are known as co-occurring, dual diagnosis or comorbidities. Individuals
with SUD associated with comorbidities of MBD (CMBD) had more severe symptoms,
reported greater suffering and consequently sought treatment more often, when
compared to those without comorbidities. However, patients with CMBD showed
poorer adherence to treatment, frequent and faster relapses, a higher
occurrence of social problems and decreased treatment compliance1.
Comorbidities
of MBD range from "high-prevalence, low-impact" disorders such as depression
and anxiety, to "low-prevalence, high-impact" severe mental illnesses such as
psychosis and major mood disorders2. The causes of CMBD in SUD
patients may include coincidence, common genetic vulnerability, common neural
substrate, underlying shared origins, self-medication, and lifestyle2,3.
Diagnosing CMBD in SUD patients is important because it enables both disorders
to be treated. This treatment can be performed sequentially, simultaneously or
in an integrated way, depending on the type and severity of the two disorders3-5.
The frequencies and interference of CMBD
associated with SUD have been studied since the 1980s. The first major
epidemiological study that assessed the prevalence of CMBD in alcohol and/or
other drug-dependent indivi&duals was conducted in the United States between
1980 and 1984 (Epidemiologic Catchment Area – ECA)6. This study
showed a prevalence of CMBD in 37% of alcohol-dependent indivi&duals and in 53%
of other drug-dependent (excluding alcohol) individuals. Since then, clinical and
epidemiological studies conducted in several countries have found high
prevalences of CMBD associated with SUD, showing that the presence of CMBD in
SUD individuals is the norm, rather than the exception7,8.
However, these studies show a wide
variation in the pre&valence of CMBD, which could be attributed to several
factors. For instance, there is no consensus on the defin
narrow definitions commonly limit comorbidity to the co-occurrence of severe
mental illness with concurrent substance use, while broad definitions can
encapsulate all mental health disorders and any level and combination of
substance use problems4. Additionally, the prevalence of CMBD may
vary according to the type of study (clinical or epi&demiological), the type of
service where it was conducted, the assessment method used, sample
socio-demographic characteristics, the drug availability in the community and
the geographic region studied9.
Moreover, it may be difficult to separate
psychiatric disorders from the symptoms of substance abuse, intoxication or
withdrawal. Therefore, the Diagnostic and Statistical Manual of Mental
Disorders, Fourth Edition (DSM-IV) of the American Psychiatric Association
recommends that the assessment to diagnose CMBD should be performed with
individuals who have been abstinent for at least four weeks3.
However, many studies did not describe the duration of abstinence before the
CMBD was diagnosed6,10, or they showed a variation in the period of
abstinence examined11-15.
A literature
review was conducted and there were no studies that assessed the prevalence of
CMBD among SUD patients according to the period of abstinence, using the same
assessment method to diagnose comorbidities. In view of the relevance of this
theme, the present study aimed to assess and compare the prevalence of
diagnosis of CMBD in patients with chemical dependency (CD) cared for at
Alcohol and Other Drug Psychosocial Care Centers (CAPS-ad, in the Portuguese
acronym), according to the duration of abstinence, and to compare
socio-demographic data and some clinical conditions between patients with and
those without CMBD.
Ethical issues
The present study was
approved by the Uberl&ndia Federal University Research Ethics Committee
(Official Opinion 156/10) and the research was conducted according to the
standards required by the Declaration of Helsinki. An informed consent form was
signed by each patient for their participation. Individual interviews were
conducted in a reserved location.
This cross-sectional study was conducted in both CAPS-ad II
in the city of Uberl&ndia, MG, Brazil, between April and September 2010. The
CAPS-ad II are outpatient care institutions that serve adult patients (≥
18 years of age) with disorders resulting from the abuse of or dependence on
Health care is provided by
multi-professional teams in two daily shifts (morning/afternoon) in one of the
CAPS-ad and in three shifts (morning, afternoon and evening until 9:00 pm) in
another one, from Mondays through Fridays. After
being received without a previous appointment and assessed by professionals,
patients are provided the type of treatment that meets their needs, i.e.
intensive, semi-intensive and non-intensive care. Patients in crisis or in need
of detoxification are referred to locations where they can be hospitalized,
i.e. municipal health units or the Uberl&ndia Federal University Clinical
Hospital. In 2010, a total of 650 individuals were registered to be cared for
in the two CAPS-ad.&
Procedures
All patients under treatment
in the two CAPS-ad during the period of data collection were approached
consecutively. The research objectives were explained to them and they were
subsequently invited to participate in the study. None of the patients
approached refused to participate. Patients who were under the effect of PAS,
experiencing a crisis of abstinence or severe psychotic episodes, taking high
psychoactive drug doses that hindered diagnostic assessment, and those with
dementia were excluded from this study. Interviews were conducted by one of the
authors (Costa-MLP), a psychologist with experience in the treatment of
patients with mental disorders, including SUD patients. Prior to data
collection, this researcher was trained to use the ICD-10 symptom checklist for
MBD, version 1.1, with patients of the CAPS-ad. The results obtained were
compared with the psychiatric assessment noted in the medical records and there
was a good level of agreement between them. Mean assessment time for each
patient was one hour and fifty minutes.
Main outcomes measures
First of all, a structured questionnaire was used to obtain
socio-demographic data (age, sex, marital status, self-reported skin color,
level of education and monthly minimum wage); and information about childhood
(family composition, family disruption, maltreatment and sexual abuse), about
PAS use (onset, PAS used, previous treatment for CD) and about mental health
(perception of other MBD apart from CD or having such condition, onset and
symptoms present, previous treatments, psychiatric hospitalizations, and
suicide attempts). The ICD-10 symptom checklist for MBD, version 1.1, was used
to diagnose mental disorders, including SUD. This checklist is a
semi-structured instrument translated by Oliveira and Cordioli16 and
used to assess psychiatric symptoms and syndromes in the F0 to F6 categories.
In addition, this checklist is divided into categories that comprise a list of
symptoms and states that should be either included in or excluded from each
disorder. These lists are followed by instructions that can help the user to
consider other possible syndromes and, consequently, the use of other checklist
categories. These categories also offer the possibility of recording the onset,
severity and duration of the syndrome, in addition to the number of episodes.
The ICD-10 symptom checklist was found to be a reliable diagnostic tool
(overall kappa 0.72), and this tool can be used by psychiatrists and
psychologists without previous training17. Symptoms of anxiety,
depression, hallucinations and delirium were not considered to be positive when
they were exclusively associated with recent PAS use, but rather when they were
present during a certain period, according to the duration and number of episodes
throughout life.
Mental status assessment was conducted
according to behavioral observations and questions made during the interview,
including the following areas: consciousness, me&mory, intellect, speech,
thought process and content, perception, mood, affectivity and appearance,
based on the norms proposed by international diagnostic assessment directives18.
Data collection from medical records was performed aiming to search for
additional sources of information about the patient, such as data on previous
and/or current treatment and information about mental health.
After the interviews were conducted,
patients were divided into three groups: those with a period of abstinence
shorter than one week (Group 1), between one and four weeks (Group 2) and
longer than four weeks (Group 3).
Data analyses
Data were organized, tabulated and analyzed with the
Statistical Package for the Social Sciences software (SPSS version 17.0, IBM
Inc., Chicago, IL, USA, 2008). A descriptive analysis was made to characterize
the sample. The frequencies of CMBD were compared between the three groups and
the clinical and socio-demographic variables were compared between patients
with and without CMBD. Chi-square test or Fisher's exact test was used to
compare the frequencies of the variables analyzed. Student's t test was used to
compare mean ages. A p &# was considered to be significant.
In the present study, a total of 188 patients were analyzed,
of which 154 (81.9%) were males and 34 (18.1%) were females, with a mean age
and standard deviation of 38.5 & 9.9 years, varying between 18 and 73 years.
All of them met the diagnostic criteria for PAS dependence syndrome: 88 (46.8%)
had multiple drug dependence, 87 (46.3%) were dependent on alcohol exclusively,
10 (5.3%) on cocaine, 2 (1.1%) on cannabinoids and 1 (0.5%) in
addition, 134 (71.3%) were also dependent on tobacco.
Of all patients, 118 (62.8%) were
diagnosed with a certain MBD; 40.4% met the diagnostic criteria for mood
disorders, with a predominance of depressive disorders (33.0%); 18.6% were
diagnosed with neurotic disorders, stress and somatoform disorders, with a
predominance of anxiety disorders (13.8%); 10.1% met the diagnostic criteria
for disorders of adult personality and behavior with a predominance of
dissocial personality disorders (4.2%); and 8.5%, for schizophrenia,
schizotypal personality disorder and persistent delu&sional disorder, with a
predominance of schizophrenia (5.3%). A total of 28 (14.9%) patients were
diagnosed with more than one CMBD ().
of CMBD were more frequent (p = 0.04) in Group 1 patients (72.0%) than those in
Group 3 (54.2%), and there were no significant differences between Group 1 and
Group 2 patients (61.0%), nor between Group 2 and Group 3 patients. The
frequencies of depressive disorders or other anxiety disorders were numerically
higher in Group 1 patients than Group 3 patients, without a significant
difference between them. However, when these two variables were analyzed
together, they were more frequent (p = 0.00) in Group 1 (46%) than in Group 3
(25%). The frequencies of persistent delusional disorder, schizoaffective,
schizotypal and schizophrenia analyzed together were higher (p = 0.04) in Group
3 (10 [13.9%]) than in Group 1 (3 [4%]) and there were no differen&ces between
Group 2 (3 [7.3%]) and Group 1 or Group 3 (). Mood disorders were more
frequent in women, whereas psychotic disorders were more frequent in men ().
There were no significant differences in
the socio-demographic characteristics assessed between patients with and
without CMBD, nor among patients with different periods of abstinence. The
majority of patients assessed reported they were single/divorced/separated
(64.9%), had a primary school level of education or lower, were white, had a
religion, received a monthly personal income lower than one minimum wage and
were unemployed ().
Child maltreatment, including sexual
abuse, was more frequent (p = 0.00) in patients with a CMBD (80 [67.8%] vs. 30 [42.8%]). By comparing patients with and those without CMBD,
there were no statistically significant differences in the frequencies of
family members who showed PAS use/abuse, occurrences of disrupted families or
children staying only with the mother after family disruption ().
Among the clinical conditions assessed,
the frequencies of the following aspects were significantly higher in patients
with CMBD than in those without comorbidities: external cause injuries,
perception of having an MBD other than CD or of having a certain psychological
problem, being involved in fights and aggressions, hospitalizations in
psychiatric hospitals or in general hospitals, legally prescribed drugs use,
suicide attempts and previous CD treatment ().
DISCUSSION
Frequency of diagnosis
of CMBD associated
Of all patients, two thirds of them had a certain diagnosis
of CMBD associated with CD. These results are similar to those found in a
clinical study conducted in Toronto, Canada, in which the Diagnostic Interview
Schedule was used to make the diagnosis of comorbidities (68.4%)11 and to another performed in S&o Paulo, Brazil, in which authors used the same
assessment tool adopted in this study (67.7%)10. Furthermore, in the
latter study, the frequencies of the following diagnoses were also similar to
those found in the present study: depressive disorders (33.9%), anxiety
disorders (11.5%), personality disorders (16.1%) and schizophrenia (2.6%).
In Group 1, 72% of patients had a certain
diagnosis of CMBD, a result that was lower than those observed in
another clinical study carried out in Alaska, USA, conducted in patients with
the same period of abstinence in an alcohol detoxification center (82%)14.
This study used the Brief Symptom Inventory as a diagnostic tool and showed
frequencies of diagnoses of depressive disorders (74.2%) and anxiety
disorders (73.5%) that were higher than those observed in the present study.
Of all patients with a period of
abstinence longer than one week (Groups 2 and 3), 56.6% were diagnosed with
CMBD. These results were lower than those found in a study conducted in the
city of S&o Paulo, Brazil, in which patients with CD showed the same period of
abstinence (72%)12. This study used the Research Diagnostic Criteria
as an assessment tool and found frequencies of depressive disorders (32%),
anxiety disorders (8%), dissocial personality disorder (2%) and schizophrenia
(8%) that were similar to those of the present study.
In Group 3, 54.2% of patients had a
certain diagnosis of CMBD, a frequency that was higher than that found by
al.13 in a study
performed in Sweden in patients with CD and a period of abstinence longer than
three weeks (42%), using the Structured Clinical Interview for DSM disorders.
The frequency of diagnosis of CMBD in
Group 1 patients was higher than that in Group 3 patients, and the higher
frequencies of depressive disorders and anxiety disorders in the former were
what mainly distinguished one group from the other. High levels of anxiety or
depression can be produced by the effects of PAS in the stage of intoxication
or withdrawal of such substances6,19. Such effects can remain for
some days and disappear, unless these disorders are primary and continue to
persist after many weeks of abstinence. For these reasons, it is recommended
that a patient's follow-up should occur during a significant time for the
diagnosis of other MBD to be reliable, and that this time could be different,
depending on the PAS used1. A higher frequency of these disorders in
Group 1 was observed in the present study, even if such diagnoses were
considered to be positive when found throughout a certain period of time,
rather than associated with recent PAS use exclusively.
Individuals seeking treatment due to SUD
frequently have a history of recent PAS use and difficulties mainta&ining
abstinence. The great challenge of clinicians who care for SUD patients is to
distinguish symptoms caused by PAS intoxication or withdrawal from those that
are primary mental disorders. Symptoms related to drug abuse, such as
nervousness, tension, agitation, depressed mood and loss of motivation, may
also be symptoms included in the diagnostic criteria for mental disorders, e.g.
generalized anxiety disorder and depressive disorder3. For these
reasons, the frequency of diagnosis of CMBD in these patients may be
overestimated.
However, it is important to identify
these mood and/or anxiety disorders in patients with CD and they should not
remain untreated, according to the assumption that these symptoms are due to
PAS intoxication or abstinence. Severe mood disorders that are not treated can
lead to relapses and even death by suicide19. In addition, it is
believed that making a diagnosis of CMBD is important, even in the period of
detoxification, as this increases the likelihood of individuals' needs being
adequately met and of better adherence to treatment14.
In this study, it was observed that the
frequencies of
diagnoses of schizophrenia, persistent delusional disorders, schizoaffective
disorders and schizotypal disorders were higher in Group 3 than in Group 1.
This could be associated with the fact that patients experiencing a crisis were
exclu&ded, due to the difficulty in distinguishing previous psychotic symptoms
from psychotic symptoms induced by PAS use or abstinence1. Another
reason for this could be the fact that patients who have more severe MBD are
referred to psy&chiatric institutions to be hospitalized when it is necessary
and they only return to the CAPS-ad for CD treatment after longer periods of
abstinence have passed.
Mood disorders, especially depressive
disorders, were more frequent in women. In several other studies, it was also
observed that depression is more common in women than men and that two thirds
of women with SUD first have depression9. In these cases, PAS could
have been used as self-medication. Psychotic disorders were more frequent in
men, which is in agreement with what has been described in another study2.
Socio-demographic data of the patients
With regard to the socio-demographic data analyzed, the
results of the present study are similar to those observed in other Brazilian
studies conducted in individuals with CD undergoing treatment, such as the
predominance of male patients12,20, with a mean age of approximately
35 years11,20, white, not married12, and with incomplete
or complete primary education20. PAS use has been found to
negatively affect conjugal relationships, with higher risks of violent behavior
in couples, resulting in separations21. The large number of
unemployed individuals or informal workers, with a personal income
predominantly lower than one minimum wage, and their low level of education
could reflect the social impairment of these patients, who show higher risks of
psychosocial problems such as school and work negligence and difficulties in
assuming responsibilities21. The low levels of education and
financial income could also be due to characteristics of the patients who
usually seek the public he&alth care network, which serves the portion of the
population that does not have access to any other type of health care.
The majority of patients reported t patients undergoing SUD treatment frequently seek a religion.
It is believed that religiosity has an inhibitory effect on PAS use, encourages
abstinence, raises self-esteem and promotes new social inclusion22.
There were no significant differences in
socio-demographic data between patients with and without CMBD. These results
differ from those described in a review study which found that patients with
CMBD associated with SUD more frequently show loss of productivity,
difficulties in maintaining jobs and a worse level of global functioning than
those without comorbidities, imposing a greater economic burden on their
families1.
Conditions associated with the patients'
Child maltreatment, including sexual abuse, was more
frequent in patients with CMBD. There could be a close relationship between
maltreatment and adverse conditions during childhood, with symptoms of
depression, mania23, some personality disorders in early adulthood24, high risk of interpersonal difficulties during adolescence and suicidal
behavior25. Children and adolescents who were exposed to negative
experiences could have feelings of abandonment and emotional problems, when PAS
use becomes a way of avoiding psychological suffering and a relief from anxiety
and anger26.
Similar high frequencies of PAS use in
family members and of family disruption in patients with or without CMBD were
observed. A review study found that these two conditions are risk factors for
PAS use27. The majority of patients stayed with the mother after
family disruption. There is clinical evidence that the absence of the father or
impairment of paternal function aspects could be a relevant factor for the
onset and maintenance of SUD27. These adverse conditions can be
interrelated and consequently hinder an individual's development, which may
contribute to the appearance of CMBD and to PAS use disorders.
Aspects associated with the clinical
conditions assessed
Patients with CMBD reported external cause injuries and
suicide attempts more frequently. Individuals with mental illness, especially
more severe disorders, and with concurrent SUD show a higher prevalence of
violent behavior and personal harms28. In addition, depressive
disorders (major depressive episode or dysthymia) influence cognitions and
behaviors associated with suicide, regardless of the presence of PAS use
disorders, and the risk of suicide in certain individuals can be increased by
the presence of SUD29. Furthermore, the risk of mood disorder, SUD
and suicidal behavior may increase in patients who have anxiety disorders and
use PAS as self-medication to relieve symptoms30.
Patients with CMBD more frequently
perceived that they had a certain mental disorder or psychological problems
apart from CD, were involved in fights and aggressions, were hospitalized in a
general or psychiatric hospital, used legally prescribed drugs and underwent
previous CD treatments. In other studies it was observed that patients with
CMBD, especially those with more severe disorders, may have higher rates of
aggression, detention due to illegal acts, suicide, relapses, spending on
treatment, re-hospitalizations, longer hospitalization periods and greater
medical service use1.
Clinical implications
The present study revealed a high frequency of CMBD among
patients with CD who sought the CAPS-ad, and these diagnoses need to be made to
optimize treatment. The relevance of waiting for at least one month of abstinence
before a diagnosis of CMBD can be defined should be emphasized, especially when
it comes to diagnoses of depressive disorders and anxiety disorders. However,
diagnosing CMBD, even in the period of detoxification, can increase the
likelihood of individual needs being adequately met and of better adherence to
treatment. As this study had a cross-sectional design, patients in Groups 1 and
2 were not reassessed to confirm diagnoses after longer periods of abstinence.
This should be performed in future cohort studies.
Study limitations
One of the limitations of the present study was the fact
that a specific sample was assessed. Patients being treated in CAPS-ad usually
have a more severe condition. Consequently, the results found may not represent
what occurs in SUD individuals in the population. The assessment of patients by
a single researcher did not enable an agreement of diagnosis to be obtained.
However, it is believed that the use of a standardized tool could reduce reliability
Conclusions
The results of the present study show that among patients
who sought treatment in the CAPS-ad: 1) approximately two thirds were diagnosed
with a certain CMBD, and the frequency of such diagnoses was higher in patients
with a shorter
2) depressive disorders and anxiety
disorders were more frequent in patients with shorter p 3)
mood disorders were more frequent in women, while psychotic disorders were mo 4) patients with a diagnosis of CMBD more frequently
experienced maltreatment during childhood, had external cause injuries,
perceived that they had a certain mental disorder or psychological problem
apart from CD, were involved in fights and aggressions, were hospitalized in
general or psychiatric hospitals, used legally prescribed drugs and had a
higher number 5) there were no differences in
socio-demographic data between patients with and without CMBD.
CONFLICTS OF INTEREST
Authors declared there were no conflicts of interest.
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Address for correspondence:
Luiz Carlos Marques de
Departamento de Cl&nica M&dica
Av. Par&, 1720, Bloco 2H, Campus Umuarama
– Uberl&ndia, MG, Brazil
Telefax: (55 34)
Recebido em 7/5/2012
Aprovado em 7/8/2012
All the contents of this journal, except where otherwise noted, is licensed under a