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Miele C, Cabé J, Cabé N, Bertsch I, Brousse G, Pereira B, Moulin V, Barrault S. Measuring craving: A systematic review and mapping of assessment instruments. What about sexual craving? Addiction 2023; 118:2277-2314. [PMID: 37493019 DOI: 10.1111/add.16287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/31/2023] [Indexed: 07/27/2023]
Abstract
BACKGROUND AND AIMS Craving is central in the definition of addictive disorders because of its diagnostic and prognostic value. Its measurement is essential in clinical practice. Previous reviews provided a better overview of existing instruments; however, they do not consider emerging substances and behaviors such as sexual addictions. Our objectives were threefold: (1) to provide a systematic review of craving assessment instruments and their psychometric characteristics within a transdiagnostic approach, (2) to highlight and map their conceptual relationships and (3) to identify potential sexual craving assessment instruments. METHODS The review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. The PubMed, Embase, PsychInfo and Cochrane/Central databases were searched for publications that met the following inclusion criterion: validation studies of craving assessment instruments, regardless of target substance or behavior. The original search identified 4561 references and included 147 articles. Each selected study was a peer-reviewed publication. RESULTS This review provides a synthesis of the psychometric properties of 36 original instruments and identified 93 variations of these instruments (e.g. translations). We were able to highlight five transdiagnostic families of instruments, each corresponding to a conceptual model. Only one instrument for assessing craving in the domain of compulsive sexual behavior, focused on pornography use, has been identified: the Pornography Craving Questionnaire. CONCLUSION This review mapped all craving assessment instruments from a transdiagnostic perspective, finding 36 original instruments and 93 variations. The evolution of instruments to measure craving mirrors the evolution of the concept of craving which has progressively integrated cognitive, conditioning and sensory dimensions, and attests to the importance of the context of assessment. Development of an instrument to measure 'sexual craving' is needed and could be based on the data from our review.
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Affiliation(s)
- Cécile Miele
- Laboratory QualiPsy, EE1901, Psychology Department, University of Tours, Tours, France
- Service d'Addictologie et de pathologies duelles, Pôle de psychiatrie, CHU de Clermont-Ferrand, Clermont-Ferrand Cedex, France
- Laboratoire Inter-universitaire de Psychologie Personnalité, Cognition, Changement Social (LIP/PC2S) Université de Grenoble Alpes, Grenoble, France
| | - Julien Cabé
- Service d'Addictologie et de pathologies duelles, Pôle de psychiatrie, CHU de Clermont-Ferrand, Clermont-Ferrand Cedex, France
- Université Clermont Auvergne, Clermont Auvergne INP, CHU Clermont-Ferrand, CNRS, Institut Pascal, Clermont-Ferrand, France
| | - Nicolas Cabé
- Service d'Addictologie, Centre Hospitalier Universitaire de Caen, Caen, France
- Normandie Université, UNICAEN, INSERM, PhIND 'Physiopathology and Imaging of Neurological Disorders', Institut Blood and Brain at Caen-Normandie, Cyceron, Caen, France
| | - Ingrid Bertsch
- Laboratory QualiPsy, EE1901, Psychology Department, University of Tours, Tours, France
- Unité de Consultation Psychiatrique Post-Pénale (UC3P), CHRU de Tours, Tours, France
| | - Georges Brousse
- Service d'Addictologie et de pathologies duelles, Pôle de psychiatrie, CHU de Clermont-Ferrand, Clermont-Ferrand Cedex, France
- Université Clermont Auvergne, Clermont Auvergne INP, CHU Clermont-Ferrand, CNRS, Institut Pascal, Clermont-Ferrand, France
| | - Bruno Pereira
- Direction de la Recherche Clinique et de l'Innovation, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - Valérie Moulin
- Laboratoire Inter-universitaire de Psychologie Personnalité, Cognition, Changement Social (LIP/PC2S) Université de Grenoble Alpes, Grenoble, France
| | - Servane Barrault
- Laboratory QualiPsy, EE1901, Psychology Department, University of Tours, Tours, France
- Centre de Soins d'Accompagnement et de Prévention en Addictologie (CSAPA 37), CHRU of Tours, Tours, France
- Laboratory of Psychopathology and Health Processes, University of Paris, Boulogne-Billancourt, France
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Bertani A, Tanni S, Godoy I. Brief Intervention for Smoking Cessation During Pregnancy. JORNAL BRASILEIRO DE PNEUMOLOGIA : PUBLICACAO OFICIAL DA SOCIEDADE BRASILEIRA DE PNEUMOLOGIA E TISILOGIA 2021; 47:e20210142. [PMID: 34259746 PMCID: PMC8332652 DOI: 10.36416/1806-3756/e20210142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Andre Bertani
- . Departamento de Medicina Interna, Pneumologia, Faculdade de Medicina de Botucatu, UNESP - Universidade Estadual Paulista, Campus Botucatu, Botucatu, São Paulo, Brasil
| | - Suzana Tanni
- . Departamento de Medicina Interna, Pneumologia, Faculdade de Medicina de Botucatu, UNESP - Universidade Estadual Paulista, Campus Botucatu, Botucatu, São Paulo, Brasil
| | - Irma Godoy
- . Departamento de Medicina Interna, Pneumologia, Faculdade de Medicina de Botucatu, UNESP - Universidade Estadual Paulista, Campus Botucatu, Botucatu, São Paulo, Brasil
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Weiss de Souza IC, Kozasa EH, Bowen S, Richter KP, Sartes LMA, Colugnati FAB, Noto AR. Effectiveness of Mindfulness-Based Relapse Prevention Program as an Adjunct to the Standard Treatment for Smoking: A Pragmatic Design Pilot Study. Nicotine Tob Res 2020; 22:1605-1613. [PMID: 32222767 DOI: 10.1093/ntr/ntaa057] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 03/24/2020] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Posttreatment relapse is a major roadblock to stemming the global epidemic of tobacco-related illness. This article presents results from a pilot trial evaluating the feasibility and initial efficacy of Mindfulness-Based Relapse Prevention (MBRP) as an adjunct to standard relapse prevention treatment (ST) for smoking cessation. AIMS AND METHODS Smokers (n = 86) in the maintenance phase of treatment were randomized to receive either ST plus MBRP (MBRP) (n = 44) or ST alone (ST) (n = 42). Data were collected at baseline and at 4-, 12-, and 24-week follow-up points. We evaluated the feasibility of the protocol with frequency analysis, and the efficacy with both intention to treat and complete case analyses of the effects of MBRP on abstinence. Secondary outcomes included mindfulness, craving, depression, anxiety, and positive/negative affect. RESULTS High adherence suggested MBRP is acceptable and feasible. Participants in the MBRP group reported increases in mindfulness (M = -7.833, p = .016), and reductions in craving (M = 17.583, p = .01) compared with the ST group. Intention to treat analysis found that, compared with MBRP (36.4%), ST (57.1%) showed trend-level superiority in abstinence at Week 4 (Prevalence Ratio = 0.63, p = .06); however at Week 24, the ST group (14.3%) demonstrated a twofold greater decrease in abstinence, compared with the MBRP group (20.1%) (Prevalence Ratio = 2.25, p = .08). Therefore, the MBRP group maintained a higher abstinence rate for longer. Reported effects were greater in the complete case analysis. CONCLUSIONS MBRP holds promise for preventing relapse after aided tobacco quit attempts. IMPLICATIONS Findings suggest that MBRP is acceptable, feasible, and valued by participants. At 24-week follow-up, there was a large effect size and a statistical trend toward fewer MBRP patients relapsing compared with ST patients. MBRP conferred ancillary benefits including reductions in craving and increases in levels of mindfulness. MBRP for tobacco cessation is highly promising and merits further research. TRIAL REGISTRATION clinicaltrials.gov. IDENTIFIER NCT02327104.
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Affiliation(s)
| | - Elisa Harumi Kozasa
- Instituto do Cérebro, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Sarah Bowen
- School of Graduate Psychology, Pacific University, Hillsboro, OR
| | - Kimber P Richter
- University of Kansas School of Medicine, Department of Preventive Medicine and Public Health, Kansas City, KS
| | | | | | - Ana Regina Noto
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, SP, Brazil
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Hezer H, Karalezli A. The Effect of Psychological Dependence on Smoking Urge and Nicotine Withdrawal Symptoms. ANKARA MEDICAL JOURNAL 2019. [DOI: 10.17098/amj.651955] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Pivovar A, Gonçalves Dos Santos ZFD, Torres-Pereira CC. Oral cancer screening for high-risk individuals in the primary healthcare setting using an active approach. J Oral Pathol Med 2017; 46:786-791. [DOI: 10.1111/jop.12552] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2017] [Indexed: 01/18/2023]
Affiliation(s)
- Allana Pivovar
- Graduate Program in Dentistry; Federal University of Paraná School of Dentistry; Curitiba Paraná Brazil
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Jhanjee S, Jain R, Jain V, Gupta T, Mittal S, Goelz P, Schnoll RA. Evaluating the Effects of Varenicline on Craving, Withdrawal, and Affect in a Randomized, Double-Blind, Placebo-Controlled Clinical Trial of Varenicline for Smokeless Tobacco Dependence in India. J Psychoactive Drugs 2015; 47:325-30. [PMID: 26317176 PMCID: PMC4699413 DOI: 10.1080/02791072.2015.1075092] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study examined changes in tobacco craving, withdrawal, and affect as correlates of efficacy in a phase-2 clinical trial of varenicline for smokeless tobacco dependence in India. Smokeless tobacco users (N = 237) at the All India Institute of Medical Sciences were randomized to placebo or varenicline. Abstinence was defined as cotinine-verified seven-day point prevalence cessation at end of treatment (EOT). General Linear Model repeated measures assessed the effects of treatment condition, time, abstinence state, and interaction effects on changes in craving, withdrawal, positive (PA) and negative affect (NA) from baseline to EOT. All participants showed a significant reduction in withdrawal (p < .001), total craving (p < .001), positive reinforcement (PR) craving (p < .001), and NA (p = .02), and an increase in PA (p = .04) from baseline to EOT. However, there were no differences between placebo and varenicline participants in measures of withdrawal, craving, or affect from baseline to week 3 or at EOT. Significant interactions between time and abstinence state were found for total craving (p = .008), PR craving (p < .001), and withdrawal (p = .001), indicating reductions in these processes among those abstinent vs. those still chewing smokeless tobacco. Additional research is needed concerning the effects of varenicline on craving, withdrawal, and affect among smokeless tobacco users.
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Affiliation(s)
- Sonali Jhanjee
- a National Drug Dependence Treatment Centre , All India Institute of Medical Sciences , New Delhi , India
| | - Raka Jain
- a National Drug Dependence Treatment Centre , All India Institute of Medical Sciences , New Delhi , India
| | - Veena Jain
- b Centre for Dental Education and Research , All India Institute of Medical Sciences , New Delhi , India
| | - Tina Gupta
- a National Drug Dependence Treatment Centre , All India Institute of Medical Sciences , New Delhi , India
| | - Swati Mittal
- a National Drug Dependence Treatment Centre , All India Institute of Medical Sciences , New Delhi , India
| | - Patricia Goelz
- c Department of Psychiatry and Abramson Cancer Center , University of Pennsylvania , Philadelphia , PA
| | - Robert A Schnoll
- c Department of Psychiatry and Abramson Cancer Center , University of Pennsylvania , Philadelphia , PA
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Clausius RL, Krebill R, Mayo MS, Bronars C, Martin L, Ahluwalia JS, Cox LS. Evaluation of the brief questionnaire of smoking urges in Black light smokers. Nicotine Tob Res 2012; 14:1110-4. [PMID: 22241828 PMCID: PMC3432274 DOI: 10.1093/ntr/ntr267] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2011] [Accepted: 10/17/2011] [Indexed: 11/13/2022]
Abstract
INTRODUCTION This study evaluated the factor structure of the Brief Questionnaire of Smoking Urges (QSU-Brief) within a sample of Black light smokers (1-10 cigarettes per day). METHODS The QSU-Brief was administered to 540 (mean age = 46.5; 66.1% women) urban Black light smokers upon entering a smoking cessation clinical trial. An exploratory factor analysis (EFA) was conducted to evaluate the factor structure of this 10-item measure. RESULTS An EFA indicated that as in other samples, the construct of craving in a Black sample is defined by 2 factors; 1 factor emphasizing the positive reinforcement of smoking and the other factor emphasizing the negative reinforcement properties of smoking. CONCLUSIONS Findings largely replicate a 2-factor structure of craving seen in smokers from other racial/ethnic groups, demonstrating the clinical utility of the QSU-Brief in measuring craving in Black light smokers.
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Affiliation(s)
| | - Ron Krebill
- Department of Biostatistics, University of Kansas School of Medicine, Kansas City, KS
| | - Matthew S. Mayo
- Department of Biostatistics, University of Kansas School of Medicine, Kansas City, KS
| | - Carrie Bronars
- Department of Preventive Medicine and Public Health, University of Kansas School of Medicine, Kansas City, KS
| | - Laura Martin
- Department of Preventive Medicine and Public Health, University of Kansas School of Medicine, Kansas City, KS
| | - Jasjit S. Ahluwalia
- Department of Medicine, Center for Health Equity, and Clinical and Translational Sciences Institute, University of Minnesota Medical School, Minneapolis, MN
| | - Lisa Sanderson Cox
- Department of Preventive Medicine and Public Health, University of Kansas School of Medicine, Kansas City, KS
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Santos JDPD, Silveira DV, Oliveira DFD, Caiaffa WT. [Instruments used to evaluate smoking habits: a systematic review]. CIENCIA & SAUDE COLETIVA 2012; 16:4707-20. [PMID: 22124912 DOI: 10.1590/s1413-81232011001300020] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2009] [Accepted: 02/12/2010] [Indexed: 11/22/2022] Open
Abstract
Smoking is one of the most important causes of illness in the world, responsible for one out of every eight deaths. To know the instruments that characterize the use of tobacco is the first step to develop reliable and comparable research to tackle this challenge. The objective was to identify and compare instruments and domains used in population-based studies over the past five years aiming to determine smoking patterns. A systematic review was conducted on articles published from September 2002 to September 2007. The terms used were: (*Smok or tobacco) AND (Questionnaire or scale or score or instrument or assessment or form) AND (*cultural* or translat* or valid* or reproduc* or psychomet*). Out of 2,236 references, 186 articles were selected, of which only 91 informed the instruments used. From the 91 manuscripts, 49 distinct instruments were identified. The main topics were profile and prevalence (38%), dependence (24%) and motivation (10.8%). The researchers used standard instruments in 96% of studies of addiction. The majority of articles about profile and prevalence (79%) used self-developed questionnaires. The transparency and standardization of instruments and the preference for the use of validated questionnaires are crucial areas for quality and reproducibility of research on smoking.
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Alves GSL, Araujo RB. A utilização dos jogos cooperativos no tratamento de dependentes de crack internados em uma unidade de desintoxicação. REV BRAS MED ESPORTE 2012. [DOI: 10.1590/s1517-86922012000200002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
O objetivo deste estudo foi avaliar a efetividade dos jogos cooperativos no manejo do craving (fissura) e da ansiedade, bem como na motivação para a mudança do comportamento aditivo em dependentes de crack/cocaína internados em uma unidade de desintoxicação. Trata-se de um ensaio clínico do tipo quase-experimental, em que foram pesquisados 30 sujeitos, do sexo masculino, entre 18 e 50 anos, dependentes de crack/cocaína, distribuídos em oito grupos. Os instrumentos utilizados foram: ficha com dados sociodemográficos, mini-mental state examination, University of Rhode Island Change Assessment scale (URICA), Beck anxiety inventory (BAI) e escala analógica visual (EAV). Foram apresentadas imagens e vídeos da cocaína sob a forma de crack com o objetivo de induzir o craving nos participantes e, em seguida, foram aplicados a EAV, a URICA e o BAI. Após, foi realizada uma oficina de jogos cooperativos, sendo reaplicados os instrumentos. Foi encontrada diferença significativa no craving e sintomas de ansiedade a partir dos jogos cooperativos (p < 0,001), porém não houve alteração na motivação para mudança do comportamento aditivo. Conclui-se que os jogos cooperativos podem ser um importante instrumento no tratamento de dependentes de crack/cocaína.
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Balbinot AD, Alves GSL, Amaral Junior AFD, Araujo RB. Associação entre fissura e perfil antropométrico em dependentes de crack. JORNAL BRASILEIRO DE PSIQUIATRIA 2011. [DOI: 10.1590/s0047-20852011000300009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVO: Verificar a variação da fissura de dependentes de crack no decorrer da internação e a associação com perfil antropométrico. MÉTODOS: Trata-se de uma pesquisa quantitativa com delineamento transversal (n = 30). Avaliaram-se o perfil de consumo de substâncias psicoativas; dados sociodemográficos; variáveis antropométricas (peso, estatura, índice de massa corporal, relação cintura-quadril, perímetros, dobras cutâneas e diâmetro ósseo); e fissura avaliada por meio do Cocaine Craving Questionnaire Brief. As coletas de dados ocorreram nas 24 horas iniciais e finais do tratamento. RESULTADOS: Observou-se aumento significativo do percentual de gordura e diminuição significativa da fissura. Não se evidenciou associação entre variáveis antropométricas e fissura, tanto no início como ao final da internação. CONCLUSÃO: Houve significativa diminuição na fissura e modificação na composição corporal, entretanto não houve correlação entre essas variáveis.
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Victor JF, Ximenes LB, Almeida PCD. [Cross-cultural adaptation of the Exercise Benefits/Barriers Scale (EBBS) for application in elderly Brazilians: preliminary version]. CAD SAUDE PUBLICA 2009; 24:2852-60. [PMID: 19082276 DOI: 10.1590/s0102-311x2008001200014] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2007] [Accepted: 04/28/2008] [Indexed: 11/22/2022] Open
Abstract
This article describes the cross-cultural adaptation of the Exercise Benefits/Barriers Scale (EBBS) to the Portuguese language and its application in elderly Brazilians. The EBBS was originally developed in the United States to identify perceptions concerning the barriers to (and benefits of) physical exercise, and thus to determine factors affecting this practice. Cross-cultural adaptation involved the following phases: initial translation, summary of the translation, retranslation into the original language (back-translation), review by an expert panel to evaluate semantic, idiomatic, experimental, and conceptual equivalence, and pre-test of the final version with 30 elderly subjects. The EBBS cross-cultural adaptation allowed proposing a preliminary Portuguese-language version. However, to ensure that the cross-cultural equivalence between the original version and the translation has been fully achieved, it is necessary to compare the psychometric properties of the Portuguese version and the original instrument, a crucial task that is now being performed and will soon be published.
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Affiliation(s)
- Janaina Fonseca Victor
- Departamento de Enfermagem, Centro de Ciências da Saúde, Universidade de Fortaleza, Fortaleza, Brasil.
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Pedroso RS, Castro MDGTD, Araujo RB. Marijuana Craving Questionnaire (MCQ-SF/Versão Brasil): validação semântica. JORNAL BRASILEIRO DE PSIQUIATRIA 2009. [DOI: 10.1590/s0047-20852009000400001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVO: O objetivo deste estudo foi realizar tradução e adaptação transcultural do Marijuana Craving Questionnaire (MCQ-SF)10, que avalia o craving por maconha em uma amostra brasileira. MÉTODO: O MCQ-SF foi traduzido do inglês para o português, aplicado em 10 sujeitos, submetido ao brainstorming num grupo de três indivíduos para reprodução individual e verbal, item a item. Realizou-se o back-translation, uma versão para o idioma de origem, a partir da primeira tradução e do brainstorming. Logo após, traduziu-se novamente para o português. Um comitê de juízes especialistas analisou todas as traduções. RESULTADOS: Após as considerações do comitê e um estudo-piloto com 30 sujeitos, a versão final do MCQ-SF/Versão Brasil foi construída. CONCLUSÃO: Os resultados demonstraram uma equivalência semântica satisfatória entre as versões. O MCQ-SF/Versão Brasil pode ser útil para avaliar o craving pela maconha nos dependentes dessa substância.
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Guimarães CF, Santos DVVD, Freitas RCD, Araujo RB. Perfil do usuário de crack e fatores relacionados à criminalidade em unidade de internação para desintoxicação no Hospital Psiquiátrico São Pedro de Porto Alegre (RS). ACTA ACUST UNITED AC 2008. [DOI: 10.1590/s0101-81082008000300005] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
INTRODUÇÃO: O presente estudo transversal foi realizado com usuários de crack do sexo masculino internados na Unidade de Desintoxicação do Hospital Psiquiátrico São Pedro de Porto Alegre (RS) no período de março a dezembro de 2007. O objetivo do presente estudo foi identificar o perfil sociodemográfico e de consumo de substâncias psicoativas e a presença de conduta anti-social, sintomas de ansiedade e de depressão em usuários de crack internados na Unidade de Desintoxicação do Hospital Psiquiátrico São Pedro de Porto Alegre (RS), bem como verificar fatores associados à criminalidade nessa clientela. MÉTODO: Trinta sujeitos participaram do estudo, e os instrumentos utilizados foram: questionário sociodemográfico e de avaliação do consumo de substâncias psicoativas e de antecedentes criminais com 55 questões, Mini-Exame do Estado Mental, Inventário Beck de Ansiedade, Inventário Beck de Depressão, Fagerström Test for Nicotine Dependence e Escala Analógico-Visual de Fissura. RESULTADOS: Os principais resultados apontam para uma população de adultos jovens, de cor/raça branca, com idade média de 27,3 anos e em situação de subemprego ou desemprego. A presença de antecedentes criminais foi observada em 40% da amostra e está associada a maior fissura (U = 58,00; p = 0,035), a mais sintomas de ansiedade (U = 56,50; p = 0,028) e de depressão (U = 47,00; p = 0,009). CONCLUSÕES: É freqüente a presença de antecedentes criminais em dependentes de crack e esta variável está relacionada a mais ansiedade, depressão e fissura. Estudos deste tipo permitem ampliar o conhecimento da população atendida, para delinear de forma mais efetiva o plano terapêutico para esta clientela.
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Araujo RB, Oliveira MDS, Pedroso RS, Miguel AC, Castro MDGTD. Craving e dependência química: conceito, avaliação e tratamento. JORNAL BRASILEIRO DE PSIQUIATRIA 2008. [DOI: 10.1590/s0047-20852008000100011] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
O craving ou fissura, cuja definição mais comum é o desejo intenso por uma substância, é um conceito controverso entre os pesquisadores da área da dependência química. OBJETIVO: Realizar revisão teórica a respeito do craving nos bancos de dados PsycInfo, Medline, ProQuest e Science Direct. MÉTODO: As palavras-chave utilizadas foram craving, dependence e drug e o período pesquisado foi entre 1995 e 2007. RESULTADOS: Os resultados demonstraram que são encontrados diversos significados para o craving, alguns se restringindo a desejo, e outros, considerando-o não só como desejo, mas como antecipação do resultado positivo do uso da substância, alívio dos sintomas de abstinência ou afeto negativo e intenção de fumar, o que reflete uma visão multidimensional deste construto. A etiologia do craving pode ser explicada por intermédio dos modelos: comportamental, cognitivo ou psicossocial e neurobiológico, porquanto a opção por um destes influencia a avaliação e o manejo. CONCLUSÃO: Conclui-se quanto à multidimensionalidade do craving e quanto à necessidade de que seja utilizado um modelo biopsicossocial que integre os diversos modelos no tratamento de dependentes químicos. Destaca-se a importância da realização de mais estudos para a compreensão do craving em função deste ser um dos principais riscos de recaída.
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