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Official websites use. Share sensitive information only on official, secure websites. Email: psantosdr med. The consumption of addictive substances is common in adolescence and raises concerns about future addiction. We investigated addictive substance consumption among young people to inform the design of drug intervention programmes. Participants were a population-based sample of to year-olds from Paredes, northern Portugal. A self-report questionnaire measured social and health variables, including tobacco, alcohol and illicit drug consumption. Data were analysed for valid responses. Participants who had drunk alcohol did so first at Participants who had smoked tobacco did so first at Illicit drug consumption was reported by We found a high prevalence of addictive substance consumption, particularly alcohol. As cultural attitudes likely influence alcohol consumption, a multigenerational approach is needed to address adolescent consumption. Keywords: Adolescent, tobacco use, alcohol drinking, substance-related disorders, health education, social planning. Adolescence is the stage of life between childhood and adulthood and involves substantial physical, psychological and social growth and development. This period is characterised by the development of self-identity, autonomy and independence. During adolescence, the capacity for abstract thought increases and individuals become more interested in intimate relationships and sexuality. This period is also characterised by the consolidation of moral values and the desire to make plans about future adult life. Adolescence is a period of experimentation. Adolescents often engage in novelty seeking and risk-taking behaviours, which can lead to special social and health care needs. During the complex stage of adolescence, an individual begins to consolidate his or her personality in the context of wider society. Teenagers learn that their choices have positive or negative impacts in the community. However, most of these studies focus on school-based populations and have excluded adolescents who have left school, either because they had finished their academic courses or because they had dropped out of school. A global perspective is needed on the experiences, needs and expectations of young people outside school. The aim of this study was to investigate patterns of addictive substance consumption alcohol, tobacco and other drugs among young people aged between 14 and 24 years using a population-based approach. We conducted a cross-sectional, population-based, self-report survey of individuals aged between 14 and 24 years from Paredes, a county in northern Portugal. Paredes was historically an industrial area and most of the population worked in the secondary economic sector, mainly in civil construction and the furniture industry. However, in the last 20 years the tertiary sector has grown and now According to the Portuguese National Census, Paredes has 12, inhabitants between 14 and 24 years old, living in 24 different civil parishes. We used stratified sampling, maintaining the proportion of civil parish inhabitants, assuming a design effect of 2. Table 1 shows the sample distribution across the 24 civil parishes. In each stratum, we used the random route method 10 of participant selection. The order of the streets, house numbers and the dwellings in each building to be visited was determined in a random way prior to the survey, excluding institutional and non-residential buildings. In each household, we interviewed members who met the inclusion criteria. If there was more than one eligible individual, we selected the individual whose birth date was the closest and fell before the date of the interview. If the selected individuals declined to participate, we proceeded to the following street until the required number of participants had been obtained according to the calculated sample size. All young people aged 14 to 24 years from Paredes were eligible for participation. The participants, or their parent or guardian if they were younger than 16 years old, gave their written, informed consent for participation. We excluded individuals who had been away from home for more than 6 months, temporary visitors, travellers and guests, individuals who did not speak Portuguese and those without the physical or mental ability to answer the questionnaire. Data collection occurred from January to September The questionnaire measured the following social and health variables: social characteristics; education, jobs and expectations; nutrition, physical activity and body image; social identity, daily routines and youth behaviours; health issues; and demographic characteristics. For the present analysis, we included data for social and demographic characteristics, social identity, daily routines and youth behaviours consumption of alcohol, tobacco or other drugs and health using a question on self-perception of global health status, rated on a 5-point Likert scale, and the frequency of self-reported symptoms of headache, back pain, stomach ache, dizziness, tiredness, sadness, sleeping problems, anxiety, anger, and fear. To measure consumption of addictive substances, participants were asked if they had already tried the substance, how old they were when they tried it for the first time, how often they used it daily, weekly, monthly, at least once in the last 3 months, sometimes , and if they had experienced being drunk. The questionnaire was pilot-tested with a group of teenagers who were not part of the study population to check the face validity and comprehensibility. The interviewers were local volunteers from the Paredes Town Hall Voluntary Program who were trained to deliver the questionnaire using the following protocol: selection of participants in accordance with the procedure described above, manual delivery of the form and the informed consent form, provision of additional information and reassurance to participants, and collection and sealing of the questionnaires and forms in an envelope to guarantee participant anonymity. All interviewers were supervised and supported by the study coordinators. Questionnaires on which more than half of the items had been answered were included in data analysis. All items with incomplete responses were treated as missing data. After excluding non-valid questionnaires, an additional 17 questionnaires were distributed using the same participant selection method, in the same civil parishes to reach the required sample size. The study procedures were in accordance with the Declaration of Helsinki and the Oviedo Convention on the rights of individuals taking part in biomedical investigations. All participants or their parents or guardians signed an informed consent form. The questionnaires were completely anonymous and sealed in an envelope after being collected. We used descriptive and inferential statistics to calculate prevalence. CIs were calculated using the Wald method. Prevalence for the main outcome was estimated after standardisation for age and sex based on data from the Portuguese National Census. The Kolmogorov—Smirnov test was used to check for normal distributions. The significance level was set at 0. The total sample included participants. Of the respondents who reported their sex, The mean age of respondents was Table 2 shows the sociodemographic characteristics of the sample by sex. Most participants were still attending school There was no significant sex difference in school attendance. Of the total sample, Data are presented as number of responses percentage unless otherwise indicated. SD: standard deviation; IQD: interquartile distance. Young people at least 18 years old who had already left school were older: After adjustment for age and sex, We found that The estimated population prevalence of alcohol consumption was Table 3 shows the outcomes by sex. CI, confidence interval. The results suggest that the consumption of both alcohol and tobacco is more common in males, who begin experimenting at a younger age. Of the participants, Cannabinoids were the drugs most frequently consumed Figure 1 shows the prevalence of drug use in both sexes, adjusted for age. The mean age at which drug use started was When asked about frequency, After adjustment for age and sex, there were no differences in casual or regular consumption of alcohol or tobacco between participants still attending school and those who had left school. However, sporadic or regular drinking was not associated with greater consumption of other drugs. General perception of health status was rated on a scale from 1 very bad to 5 very good. The total mean score was 3. Substance consumption did not affect health status perception. More than half of the participants experienced psychological symptoms, such as sadness, sleeping problems, anxiety, anger and fear at least once a week: Figure 3 shows the main information sources. Both males and females obtained most information from family and friends. Health care providers were minor sources of information for this sample. The estimated prevalence of regular alcohol drinking for this sample of to year-olds was In this sample, These findings suggest that this was a representative population-based sample. One possible study limitation relates to the adequacy of randomisation. The random route method is a popular method of sample selection and permits representative sampling of the population of interest. Our interviewers were volunteers from the Paredes Town Hall Voluntary Program and the participant selection process took much longer than we anticipated. However, our sample data by age and sex are similar to population distribution data from the Portuguese National Census, suggesting that the sample was representative and wider conclusions can be drawn from the data. Another limitation was the size of the questionnaire. This study was part of the Morpheus project, which aims to profile the physical, psychological and social characteristics of young people in Paredes. The questionnaire had to include a large number of variables in total , resulting in a large response burden. However, the quality audits performed on the questionnaire did not reveal any substantial problems. Several sample characteristics should be mentioned. Most participants were single, still in the academic system and economically dependent on their family. Those who were active workers were mainly employed in the tertiary sector. These characteristics are representative of Portuguese to year-olds. The present demographic findings differ from those of some other Portuguese studies, but this may because those studies used school-based samples. In addition, the interviewers distributed and collected the questionnaire, so participants were not required to use public transport or have Internet access to take part. The mean age of respondents in our sample was higher than that of the HBSC study, 6 a school-based study involving teenagers with a mean age of 14 years, but lower than that of the ULisboa study, 4 a college student survey of non-randomly selected participants with a median age of 20 to 22 years. The target populations of the HBSC and ULisboa studies were school-based, which could explain several differences between the findings of these studies and the present findings. Our results show a higher prevalence of tobacco smoking, even if we consider the age distribution. In the ULisboa study, In France, the prevalence of substance use is higher, both in the community 12 and in schools. The present findings were in accord with those of previous studies regarding the association of age and sex male with a greater likelihood of occasional or regular substance consumption, mostly beginning in adolescence. Our results support the notion of a progression in drug use and addiction. Drug consumption is more common in individuals who have already tried alcohol or tobacco. As the psychological mechanisms of self-control are incipient in adolescents, 17 the development of strategies aimed at avoidance of first drug consumption is particularly important. We found that social context and leisure activities influenced substance use. Compared with participants who were still at school, those who were unemployed had greater consumption of substances other than alcohol and tobacco. In Portugal, school education is mandatory until 18 years of age or 12 academic years. The school environment plays a role in health choices and risky behaviours in young people. Therefore, it is crucial that the school community promotes healthy goals to young people. The Portuguese Youth and Child National Health Program recommends the health screening of adolescents across three different visits according to the key ages of individual development: 10 to 13 years, 15 years and 18 years. The aim is to establish trust and communication channels between health and education. However, our results show that young people do not regard health care providers as partners who can provide substance consumption counselling, perhaps because young people do not perceive their health status as associated with consumption history. It is possible that young people do not regard substance consumption as a health problem or as risky behaviour and therefore do not mention it in medical visits. In addition, doctors often adopt a punitive, or at least a prohibitive, attitude toward young people who use drugs. However, our findings indicate that parents and other relatives play an important role when young people are seeking advice. Therefore, it may be more effective to focus on educating individuals such as family members to provide clear and reliable information on drug use to young people. It is crucial that parents acquire knowledge and skills to enable them to influence the attitudes of the next generation. Although the media is an important tool in this endeavour, other interventions directed at core groups are also valid. Psychological symptoms were more common in participants who had used tobacco and other drugs but not alcohol. Future research needs to confirm whether psychological symptoms are a cause or consequence of drug use. The lack of association between psychological symptoms and alcohol consumption may be a result of positive cultural perceptions of alcohol consumption in Portugal. Aside from the question of the cause and effect relationship between psychological symptoms and drug use, this association raises concerns about the social consequences of drug use and the ability of young people to integrate successfully into society. There is a need to implement inclusion strategies to promote social skills; the association between substance consumption and unemployment found here suggests that pro-employment policies may be useful. Portuguese adolescents showed a high prevalence of substance consumption, particularly alcohol. As this may stem from cultural attitudes to alcohol, a multigenerational approach is needed in future studies on substance consumption in adolescents. The main sources of information for participants were family members, indicating the need to educate parents and other relatives to change culturally acquired habits. As a library, NLM provides access to scientific literature. J Int Med Res. Find articles by Carlos Franclim Silva. Find articles by Paula Rocha. Find articles by Paulo Santos. Open in a new tab. Similar articles. Add to Collections. Create a new collection. Add to an existing collection. Choose a collection Unable to load your collection due to an error Please try again. Add Cancel.

Crime, Illegal Drugs, and Mental Health

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This chapter is about the complex connections between drugs, violence, criminality, and mental illness. To approach this theme, we recall the history of drug from the perspective of the amplified social context involving illness and public policies that guide the discussion about violence and drugs insertion in urban setting. Drug use, manifestations of crime, and the development of mental illness are socially produced symptoms and the way they are expressed in our current society indicate vulnerabilities and dysfunctionalities of the urban organization. The etiology of the problem is complex and based on a society with marked differences. Drugs bring to light a circuit of illegality and criminality, forming a parallel system of laws and punishment. The mental illness can add damages to inhibitory control, increase impulsivity and emotional instability, leaving the users more exposed to violence outcomes. The criminality can designate a stigma without a clear distinction between the evolutionary phases of substance dependence, which inhibits the development of therapies directed to different profiles. Prevention and treatment of these conditions are as broad and multicausal as the problem itself. So, we proposed a theoretical model of functional staging of drug users to identify a clinical expression associated with vulnerabilities and violence expression. Anyway, the treatment to substance abuse should not configure an exclusion of these aspects that can make up the user profile and its relationship with society. The analysis of violent contexts should include socioenvironmental factors that should not be reduced to the social group where it is manifested. The association of drugs with violence may be an aspect that highlights the emphasis it has on the current social context. It also indicates the need to develop public health policies that address drugs, violence, and mental illness in a more holistic way. This is a preview of subscription content, log in via an institution to check access. Institutional subscriptions. Pharmacol Rev 64 2 — Int J Drug Policy 25 1 — Article PubMed Google Scholar. Bennet T et al The statistical association between drug misuse and crime: a meta-analysis. Aggress Violent Behav — Article Google Scholar. Google Scholar. Health Educ Res 16 4 — Caballero F, Bisiou Y Droit de la drogue. Dalloz, Paris, p Prev Sci 17 2 — Accessed 25 Feb Inv Salud 4 2 — Psychother Psychosom 82 1 — Int J Drug Policy 26 4 — Rev Bras Psiquiatr 29 1 — Eronen M Mental disorders and homicidal behavior in female subjects. Am J Psychiatry 8 — J Psychoactive Drugs 34 3 — Rev Saude Publica 37 6 — AIDS — Gaffney A et al. Institute for Criminology, Canberra. Home Office Online Report, vol 16, 6th edn. Home Office, London. Health Aff 21 2 — Rev Psiquiatr Rio Gd Sul 30 2 — Hodgins S The major mental disorders and crime: stop debating and start treating and preventing. Int J Law Psychiatry 24 — Rev Saude Publica 44 6 — Inciardi JA, Surratt HL Drug use, street crime and sex-trading among cocaine-dependent women: implications for public health and criminal justice policy. J Psychoactive Drugs 33 4 — Bull Am Acad Psychiatry Law 16 1 — Kessler F, Pechansky F A psychiatric view on the crack phenomenon nowadays. Am J Addict — Krug EG et al World report on violence and health. World Health Organization, Geneva. Rev Bras Psiquiatr 47 5 — Cambridge University Press, Cambridge. Book Google Scholar. Rev Bras Epidemiol 17 Suppl 1 — J Urban Health 92 6 — Drug Alcohol Depend — Rev Bras Psiquiatr — Narvaez J O amor nos tempos do crack. Compr Psychiatry 53 3 — Soc Psychiatry Psychiatr Epidemiol 49 8 — Compr Psychiatry 55 6 — Rev Bras Psiquiatr 37 3 — Nestor PG Mental disorder and violence: personality dimensions and clinical features. Am J Psychiatry 12 — Child Abuse Negl — Health Place — Addiction 99 9 — Richardson LA et al Socioeconomic marginalization in the structural production of vulnerability to violence among people who use illicit drugs. J Epidemiol Community Health — Artmed, Porto Alegre. Department of Health and Human Services. Int J Drug Policy 24 5 — Hosp Community Psychiatry 41 7 — Risk of violence among psychotic men. Br Med J — Tengstrom A, Hodgins S Criminal behavior of forensic and general psychiatric patients with schizophrenia: are they different? Acta Psychiatr Scand Suppl — United Nations Publication, New York. Vienna International Centre, Vienna. Results from a national sample. Am J Drug Alcohol Abuse 36 4 — Velho G Nobres e Anjos. Arch Womens Ment Health 13 3 — Int J Drug Policy 22 2 — Xiberras M A sociedade intoxicada. Instituto Piaget, Lisboa. Download references. You can also search for this author in PubMed Google Scholar. Reprints and permissions. Crime, Illegal Drugs, and Mental Health. In: Okkels, N. Mental Health and Illness Worldwide. Springer, Singapore. Published : 26 October Publisher Name : Springer, Singapore. Print ISBN : Online ISBN : Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative. Policies and ethics. Skip to main content. Mental Health and Illness in the City. Abstract This chapter is about the complex connections between drugs, violence, criminality, and mental illness. Access this chapter Log in via an institution. Socioeconomic and psychosocial determinants of substance misuse — a national perspective Article Open access 08 September Rev Bras Psiquiatr — Article PubMed Google Scholar Richardson LA et al Socioeconomic marginalization in the structural production of vulnerability to violence among people who use illicit drugs. View author publications. Rights and permissions Reprints and permissions. Copy to clipboard. Publish with us Policies and ethics. Search Search by keyword or author Search. Navigation Find a journal Publish with us Track your research.

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