The impact of psychiatric diagnosis on treatment adherence and duration among victimized children and adolescents in São Paulo, Brazil

Autor(es)

Sandra Scivoletto ^[1] ; Thiago F Silva ^[2] ; Paulo Jannuzzi Cunha ^{[3, 4]} ; Robert A Rosenheck ^{[5, 6, 7, 8]}

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo, Fac Med, Hosp Clin, Dept Psiquiatria, Serv Psiquiatria Infancia & Adol, Sao Paulo - Brazil

^[2] Univ Sao Paulo, Fac Med, Hosp Clin, TEP, Sao Paulo - Brazil

^[3] Univ Sao Paulo, Fac Med, Dept Psiquiatria, Lab Psychiat Neuroimaging LIM 21, Sao Paulo - Brazil

^[4] Univ Sao Paulo, NAPNA, Sao Paulo - Brazil

^[5] Yale Univ, Sch Med, Ctr Child Study, New Haven, CT 06510 - USA

^[6] Yale Univ, Sch Med, Dept Psychiat, New Haven, CT - USA

^[7] Yale Univ, Sch Med, Dept Epidemiol & Publ Hlth, New Haven, CT 06510 - USA

^[8] Vet Affairs Connecticut Healthcare Syst, New England Mental Illness Educ Res & Clin Ctr, West Haven, CT - USA

• Tipo de documento: Artigo Científico
• Fonte: Clinics; v. 67, n. 1, p. 3-9, 2012-00-00.

Resumo

OBJECTIVE: Despite the high prevalence of substance abuse and mood disorders among victimized children and adolescents, few studies have investigated the association of these disorders with treatment adherence, represented by numbers of visits per month and treatment duration. We aimed to investigate the effects of substance abuse and mood disorders on treatment adherence and duration in a special program for victimized children in São Paulo, Brazil. METHODS: A total of 351 participants were evaluated for psychiatric disorders and classified into one of five groups: mood disorders alone; substance abuse disorders alone; mood and substance abuse disorders; other psychiatric disorders; no psychiatric disorders. The associations between diagnostic classification and adherence to treatment and the duration of program participation were tested with logistic regression and survival analysis, respectively. RESULTS: Children with mood disorders alone had the highest rate of adherence (79.5%); those with substance abuse disorders alone had the lowest (40%); and those with both disorders had an intermediate rate of adherence (50%). Those with other psychiatric disorders and no psychiatric disorders also had high rates of adherence (75.6% and 72.9%, respectively). Living with family significantly increased adherence for children with substance abuse disorders but decreased adherence for those with no psychiatric disorders. The diagnostic correlates of duration of participation were similar to those for adherence. CONCLUSIONS: Mood and substance abuse disorders were strong predictive factors for treatment adherence and duration, albeit in opposite directions. Living with family seems to have a positive effect on treatment adherence for patients with substance abuse disorders. More effective treatment is needed for victimized substance-abusing youth (AU)

• Processo FAPESP: 10/15786-1 - Integridade de substância branca em corpo caloso e desempenho neuropsicológico em crianças e adolescentes vítimas de violência e maus tratos: estudo morfométrico cerebral e de imagem por tensores de difusão
• Beneficiário: Geraldo Busatto Filho
• Modalidade de apoio: Auxílio à Pesquisa - Regular
• Processo FAPESP: 10/15604-0 - Integridade de substância branca em corpo caloso e desempenho neuropsicológico em crianças e adolescentes vítimas de violência e maus tratos: estudo morfométrico cerebral e de imagem por tensores de difusão
• Beneficiário: Paulo Jannuzzi Cunha
• Modalidade de apoio: Bolsas no Brasil - Pós-Doutorado
• Processo FAPESP: 10/18374-6 - Perfil neuropsicológico de adolescentes expostos a situação de estresse emocional precoce
• Beneficiário: Sandra Scivoletto
• Modalidade de apoio: Auxílio à Pesquisa - Regular