International International Archives of Medicine 2017

Medical Society Section: Psyquiatry & Mental Health Vol. 10 No. 180
http://imedicalsociety.org ISSN: 1755-7682 doi: 10.3823/2450

Sociodemographic and Clinical Profile of

Men Assisted in a Psychiatric Detoxification Service
in Natal, Rio Grande do Norte, Brazil
ORIGINAL

Romeika Carla Ferreira de Sena1, Francisco Arnoldo Nunes de Miranda1,

Joo Mrio Pessoa Jnior2, Ronaldo Augusto de Medeiros3, Glauber Weder dos Santos Silva1,
Francisca Patrcia Barreto de Carvalho4, Joo Evangelista Costa1,
Eder Samuel de Oliveira Dantas1, Michell Platiny Cndido Duarte5, Cllia Albino Simpson1

1  Universidade Federal do Rio Grande do

Norte. Natal/RN, Brasil.
Abstract 2 Universidade Federal do Rio de Janeiro.
Maca/RJ, Brasil.
3 Hospital do Corao de Natal. Natal/
Introduction: The male population has a high probability of aban-
RN, Brasil.
doning treatment, avoidance of health services, great exposure to 4 Universidade do Estado do Rio Grande
violence, mainly due to abusive use of alcohol and other drugs, and do Norte, Mossor/RN, Brasil.
high crime rates also associated with this problem. 5 Centro Universitrio do Rio Grande do
Norte. Natal/RN, Brasil.

Objective: To characterize the sociodemographic and clinical profile

of men admitted to a Psychiatric Detoxification Hospital Unit for al- Contact information:
cohol and drug abuse. Romeika Carla Ferreira de Sena.

Method: It is a cross-sectional and retrospective study, with data Address: Universidade Federal do Rio
Grande do Norte, Campus Universitrio
collection in 2015, with a temporal cut in patients records between Lagoa Nova. Av. Senador Salgado filho,
2008 and 2014, reaching a sample of 1,152 medical records. The data s/n, Lagoa Nova, Natal/RN. Brasil
collection instrument was composed of a structured form. The data CEP: 59.078-970.
were analyzed in a descriptive way.
romeikacarla@hotmail.com
Results: Regarding the age, the age group between 21 and 50 years
old had 30.73% between six and ten days hospitalized, and 11.98%
had readmissions. The main diagnoses for this disorders were linked
to the use of opiates, cannabinoids, sedatives and hypnotics.

Conclusion: The profile of internal and assisted men was characte- Keywords
rized such as adults of productive age, residents of the metropolitan Mental Health; Psychiatric
area of the city, with long periods of hospitalization, generally with Hospitals; Drug Users.
improved type discharge, low readmission and diagnoses of mental
disorders related to the excessive use of alcohol and other drugs.

Under License of Creative Commons Attribution 3.0 License This article is available at: www.intarchmed.com and www.medbrary.com 1

Introduction
The consumption of psychoactive substances, or
drugs, follows the man from the beginnings of his
civil conceptions as a manifestation related to em-
piricism and mythology in their different contexts
[1,2]. This phenomenon is an integral part of the
capitalist logic and the consumer market that uses
scientific, technological and innovative advances
to promote the industrialization, distribution, and
sale of these substances. Consequently, it produ-
ces enormous profits for the groups in charge of
this illegal and democratic commerce, seeing that
it reaches all the social and economic classes in its
schools, big malls as well as in the hills and com-
munities in need [3].
The indiscriminate use of drugs and their delete-
rious effects on health also destabilize social struc-
tures. Significant economic losses are attributed,
linked to the expenses with treatments and hospi-
talizations, as well as to the urban violence associa-
ted with it. There is also an increase in the number
of accidents at work and traffic, deaths and a fall
in the productivity of men and women of different
ethnic groups or levels of education, decreasing the
quality of life [4,5]. When reflecting on family and
society, these consequences make drug abuse a glo-
bal public health problem [6].
Intrafamily violence expressed as verbal and phy-
sical violence besides sexual abuse was a risk factor
for the use of drugs by adolescents. Curiosity in
experiencing new sensations or living new expe-
riences, the alleviation of pain and suffering, social
and friend pressure on the consumption of substan-
ces (alcohol, tobacco, cocaine, among others) are
the main causes leading the rapprochement of this
group of drugs [6].
The United Nations Office on Drugs and Crime
(UNODC) on the Global Report on Drugs, presented
in 2013, highlights that drug use and the problem
drug use have remained demographically stable but
increasing in number between 2006 and 2011, cir-
cumscribing illicit drug users by an average of 5.6%
2 This article is available at: www.intarchmed.com and www.medbrary.com
International Archives of Medicine 2017
Section: Psyquiatry & Mental Health Vol. 10 No. 180
ISSN: 1755-7682 doi: 10.3823/2450
of the global population in those years, from 208
million people in 2006 to 240 million in 2011. [7]
In Brazil, the Second Household Survey on the
Use of Psychotropic Drugs made in several capitals
revealed that 22.8% of the population surveyed had
already used psychoactive substances during their
lives. In a similar survey conducted in the United
States in 2004, this percentage reached 45.4% and
in Chile, 17.1%. Estimates of Alcohol dependents
were 12.3% and tobacco 10.1%. The use of mari-
juana appears first among illicit drugs, with 8.8%
of those interviewed having used it at least once in
their lifetime [8].
Abuse of licit and illicit drugs increases morbi-
dity and mortality rates. Also, the occurrence of
frequent psychiatric comorbidity indicates an un-
favorable prognosis for the treatment of chemical
dependence, hindering to diagnose, follow up and
appropriately treat diseases and promote the health
of users [9]
In 2013, another study conducted in Brazil revea-
led the prevalence of alcohol consumption among
men compared to women being young, black-
skinned or indigenous adults and smokers [10]. The
male population occupies considerable and wo-
rrying space, since, depending on the type of drug,
they consume more quantity than women. It is also
noted the difficulties of this group regarding the
care and maintenance of their health, since men,
culturally, do not seek health services in the preven-
tion of injuries [11].
It is recognized that the use of health services by
men differs from women, focusing on rehabilita-
tion assistance and especially on situations requiring
specialized emergency care. It should be noted that
the male population also has a high probability of
abandonment of treatment, health services evasion,
great exposure to violence, mainly due to drug abu-
se and high crime rates also associated with this
problem [12, 13]
In this perspective, the study is justified by the
relevance of knowing the reality of referral servi-

ces in the public psychiatric network performing
specialized care for men with problems of drug
abuse and chemical dependence, based on the
clinical and sociodemographic profile of the users
with the aim of contributing to the debate on the
formulation of public mental health policies and
improving the quality of health care. Thus, the
question is: what are the clinical and sociodemo-
graphic characteristics of alcohol users and other
male sex drugs admitted to a detoxification service
of a Psychiatric Hospital reference of the Rio Gran-
de do Norte?
The objective of this study was to characterize
the profile of men admitted to a Psychiatric Detoxi-
fication Hospital Unit for alcohol and other drugs
abuse.
Method
This is a cross-sectional, retrospective study con-
ducted at a hospital and alcohol detoxification
service in the city of Natal, Rio Grande do Norte,
Brazil.
Data collection took place from January to March
2015, from the medical records of 1,152 male users
who entered the detoxification service of the State
Reference Psychiatric Hospital and presented co-
morbidities of mental disorders between 2008 and
2014. Therefore, we did not use the sample cal-
culation, that is, we worked with a population of
the study, all 1,152 medical records. All records of
users assisted, users of 18 years old or older were
included, and deleted records with incomplete in-
formation were medical.
A structured form was used in the data collection
to identify the socio-demographic and clinical cha-
racteristics of the users, consistent with the research
objective. A pilot study with three medical records
was carried out before the beginning of the data
collection to evaluate the form, to correct possible
errors and to make the necessary adjustments. The
variables contained in the form were: age, origin,
Under License of Creative Commons Attribution 3.0 License
International Archives of Medicine 2017
Section: Psyquiatry & Mental Health Vol. 10 No. 180
ISSN: 1755-7682 doi: 10.3823/2450
the number of days of hospitalization, the num-
ber of readmissions, type of discharge received and
diagnosis according to the Diagnostic and Statistical
Manual of Mental Disorders [14].
After data collection, the database was prepa-
red in the program Microsoft Office Excel version
2013, and later, it was exported and analyzed with
the help of the Statistical Package for Social Scien-
ces (SPSS), version 20.0.
The data were analyzed in a descriptive way, dis-
cussed through the national and international lite-
rature, valuing the ethical precepts of the Brazilian
Psychiatric Reform.
The research was approved by the Human Re-
search Ethics Committee on December 20, 2015,
with CAAE: 25851913.7.0000.5672 and technical
advice n 508.803.
Results
There were 91.58% (n=1,055) of the medical re-
cords with a minimum age of 18 years old and
a maximum of 80 years old, with an average of
37.6 years old; highlighting the age group of 21
to 51 years old, corresponding to 73.51% of users
(n=847), followed by the age group older than 51
years old, equal to 13.28% (n=153) and the group
from 18 to 20 years old with 4.77% (n=55) of the
total users (Table 1).
Regarding the time of hospitalization of the users
in treatment in the mental health service, 9.81%
(n=113), there was no information in the medical
records allowing the calculation of the treatment
time. There were 74.48% (n=858) entering in the
institution with 1 to 15 days of hospitalization, and
15.71% (n=181), exceeding the period of 15 days. As
for the medical diagnostics of mental disorders, the
use of alcohol was in 54.7% (n=630), followed by
using multiple drugs and the use of other psychoac-
tive substances (F19) 22.2% (n=256). Diagnoses re-
lated to alcohol use with other drugs (F10 + F19)
totaled 11.4% (n=131) of the cases. (Table 1).
3
 International Archives of Medicine 2017
Section: Psyquiatry & Mental Health Vol. 10 No. 180
ISSN: 1755-7682 doi: 10.3823/2450

Table 1. D
 istribution of hospitalized users by age Table 2. D
 istribution of hospitalized users according
group, the length of stay in the institution/ to location, the number of readmissions
treatment and diagnosis. Natal, RN, Brazil, and types of discharge/treatment. Natal,
2016. RN, Brazil, 2015.
Variables n % Variables n %
Age group Location
18 to 20 55 4.77 Natal and Metropolitan Region 174 15.10
21 to 30 291 25.26 Other cities 25 2.17
31 to 40 292 25.35 Incomplete identification 19 1.65
41 to 50 264 22.92 Not identified 934 81.08
> 51 153 13.28 Number of admissions
Not informed 97 8.42 Returned once 100 8.68
Time of hospitalization Returned twice 23 2.00
< 5 days 232 20.14 Returned three or more times 15 1.30
6 to 10 days 354 30.73 Did not return 1014 88.02
11 to 15 days 272 23.61 Type of discharge
>15 days 181 15.71 Improvement 111 9.64
Ignored 113 9.8 Internal or external transfer 47 4.08
Diagnostic CID-10 Abandonment of treatment 47 4.08
F10 630 54.70 Hospital evasion 49 4. 25
F19 256 22.22 Death 01 0.09
F11, F12, F13, F14, F15, F16, F17 or F18 45 3.90 Not specified 488 42.36
F10 + F19 131 11.37 Not informed 409 35.50
Not informed 90 7.81 Total 1152 100
Total 1152 100

According to Table 2, only 18.92% (n=218) of the

records analyzed informed the origin of the users.
Of them, 15.1% (n=174) come from the city of Na-
tal/RN or metropolitan region; 2.17% (n=25) from
cities in the interior of the state and two from other
states.
As for readmission cases, 11.98% (n=138) of the
patients returned to the service. There were 9.64%
(n=111) of the analyzed records discharged from
hospital for improvement; 4.25% (n=49) due to
hospital circumvention; 4.08% (n=47) due to aban-
donment of treatment with consent; 4.08% (n=47)
were submitted to some type of internal or external
transfer. There were 0.09% deaths (n=01) during
the treatment (Table 2).
Discussion
The predominant age group of the records analyzed
is characterized by young adult men (mean age 37.6
years old) with an average hospital stay of eight
days, a finding that reflects the social and economic
burden from the perspective of public health since
they are individuals at the peak of the productive
age who are away from work as the length of hos-
pital stay, increasing work absenteeism. Research
developed in Braslia, Federal District, Brazil, obtai-
ned similar percentages, in which about 70% of
hospitalizations for the use of psychoactive subs-
tances occurred in individuals aged between 20 and
49 years old [15].
According to the Brazilian Report on Drugs pre-
pared by the National Secretariat for Drug Policies
of the Ministry of Justice, hospitalizations resulting

4 This article is available at: www.intarchmed.com and www.medbrary.com


from drug use in the country occur mostly in the
age group varying between 20 and 59 years old,
corresponding to about 89% of admissions among
all ages [8]. It is also worth noting that approxima-
tely 69% of the cases of hospitalizations associa-
ted with mental and behavioral disorders due to
drug use are related to alcohol abuse, causing the
greatest number of hospitalizations [8].
The medical diagnostics prevalent in the study
were those of mental disorders associated with al-
cohol use (F10) and disorder associated with the use
of multiple drugs and the use of other psychoac-
tive substances (F19). A study conducted in Nige-
ria revealed that the consumption of psychoactive
substances was quite common among patients with
other psychiatric disorders, with alcohol, cannabis,
and tobacco being the most commonly used subs-
tances [16].
It is known that in Brazil there is an extremely
tolerant attitude towards alcohol consumption and
with minimal restrictions, including the consump-
tion and sale of children under eighteen. In general,
the treatment for chemical dependence is sought
at around the age of forty, concomitant with the
emergence of serious health problems resulting
from excessive consumption of the substance [5].
Such reality was observed in a study carried out
in a municipality in the south of Brazil, where ap-
proximately 46% of the population sample affirms
that they frequently consume alcohol [1].
Psychic suffering is a social problem when the
patient is ill, interfering with the personal and pro-
fessional relationships of the individual and those
around him, and in cases of risk for themselves and
others, the hospitalization is indicated in a period
that should be the most possible, with the institu-
tion having a role that is not limited only to the po-
litical guidelines of health, but comprising a percep-
tion that demands focus on the need to rescue the
citizenship of the individual. There is also suffering
caused by comorbidities derived especially from the
abusive use of drugs, especially alcohol, considered
Under License of Creative Commons Attribution 3.0 License
International Archives of Medicine 2017
Section: Psyquiatry & Mental Health Vol. 10 No. 180
ISSN: 1755-7682 doi: 10.3823/2450
a licit substance and of harmful consequences for
human health.
A study carried out with alcoholics, and other
addicts in the abstinence state found the occurren-
ce of several comorbidities, where smoking predo-
minates, found in 58.1% of the patients, followed
by psychiatric comorbidities such as depression and
generalized anxiety disorder (GAD) [18].
In Ontario, Canada, a study to explore the
functions and factors that lead subjects combining
the use of several psychoactive substances simulta-
neously, identified that combined use would help
reduce users irritability and anxiety, provoking good
feelings, stress relief, but also disinterest in seeking
a health service to treat their morbidities. Another
curiosity revealed their use assisting in the relaxa-
tion process, particularly when alcohol is used after
cocaine use [19].
In this scenario, social problems, such as ma-
rital and labor difficulties in predominance, and
a high level of suicide risk in the population stu-
died (34.5% in the group dependent on multiple
abstinence psychoactive substances and 28.6% in
the chemical dependent group on crack/cocaine
abstinence, alcohol and marijuana) [18]. The occu-
rrence of two disorders, especially mental, is con-
sidered a poor prognosis. Thus, with the difficulty
of adherence to treatment, cases of comorbidities
are aggravated, requiring intensive and prolonged
attention, with the permanence in treatment as-
sociated with the increase in abstinence rates and
the improvement of cognitive and emotional per-
formance [18].
The importance of ensuring adequate time for
crisis situations is reinforced, not exceeding for long
periods, which would contrast with the practice of
the old models of psychiatric hospitals. It should be
emphasized that hospitalization time should be as
short as possible through institutional supervision
and inspection, considering the psychiatric behavior
and evaluation performed by the multi-professional
team monitoring the person assisted [5, 20].
5

In the hospitalization phase, that is, during the
detoxification period, it becomes important to pro-
vide strategies for adherence to treatment, social
reintegration, prevention of relapse, among other,
through a unique therapeutic design (PTS) for the
user, making clear the importance of the treatment
he is subjected, going beyond the time that can
even remain hospitalized.
A study aimed to investigate the perception of
drug users about the period of detoxification in the
hospital observed the valorization of the treatment
by the users who do it, this valuation being an indis-
pensable point in the determination to abandon the
addiction, demonstrating a clear interest in re-so-
cialization associated with drug abandonment [21].
The percentage of users who are discharged for
consented leave together with those who present
hospital evasion is close to users who are dischar-
ged at the end of treatment and improved. For the
origin and residence of the user, there was also a
flaw in the analysis of the data due to lack of ade-
quate registration. With the lack of registration, it is
impossible to investigate the exact number of cases
not concluding treatment, and information relevant
to the control and study of the various instances
involved in the process is lost.
Similarly, it is not possible to observe if the pa-
tients are discharged with referral for continuity of
treatment in another specialized service. This fact
reveals the fragility of the service, the lack of active
search for those users who abandoned treatment,
with serious aggravating factors for the process of
their chronification and illness.
The lack of information in the medical records
hinders to analyze the data collected, a fact com-
mon to other studies of the same nature. In poor
medical records, it is difficult to collect data, su-
ggesting that healthcare professionals who handle
information should be concerned about the availa-
bility of medical records with the largest number of
records, allowing sources to be reliable for future
research [22, 23].
6 This article is available at: www.intarchmed.com and www.medbrary.com
International Archives of Medicine 2017
Section: Psyquiatry & Mental Health Vol. 10 No. 180
ISSN: 1755-7682 doi: 10.3823/2450
The importance of filling in all the patients data
goes beyond a database for research, comprising
a valuable element for the patient, the institution
and the professional that assists him, as well as for
the legal and public health services. A similar study
carried out in the city of So Paulo shows that most
of the medical records that were part of the sample
do not have a record of the diagnostic hypothesis,
losing data and excluding medical records of their
sample due to lack of information on the screen
[23, 24].
It is observed that, proportionally, most users
come from the city of Natal/RN/Brazil in its five
health districts or metropolitan region, intercon-
nected among nine surrounding municipalities. The
presence of patients from the interior of the state
can be observed for the treatment segment. There
are five Psychosocial Alcohol and Drug Attention
Centers throughout the state, three of them in
the capital and metropolitan region, the other two
being in the most populous city in the interior.
The phenomenon of hospital admissions was
another interesting finding, observing a low per-
centage of users who entered the service having
previous hospitalizations. It is understood that only
hospital admission does not fully correspond to the
needs of the users, and the segment in substitu-
tive/outpatient services is necessary, observing the
sociocultural context of individuals other than bio-
logical. The occurrence of this practice may also be
related to the failure or lack of reference services far
from the capital and large urban centers of the stu-
died reality, concomitant with the reduced number
of specialized services for health care at the request
of the smaller municipalities.
Conclusion
The profile of the internal men assisted in the stu-
dy hospital is characterized as adults of productive
age, living in the metropolitan area of the city, with
long periods of hospitalization, usually with dischar-
 International Archives of Medicine
ge from the improved type, with low incidence of
readmissions and diagnosis of mental disorders rela-
ted to the excessive use of alcohol and other drugs.
Difficulties in the quality of medical and nursing
records are recorded, a reality that prevents data
acquisition and, consequently, propose actions, care
and interventions, since the patients medical record
must have information that fully contains the care
provided in the hospitalization, evolution, reactions
and concerns, using terms that clearly explain the
facts, so that it can subsidize not only documen-
tary research but, above all, to aid in subsequent
interventions.
It is suggested to carry out other analytical re-
search to advance scientific production, mainly
due to the shortcomings pointed out by the study,
mainly in the investigation of the assistance provi-
ded to these users in the post-discharge, focusing
on the continuity of the treatment/follow-up in out-
patient clinics or specialized services, since the need
for greater mobilization of constituted powers and
society around actions aimed at health promotion
and the prevention of injuries due to the use of
alcohol and other drugs is well-known.
The study may contribute to formulations of new
public policies and even regional micro-politics in
mental health to qualify the provision of assistance
and care available to users of alcohol, tobacco and
other drugs, as the characterization of users allied
with information of readmissions, facilitating the
identification of the actual needs and demands of
the population in the magnitude of this problem.
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International Archives of Medicine is an open access journal
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