Cognitive-behavioral disorders in young crack users: a systematic review

Resumo

Introduction: The use of drugs by young people can cause acute (intoxication / overdose) and chronic complications (reduction of executive and cognitive function, depressive disorder and phobia), with long-lasting or even irreversible changes. There are important knowledge gaps in this area, especially among the youth.

Objective: Review the scientific evidence on the cognitive-behavioral changes in adolescents and young crack users.

Methodology or experience description: Systematic review of studies published up to September 2013, without language restrictions, in VHL Portal, SCIELO, Science Direct, Ministry of Health, DATASUS and CAPES Portal. Inclusion criteria: Adolescents and young crack users, alone or in combination with other drugs, with changes in cognition or behavior. Exclusion criteria: Adolescents and young people not using crack, users who did not have cognitive- behavioral changes and use of the drug for less than six months.

Results: We included 26 moderate to high methodological quality articles, nine published in English and 17 in Portuguese; mostly transversal type and one systematic literature reviews. Crack use by young people appears to be associated with the development of depressive and mood disorder; deficits in attention span, reduced memory and language, verbal inhibition, reduction of executive functions, learning deficit, impulsivity, impairment of sustained attention, risky sexual behavior, aggression and oppositional defiant disorder. Authors disagreed on changes in intellectual capacity.

Conclusions or Hypothesis: The use of crack seems to trigger broad spectrum of cognitive-behavioral changes, which can be acute or chronic, temporary or permanent. These findings can inform policies and programs to prevent use of crack and be useful for the clinical management of such population.