Dependência de açúcares: investigação dos critérios de dependência do DSM-IV adaptados para açúcar de adição

Abstract

INTRODUCTION: High consumption of sugar can potentially cause many problems to the body of individuals from the development of several chronic diseases. Most of these diseases are liable to prevention, since they are somehow related to eating habits development. However, overconsumption of sugar could be related to its possible abuse or dependence. The dependence of sugar is a plausible hypothesis, although not yet proven empirically. Seeking information in scientific literature, one notice very limited information about this topic. In 2005, an instrument for diagnosing addiction on added sugars, based on DSM-IV dependence criteria, was developed in Brazil. OBJECTIVE: Investigate the instrument for dependence of added sugar from the psychometric analysis of DSM-IV dependence criteria. METHOD: Use of instruments for evaluating substance dependence (added sugar, alcohol, cocaine, marijuana and nicotine), periodic binge eating scale and impulsivity scale in a convenience sample of 1.081 individuals enrolled in public spaces and clinics for treatment of obesity and chemical addiction in two Brazilian cities (Porto Alegre and Belo Horizonte). Data were analyzed using the techniques of Exploratory Factor Analysis, Item Response Theory, bivariate and logistic regression. RESULTS: Among the individuals studied, approximately 53.4% were men, the average age was 34.5 (± 12.5), 12.4% were obese (BMI> 30),100% sugar users, 68.3% alcohol users, cocaine users 20.9% and 27.4% of marijuana users. The prevalence of individuals with current substance addiction were approximately 24% for added sugar, 25% for alcohol, 14% for cocaine, 10% for marijuana and 28% for nicotine. The periodic binge eating disorder was observed in approximately 13% of the sample. The exploratory factor analysis suggested a unidimensional instrument. The model of Item Response Theory demonstrated by the discrimination and severity parameters, that all dependence criteria applied to sugar showed high discrimination and that the severity values ranged between 0.07 and 2.62. The criterion with the lowest severity for sugar was "larger than the desired consumption" and the worst was the "Decline of important activities." The analysis of differential item functioning showed that few items showed significant differences, suggesting that the instrument is suitable for evaluation in different groups. CONCLUSION: The analysis of DSM-IV dependence criteria for added sugar showed adequate psychometric properties, which contributed to the evidence of this new construct called "dependence of added sugar."