"Attacks of bad nerves" appeared as a subject for study during an Inquiry into Refered Morbidity in 25 small villages of a rural area of the State of Espirito Santo, Brazil, which have subsisted by virtue of the labor needed for the harmsting of the coffee crops since the beginning of the century. Through the systematic sampling proceduce, 93 adults were interviewed about health problems which had occurred in their families during the previous 48 hours and about their attitudes concerning these problems. "Attacks of nerves" or simply "nerves" were reported in the cource of 28 (30%) interviews, resulting in 34 reports on the problem, proportionately distributed among settlers and owners of small properties; 14 were men and 20 women; all were rural workers. In 11 (32%) reports, over-work was quoted as the main couse of "nerves", either due to its direct effects, or to the affliction releted with the coexistence of great efforts to cope with responsibilities, and the small return on all their efforts. In 30 cases (88%) the use of at least one of the 26 psychotropic drugs mentioned was constant (being dauly in 68%). Dependence was explicit by confessed in 47% of them. The reference to "nerves pills" came first or even replaced the description of "attacks of nerves" in 18 (53%) of the interviews, reflecting the strong influence of medical practice and speech on the population. The more common expressions of "nerves" described were: insomnia, body pains, dizziness, trembling and weakness, as well as behaviours expressing emotions varying from sadness to fury. This the fragility of the threshold between normal and pathological is clearly brought out and suggests thak "nerves" syndrome which is culturally is a interpreted. The medicalization of "nerves" creates a chronic sick role for patients, obscuring the reasons for their suffering, and keeping the problem on the individual level. The facilities for the obtaining of medical prescriptions are here discussed in relation to the social determinants of the use of medicines.
Psychotropic drugs; Rural population; Drug use habits
