Prevalência de ansiedade e fatores associados em adultos

Prevalence of common mental disorders in southern Brazilian women: a comparison of two population-based studies (2003 vs. 2015)

PURPOSE

To investigate the prevalence and associated factors of common mental disorders (CMD) in women, and comparing them in two periods, 2003 and 2015.

METHODS

A comparative study was conducted between two surveys with representative samples of women aged 20-60 years residing in southern Brazil. The final sample included 988 and 987 women from the 2003 and 2015 surveys, respectively. The presence of CMD was assessed using the Self-Reporting Questionnaire (SRQ-20 ≥ 8) in both surveys. Poisson regression analysis was used to evaluate the associations between the outcome (CMD) and variables of interest.

RESULTS

The mean age of the participants was 38.5 ± 11.1 years (2003) and 40.3 ± 11.4 years (2015). In 2003, the prevalence of CMD was 33.4% (95%CI: 30.5-36.3) and in 2015, it was 33.7% (95%CI: 30.8-36.7). Over 12 years, no significant differences were observed in the prevalence of CMD, except for a reduction in the prevalence in women of color and physically active. After adjusting, the prevalence ratios of CMD in 2003 and 2015 remained associated with low family income, a higher number of pregnancies, and tobacco use.

CONCLUSIONS

This study showed a trend toward stability in the high prevalence of CMD among women.

Generalized anxiety disorder and associated factors in primary health care workers in Minas Gerais, Brazil

BACKGROUND

The COVID-19 pandemic had direct and indirect impacts on public health, also affecting the mental health of the population.

OBJECTIVE

To analyze symptoms of generalized anxiety disorder (GAD) and associated factors, in primary health care (PHC) professionals.

METHODS

Cross-sectional and analytical study conducted with professionals who work in the Primary Health Care (PHC) of the Northern health macro-region of the state of Minas Gerais, Brazil. Data collection was carried out through an online, self-administered questionnaire, made available from August 27, 2021, to October 30, 2021 using the Google Forms tool. The questionnaire included sociodemographic questions as well as questions related to the history of anxiety and work during the pandemic. To assess anxiety symptoms, the General Anxiety Disorder-7 (GAD-7) instrument was used. Data treatment consisted of descriptive analysis of the variables, bivariate analysis followed by multivariate Poisson Regression with robust variance.

RESULTS

702 health professionals participated in the study and the general prevalence of GAD was 32.2%. Current anxiety symptoms were self-reported by 37.6% of the participants. In the final model, the associated factors identified were: female sex (PR = 1.82; 95% CI = 1.17-2.84; p = 0.007), previous symptoms (PR = 1.58; 95% CI = 1.19-2.10; p = 0.002) and (PR = 2.68; 95% CI = 2.00-3.62; p < 0.001) current self-reported anxiety.

CONCLUSION

The results show the need to implement actions in mental health promotion and anxiety prevention, through the dissemination of information about mental health care, health education activities, encouraging the adoption of healthy habits and professional monitoring when necessary.

Working conditions and mental health of community health workers in the COVID-19 pandemic

This study examined the prevalence of anxiety and depression associated with Community Health Workers' (CHWs') working conditions in the context of the COVID-19 pandemic. This cross-sectional study was carried out in the north of Minas Gerais, Brazil by applying a questionnaire addressing sociodemographic conditions, command of technologies and working conditions during the pandemic, as well as the State-Trait Anxiety Inventory and the Patient Health Questionnare-9 (PHQ-9). Descriptive and multiple Poisson regression analyses were performed with robust variance, to a 5% level of significance (p < 0.05) for the final model. A total of 1,220 CHWs from 36 municipalities participated in the study. Prevalences were 41.8% and 31.6% for anxiety and depression, respectively, while 22.5% of the group displayed symptoms of both conditions. Being female, up to 40 years old, having more than 500 users registered for monitoring, and inadequate supply of personal protective equipment were associated with anxiety and depression among the CHWs. Prevalence of anxiety and depression was high among CHWs during the pandemic and working conditions figured prominently among the associated factors.

Association between obesity and common mental disorders in women: a population-based study in Southern Brazil

PURPOSE

The study aimed to investigate the relationship between obesity and common mental disorders (CMD) among women.

METHODS

This is a cross-sectional population-based study with a representative sample of 981 adult women (20-60 years of age) living in the urban area of the municipality of São Leopoldo, RS, Brazil, in 2015. The presence of CMD was assessed using the Self-Reporting Questionnaire (SRQ-20 ≥ 8). Obesity was defined by body mass index (BMI ≥ 30.0 kg/m²). Prevalence ratios (PRs) for the association between obesity and CMD were measured by Poisson regression with robust variance, including their respective 95% confidence intervals (CIs).

RESULTS

The mean age of the sample was 40.3 years (standard deviation = 11.4 years). The prevalence of CMD was 33.7% (95% CI 30.8-36.7), while obesity was 31.2% (95% CI 28.3-34.1). The occurrence of CMD was higher in women with low levels of education and belonging to lower economic class, as well as smokers and those who were insufficiently active. Obesity was more prevalent in older women (50-60 years old) with less schooling, who did not consume alcohol, and those who were insufficiently active. After adjusting for potential confounding factors, women with obesity were 22% more likely to have CMD when compared to those without obesity (PR = 1.22; 95% CI 1.02-1.45; p = 0.030).

CONCLUSIONS

This study demonstrated a significant association between obesity and the presence of CMD among women. Additionally, the prevalence of obesity and CMD were high in this population group.

Chronic diseases and health conditions in adolescents: Sex inequalities

OBJECTIVE

To estimate the prevalence of chronic diseases and health conditions in adolescents from Campinas (São Paulo), investigating sex differences according to age group.

METHODS

This population-based study analyzed data from the ISACamp 2014/15 health survey, with a total of 1,022 adolescents interviewed. The interviewees consisted of 517 boys and 505 girls; 492 of them in the ten to 14 age group and 530 in the 15 to 19 age group. We verified the associations using the χ2 test with Rao Scott adjustment and estimated prevalence ratios (PR) with multiple Poisson regression adjusted for age. Analyses were also stratified by age group.

RESULTS

Respiratory diseases, such as rhinitis (25.3%), sinusitis (15.7%), and asthma (10.9%), were the most prevalent among adolescents. Health complaints were high, especially headaches (39.5%), emotional conditions (34.5%), allergies (27.5%), and back pain (21.3%). More than 22.0% of adolescents reported having three or more health conditions. Girls declared a higher number of health conditions (three or more) than boys (PR=2.27).

CONCLUSION

The study showed that adolescents presented a significant number of health conditions, particularly regarding complaints, indicating the need for clinical care and public policies aimed at controlling and preventing these diseases in this age group.

Effects of the COVID-19 pandemic on nurses’ psychological well being in an emergency room

ABSTRACT Objectives: to assess the level of anxiety of nurses in an emergency room in view of the new Coronavirus and describe the relationship between the degrees of anxiety and their sociodemographic variables. Methods: quantitative descriptive-correlational study with a sample of 60 nurses. A questionnaire was used as a data collection instrument based on the Hamilton Anxiety Assessment Scale. Results: the nurses’ average anxiety is mild. A statistically significant relationship was found between anxiety and the variables “sex” and “children”, with women having higher levels of anxiety than men, and nurses who do not have children showing mild, moderate, or severe anxiety. Conclusions: COVID-19 triggers anxiety in nurses, sometimes at pathological levels. Being female and not having children increase the anxiety experienced. Sex can be considered the determining factor for the level of anxiety experienced.

Chronic diseases and health conditions in adolescents: Sex inequalities

ABSTRACT Objective: To estimate the prevalence of chronic diseases and health conditions in adolescents from Campinas (São Paulo), investigating sex differences according to age group. Methods: This population-based study analyzed data from the ISACamp 2014/15 health survey, with a total of 1,022 adolescents interviewed. The interviewees consisted of 517 boys and 505 girls; 492 of them in the ten to 14 age group and 530 in the 15 to 19 age group. We verified the associations using the χ2 test with Rao Scott adjustment and estimated prevalence ratios (PR) with multiple Poisson regression adjusted for age. Analyses were also stratified by age group. Results: Respiratory diseases, such as rhinitis (25.3%), sinusitis (15.7%), and asthma (10.9%), were the most prevalent among adolescents. Health complaints were high, especially headaches (39.5%), emotional conditions (34.5%), allergies (27.5%), and back pain (21.3%). More than 22.0% of adolescents reported having three or more health conditions. Girls declared a higher number of health conditions (three or more) than boys (PR=2.27). Conclusion: The study showed that adolescents presented a significant number of health conditions, particularly regarding complaints, indicating the need for clinical care and public policies aimed at controlling and preventing these diseases in this age group.

Bach Flower Remedies as Complementary Therapies in Health Care: A Scope Review

The objective of this article was to map the use of Bach flower remedies in adult health care. The studies reported that the following flower essences were used: Impatiens, Cherry Plum, White Chestnut, and Beech. When applied in 4 diluted drops, they helped reducing anxiety, depression, fear, and pain.

Evidências de Validade da GAD-7 em Adolescentes Brasileiros

Resumo O objetivo deste estudo foi investigar evidências validade para a escala Generalized Anxiety Disorder (GAD-7) em adolescentes brasileiros, bem como validade concorrente para esta escala e apresentar a distribuição social do Transtorno de Ansiedade Generalizada (TAG). Participaram 302 adolescentes, com idades entre 15 e 19 anos, de ambos os sexos. Aplicou-se o questionário sociodemográfico, a GAD-7, a Hospital Anxiety and Depression Scale (HADS) e o Patient Health Questionnaire (PHQ-9). Os resultados da Análise Fatorial Exploratória (AFE) atestaram a unidimensionalidade da GAD-7 e indicaram consistência interna satisfatória. As evidências de validade concorrente apresentaram associações estatisticamente significativas e positivas entre a GAD-7 e as escalas PHQ-9 e HADS-A. Quanto à distribuição social, aproximadamente metade da amostra apresentou a ocorrência de sintomatologia positiva para TAG, sendo mais comum para o sexo feminino e em adolescentes mais jovens. Esses dados sugerem que a GAD-7 apresenta adequadas propriedades psicométricas para rastreamento de ansiedade em adolescentes.

Knowledge About Biosafety Measures in Clinical Setting During the COVID-19 Pandemic: A Cross-Sectional Study With Brazilian Dental Students

OBJECTIVE

The aim of this study is to evaluate the knowledge of Brazilian dental students about biosafety measures that should be adopted in the clinical setting during the coronavirus disease (COVID-19) pandemic.

METHODS

A cross-sectional study with 1050 dental students was conducted. A semi-structured questionnaire was shared with students. Mean knowledge score on biosafety guidelines during the COVID-19 pandemic was the outcome, with a maximum of 8 scores. Explanatory variables included sociodemographic and educational characteristics, aspects related to biosafety education, actions adopted by the dental schools during the pandemic, and sources of biosafety information. Multivariate linear regression analyses were performed.

RESULTS

Mean knowledge score was 5.19 (1.28). Female students (β = 0.346; 95% CI: 0.154-0.539), those enrolled in the intermediate (β = 0.525; 95% CI: 0.167-0.883) or final (β = 0.569; 95% CI: 0.200-0.937) stage of course, and those who had already received theoretical-practical training in biosafety (β = 0.464; 95% CI: 0.063-0.866) presented higher mean knowledge scores. Students who did not receive guidance on aerosol control measures before the pandemic (β = -0.324; 95% CI: -0.519 to -0.130) had the lowest score.

CONCLUSION

Students presented a medium level of knowledge about dental biosafety measures concerning the COVID-19 pandemic. Sociodemographic characteristics and those related to the institutional profile of the participants, and access to orientation and training in biosafety, may influence their knowledge.

Overweight and associated factors in Basic Education teachers during the Covid-19 pandemic: gender differentials

ABSTRACT Objective To estimate the prevalence of overweight among teachers in Minas Gerais during the Covid-19 pandemic and to review relevant gender associated factors. Methods Cross-sectional and analytical study, websurvey type, carried out with 15,641 teachers of public Basic Education in Minas Gerais, Brazil. Data collection took place from August to September 2020 with the use of a digital form. The dependent variable was overweight, calculated by the body mass index using the teachers’ self-reported weight and height. Poisson regression was used, with robust variance. Results Among the participating teachers, 52.4% were overweight. When stratified by gender, 51.1% women and 58.2% men were considered overweight, with a significant difference between them (p<0.001). There was a higher prevalence of overweight among women in the age group of 30 to 59 years (PR=1.39) and in women 60 years or older (PR=1.45) living in the metropolitan region of the state (PR=1.06) who had children (PR=1.19), who were not exercising (PR=1.09) and with a worse dietary pattern during the pandemic (PR=1.12), much afraid of Covid-19 (PR=1.04) and with anxiety and/or depression during the pandemic (PR=1.14). Among men, there was a higher prevalence of overweight among those individuals aged 30 to 59 years (PR=1.19), who lived with a spouse (PR=1.15) working more than 40 hours per week (PR=1.12) and those with the worst dietary pattern during the pandemic (PR=1.10). Conclusion The results showed a 52.4% prevalence of overweight teachers and different associated factors between the genders.

Sociodemographic and occupational factors associated with anxiety symptoms in Community Health Agents

Community Health Agents (CHAs) play a crucial role in assisting the population. Due to the complexity of functions and situations to which they are exposed, they can present with emotional problems. The aim of this article was to verify the prevalence of anxiety symptoms and the association with sociodemographic and occupational factors in community health agents. It is a cross-sectional and populational study that used a questionnaire to collect data on the sociodemographic, economic and occupational conditions and the State Trait Anxiety Inventory (STAI). Descriptive analyses and multiple Poisson regression were performed with robust variation, considering a 5% significance level (p <0.05) for the final model. A total of 673 community health agents were evaluated. The prevalence of anxiety symptoms in the STAI-State was 47.4% and in the STAI-trait, 42.4%. The time working as a CHA longer than five years was associated with the STAI-state (p<0.001) and the STAI-trait (p=0.018), where as the female gender was associated with the STAI-trait (p=0.011). A high prevalence of anxiety symptoms in community health agents was verified. Health promotion strategies aimed at improving and monitoring the mental health of these workers by reducing anxiety disorders is required.

Prevalência e fatores associados ao uso de benzodiazepínicos em idosos atendidos em um ambulatório especializado em Porto Alegre, Brasil

Objetivos: verificar a prevalência de uso de BZDs na população idosa atendida em um ambulatório de psiquiatria geriátrica de um hospital universitário em Porto Alegre, Brasil.Métodos: estudo transversal realizado no ambulatório de psiquiatria geriátrica. A coleta de dados ocorreu durante a primeira consulta dos indivíduos com idade igual ou superior a 60 anos. Os dados avaliados compreendem questões sociodemográficas, clínicas, de saúde e uso de medicamentos. Para análise estatística foi utilizado o programa SPSS (do inglês, Statistical Package for the Social Sciences).Resultados: um total de 295 idosos foram incluídos no estudo. A média de idade foi de 72,1±8,3 anos, sendo na maioria mulheres (76,6%), com escolaridade de 5 a 8 e 9 a 12 anos de estudo (ambos com a mesma frequência, 28,9%), casados (45,0%), residindo com familiar (34,4%), aposentados (79,8%). A prevalência de utilização de BZD foi de 33,6% (n=99). A queixa principal de ansiedade e o diagnóstico de transtornos ansiosos foram associadas ao uso de BZDs.Conclusões: a prevalência do uso de BZDs foi alta e associada à queixa principal de ansiedade e aos diagnósticos de transtornos ansiosos e depressivos, mesmo esses sendo considerados medicamentos potencialmente inapropriados e com alto risco de complicações. O tratamento da população geriátrica, muitas vezes, é colocado em segundo plano, não recebendo devidamente os cuidados direcionados às demandas específicas que esses indivíduos necessitam. O conhecimento epidemiológico da população idosa expõe características e auxilia na elaboração de plano terapêutico diferenciado.

Do inflammation and adiposity mediate the association of diet quality with depression and anxiety in young adults?

BACKGROUND & AIMS

Diet quality has been inversely associated with depression, but less is known about its association with anxiety and about the mechanisms involved in the association between diet and mental health. This study aimed to assess the associations of diet quality with major depressive disorder (MDD) and generalized anxiety disorder (GAD) in young adults, and to explore whether inflammation, indexed by interleukin-6 (IL-6) and C-reactive protein (CRP), and body mass index (BMI) mediate this association.

METHODS

We used data of 3331 participants from the 1993 Pelotas Birth Cohort (Brazil). Data on dietary intake and inflammatory markers were assessed at 18 years, and information on mental disorders was obtained at both 18 and 22 years. A food frequency questionnaire was used to assess dietary intake, and diet quality was estimated using the Brazilian Healthy Eating Index - Revised (BHEI-R). The occurrence of MDD and GAD was assessed using the Mini International Neuropsychiatric Interview (MINI), conducted by psychologists. The associations of diet quality, BMI and inflammatory markers with mental disorders were explored using logistic regression. The mediation analysis was performed using structural equation modelling.

RESULTS

A one standard deviation increase in the diet quality score at age 18 years was associated with both lower levels of CRP (-0.06 mg/L; 95% CI: -0.10; -0.008) at 18 years and 23% lower odds of MDD at 22 years (OR: 0.77; 95% CI: 0.61; 0.97). No association was found between diet quality score and both BMI and GAD. Obesity was associated with higher odds of MDD, but CRP and IL-6 were not associated with MDD or GAD. Our results provide no evidence that inflammatory markers and BMI mediate the association between diet quality and MDD in young adults.

CONCLUSIONS

A better diet quality is associated with lower occurrence of MDD among young adults, but we did not find evidence that inflammatory markers and BMI mediate this association.

Sintomas de ansiedade entre mulheres rurais e fatores associados

Resumo Objetivos identificar os sintomas de ansiedade em mulheres rurais e a influência de variáveis sociodemográficas, econômicas, comportamentais e de saúde reprodutiva sobre os sintomas de ansiedade. Método estudo observacional e transversal. Participaram 280 mulheres residentes na área rural. Foi utilizado o inventário de ansiedade Traço-Estado. Na análise bivariada, foram usados o teste t-Student e a correlação de Pearson. Para a análise multivariada, foi realizada a regressão linear múltipla. Resultados os escores médios das mulheres foram de 38,3 e 41,4 pontos na ansiedade-estado e ansiedade-traço respectivamente. As mulheres que referiram convivência “ruim” com o companheiro apresentaram maiores escores de sintomas de ansiedade-estado e ansiedade-traço. A variável número de filhos foi preditora dos escores dos sintomas de ansiedade-estado e ansiedade-traço e a variável idade, preditora do escore dos sintomas de ansiedade-traço. Conclusão os resultados evidenciaram a influência de diferentes fatores com os sintomas de ansiedade entre as mulheres rurais. A identificação dos sintomas e os fatores associados, por parte da equipe de saúde, pode contribuir para ações específicas e encaminhamentos adequados.

Transtorno de ansiedade generalizada entre estudantes de cursos de pré-vestibular

RESUMO Objetivo Medir a prevalência de sintomatologia de transtorno de ansiedade generalizada (TAG) entre estudantes de um curso pré-vestibular do sul do Brasil e sua associação com fatores sociais, demográficos, acadêmicos e psicológicos. Métodos Este estudo teve delineamento transversal, tendo como participantes estudantes com idade igual ou superior a 18 anos de um curso pré-vestibular privado do sul do Brasil. Foi administrado um questionário autoaplicável que avaliava aspectos sociais, demográficos, acadêmicos, de ansiedade relacionada à prova e estresse percebido. O desfecho analisado foi a sintomatologia de TAG, por meio do instrumento General Anxiety Disorder-7 (GAD-7). Para análise multivariável, utilizou-se a regressão de Poisson com ajuste robusto da variância. Resultados Participaram 137 alunos (taxa de resposta de 90,7%) e a prevalência de sintomatologia de TAG foi de 41,4%. Após análise ajustada, ser do sexo feminino, ter estudado em escola privada, ter maiores escores de estresse percebido e de ansiedade relacionada à prova permaneceram como fatores de risco. Estar com 19 anos apresentou-se como fator de proteção. Conclusões A ansiedade relacionada à prova foi o fator mais fortemente associado com a sintomatologia de TAG, o que sugere que as emoções e preocupações específicas do contexto de avaliação podem predispor o indivíduo a maior risco de desenvolver esse transtorno. A partir desses resultados, sugere-se a inclusão de profissionais da saúde mental no contexto do pré-vestibular, assim como intervenções direcionadas ao desenvolvimento de uma relação saudável entre o aluno e suas demandas acadêmicas.

Saúde dos adolescentes da coorte de nascimentos de São Luís, Maranhão, Brasil, 1997/1998

Resumo: O objetivo foi estimar a prevalência de indicadores de saúde de adolescentes em São Luís, Maranhão, Brasil, em 2016. Foram estudadas condições sociodemográficas, hábitos de vida, composição corporal, qualidade do sono, atividade física, habilidade cognitiva e risco de suicídio de 2.515 adolescentes com 18 e 19 anos. Os adolescentes pertencem à coorte de nascimento 1997/1998 ou foram incluídos, retrospectivamente, utilizando-se o banco do SINASC (Sistema de Informações sobre Nascidos Vivos). Os adolescentes eram, principalmente, da classe econômica C (50,1%), 69,5% estudavam, 40,3% trabalhavam e 25,2% não estudavam nem trabalhavam; 60,3% já foram vítimas de assalto e 48,7% tinham pais separados. Apresentaram padrão de consumo nocivo, excessivo ou provável dependência de álcool 19,4%, 19,1% usaram ou estavam usando drogas ilícitas, 53,7% tinham qualidade de sono ruim, 40,8% referiram dor de cabeça frequente, 34,3% declararam tempo de tela por dia maior que cinco horas e 4,1% apresentaram alto risco para suicídio. A prevalência de hipertensão arterial foi de 12% e de obesidade, 6%. As meninas eram mais inativas (80,7%) e apresentaram maior percentual de gordura corporal alto (15,8%) e muito alto (21,5%), já os meninos tiveram maior prevalência de hipertensão arterial (21,2%) e menor prevalência de inatividade física (40,9%). As elevadas prevalências de fatores de risco à saúde aumentam a vulnerabilidade dos adolescentes, expondo estes indivíduos precocemente a fatores que levam ao acometimento cada vez mais cedo de doenças e agravos à saúde.