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Buta BO, Mota ACP, Couto VVD, Tabak BM. Mental health literacy for public employees. BMC Public Health 2024; 24:2593. [PMID: 39334112 PMCID: PMC11429317 DOI: 10.1186/s12889-024-19937-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Accepted: 08/29/2024] [Indexed: 09/30/2024] Open
Abstract
PURPOSE Although mental disorders are common in the workplace, they often go unnoticed. There is frequently a gap in the recognition and effective management of these disorders, leading to delayed recovery and worsening conditions. This study evaluates the level of Mental Health Literacy (MHL) among employees of the Finance and Planning Departments in the Federal District, Brazil, and proposes preventive measures and de-stigmatization strategies for mental health in the workplace. METHODS MHL among active employees was assessed using the Mental Health Literacy Scale (MHLS), developed by O'Connor and Casey (2015) and validated for Brazilian Portuguese by Buta et al. (2024). The data analysis included descriptive and inferential statistics, with nonparametric tests used to compare MHL across different groups. RESULTS The results showed that 27.6% of participants had adequate literacy, 67.9% had problematic levels, and 4.5% had inadequate levels. Women were observed to have higher literacy levels than men. Additionally, significant variations in literacy levels were noted among individuals with different health conditions; those diagnosed with cancer, depression, or other illnesses had higher literacy than those without diagnosed conditions. CONCLUSION To address MHL challenges, educational actions such as awareness campaigns, training, and consultancy programs are essential.
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Affiliation(s)
- Bernardo Oliveira Buta
- Getulio Vargas Foundation - School of Public Policy and Government, SGAN 602, Módulo A, B e C, Brasília, Distrito Federal, 70830-020, Brasil.
| | - Antônio Cláudio Pimentel Mota
- Getulio Vargas Foundation - School of Public Policy and Government, SGAN 602, Módulo A, B e C, Brasília, Distrito Federal, 70830-020, Brasil
| | - Vilma V D Couto
- Department of Psychology, Federal University of Triângulo Mineiro, Av. Frei Paulino, nº 30 - Bairro Abadia, Uberaba, MG, 38025-180, Brazil
| | - Benjamin Miranda Tabak
- Getulio Vargas Foundation - School of Public Policy and Government, SGAN 602, Módulo A, B e C, Brasília, Distrito Federal, 70830-020, Brasil
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Teixeira DS, Fortes S, Kestenberg C, Alves K, Campos MR, Neto AO, Ortega F, García-Campayo J, Demarzo M. Improving patient-centered mental health promotion in primary care in vulnerable communities through mindfulness training in Rio de Janeiro, Brazil. Front Med (Lausanne) 2024; 11:1356040. [PMID: 39040898 PMCID: PMC11261806 DOI: 10.3389/fmed.2024.1356040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 06/07/2024] [Indexed: 07/24/2024] Open
Abstract
Introduction Brazilian Primary Health Care (PHC) is responsible for all-sanitary actions for a community-based population, including health promotion and mental health care. Mindfulness Based Health Promotion (MBHP) is an intervention that can promote self-care and psychosocial support in PHC. Objective To discuss the effects of mindfulness based psychosocial group interventions for health promotion in primary care units in Rio de Janeiro, Brazil. Methods The intervention was based on the MBHP model adapted for SUS. Nine groups were held in Rio de Janeiro. A quali-quanti research was held with two parts: (a) quantitative study, pre and after the 8 weeks intervention, evaluating the effect on mindfulness and self-compassion and their association with levels of anxiety, depression, and quality of life. (b) Qualitative research using Focus Groups with the participants to investigate their experience at the end of the mindfulness groups. Results and discussion Sixty-two participants finished the 9 groups where 86% were women, mostly between 30 and 59 years of age and low income, and around 80% under regular medical care in PHC in SUS. In the studied sample 80% had at least one chronic health condition under treatment, including 42% with anxiety and 35% with depression. The effects included significant improvement in Anxiety and Depression and in Quality of Life, mainly in the psychological but also in the physical and interrelation domains. The qualitative study showed that most patients joined the group on the recommendation of health professionals for managing physical and mental health symptoms. Patients reported being able to use the practices taught in the sessions to manage symptoms such as insomnia and emotionally distressing situations in their daily lives. Including family members in mindfulness practices was a strategy to negotiate not only a space at home to meditate, but also to obtain a different approach to health problems. Participants pointed to mindfulness as a complementary therapeutic option to medication and psychotherapy. Conclusion Mindfulness-Based Intervention have shown to be a feasible, well-accepted and efficacious method of offering psychosocial support and promoting well-being for low-income patients in primary care in LAMIC.
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Affiliation(s)
- Débora Silva Teixeira
- Department of Integral Family and Community Medicine, Medical Sciences College, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Sandra Fortes
- Medical Sciences College, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Celia Kestenberg
- Nursing School, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Kali Alves
- Pedro Ernesto University Hospital – State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Alfredo Oliveira Neto
- Primary Health Care Department, Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Francisco Ortega
- Catalan Institution of Research and Advanced Study, Barcelona, Spain
- Medical Anthropology Research Center, Universitat Rovira i Virgili, Tarragona, Spain
| | | | - Marcelo Demarzo
- Mente Aberta – The Brazilian Center for Mindfulness and Health Promotion – Department of Preventive Medicine, Paulista Medical School – Federal University of São Paulo, São Paulo, Brazil
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Duarte WBA, Silva EP, Ludermir AB. The effect of common mental disorders on suicidal attempts by women, during pregnancy and six to nine years after birth. CIENCIA & SAUDE COLETIVA 2024; 29:e03742023. [PMID: 38324825 DOI: 10.1590/1413-81232024292.03742023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 06/13/2023] [Indexed: 02/09/2024] Open
Abstract
There is scarcity of global data on suicide attempts (SA). The higher frequency of mental disorders places women at a higher risk for SA. Mental disorders (MD) are ranked first in the Global Burden of Diseases (GBD) in terms of years lived with disability (YLD) and common mental disorders (CMD) affect women the most. IN this light, the present study aimed to investigate the impact of CMD during pregnancy, as well as 6 to 9 years after birth, on SA in women who were registered in the Family Health Strategy from the town of Recife, Pernambuco, Brazil. This study consisted of two stages of a prospective cohort. 643 adult women were included. The prevalence of CMD in stage I (pregnancy) and in stage III (six to nine years after birth) were, respectively, 19.3% and 12.6%. The incidence of SA was 10.9%. The multivariate analysis demonstrated a cumulative effect of CMD for SA: only during pregnancy (OR 5.4; 95%CI 2.2-13.3); only in the third stage (OR 5.8; 95%CI 2.3-14.9); and in both stages (OR 6.0; 95%CI 2.5-14.4). The increase of CMD in women increases the chances of SA, hence the importance of implementing public policies for women's health, especially for those with a history of mental disorders and unhealthy habits, and those who suffer violence.
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Affiliation(s)
- Wellington Bruno Araujo Duarte
- Programa Pós-Graduação em Saúde Coletiva, Centro de Ciências Médicas, Universidade Federal de Pernambuco. Av. Prof. Moraes Rego 1235, Cidade Universitária. 50670-901 Recife PE Brasil.
| | - Elisabete Pereira Silva
- Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Centro de Ciências Médicas, Universidade Federal de Pernambuco. Recife PE Brasil
| | - Ana Bernarda Ludermir
- Programa Pós-Graduação em Saúde Coletiva, Centro de Ciências Médicas, Universidade Federal de Pernambuco. Av. Prof. Moraes Rego 1235, Cidade Universitária. 50670-901 Recife PE Brasil.
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de Almeida ACP, de Azevedo VD, Alves TRDM, Santos VEP, Silva GWDS, de Azevedo IC. Common mental disorders in hematopoietic stem cell transplant patients: a scoping review. Rev Bras Enferm 2023; 77:e20220581. [PMID: 38088687 PMCID: PMC10704667 DOI: 10.1590/0034-7167-2022-0581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 09/22/2023] [Indexed: 12/18/2023] Open
Abstract
OBJECTIVE to map common recurrent mental disorders in patients undergoing hematopoietic stem cell transplantation. METHODS this is a scoping review carried out in January 2022 in electronic databases and repositories of dissertations and thesis. Studies that answered the research question, met the objective of the study and were available in full electronically, in any language, were included. RESULTS the sample consisted of 28 studies, 14 of which were published in the United States of America. The common mental disorders found were depressive, anxiety, post-traumatic stress and mood disorders. Twenty symptoms were mentioned, among the most prevalent are fatigue and sleep disorders/insomnia. CONCLUSIONS the difficulty and importance of carrying out the differential diagnosis of these disorders were highlighted, since their symptoms can be confused with other health problems and have a strong potential to interfere with patients' evolution.
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Levkovich I, Elyoseph Z. Identifying depression and its determinants upon initiating treatment: ChatGPT versus primary care physicians. Fam Med Community Health 2023; 11:e002391. [PMID: 37844967 PMCID: PMC10582915 DOI: 10.1136/fmch-2023-002391] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023] Open
Abstract
OBJECTIVE To compare evaluations of depressive episodes and suggested treatment protocols generated by Chat Generative Pretrained Transformer (ChatGPT)-3 and ChatGPT-4 with the recommendations of primary care physicians. METHODS Vignettes were input to the ChatGPT interface. These vignettes focused primarily on hypothetical patients with symptoms of depression during initial consultations. The creators of these vignettes meticulously designed eight distinct versions in which they systematically varied patient attributes (sex, socioeconomic status (blue collar worker or white collar worker) and depression severity (mild or severe)). Each variant was subsequently introduced into ChatGPT-3.5 and ChatGPT-4. Each vignette was repeated 10 times to ensure consistency and reliability of the ChatGPT responses. RESULTS For mild depression, ChatGPT-3.5 and ChatGPT-4 recommended psychotherapy in 95.0% and 97.5% of cases, respectively. Primary care physicians, however, recommended psychotherapy in only 4.3% of cases. For severe cases, ChatGPT favoured an approach that combined psychotherapy, while primary care physicians recommended a combined approach. The pharmacological recommendations of ChatGPT-3.5 and ChatGPT-4 showed a preference for exclusive use of antidepressants (74% and 68%, respectively), in contrast with primary care physicians, who typically recommended a mix of antidepressants and anxiolytics/hypnotics (67.4%). Unlike primary care physicians, ChatGPT showed no gender or socioeconomic biases in its recommendations. CONCLUSION ChatGPT-3.5 and ChatGPT-4 aligned well with accepted guidelines for managing mild and severe depression, without showing the gender or socioeconomic biases observed among primary care physicians. Despite the suggested potential benefit of using atificial intelligence (AI) chatbots like ChatGPT to enhance clinical decision making, further research is needed to refine AI recommendations for severe cases and to consider potential risks and ethical issues.
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Affiliation(s)
| | - Zohar Elyoseph
- Department of Psychology and Educational Counseling, Max Stern Academic College Of Emek Yezreel, Emek Yezreel, Israel
- Department of Brain Sciences, Imperial College London, London, UK
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Fentahun S, Takelle GM, Rtbey G, Andualem F, Tinsae T, Tadesse G, Melkam M. Common mental disorders and associated factors among Ethiopian prisoners: a systematic review and meta-analysis. Front Psychiatry 2023; 14:1214223. [PMID: 37484685 PMCID: PMC10360204 DOI: 10.3389/fpsyt.2023.1214223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 06/21/2023] [Indexed: 07/25/2023] Open
Abstract
Background Common mental disorders are a major public health concern in the world and negatively influence people's psychological, physical, economic, and overall well-being. Since prisoners live with restricted freedom and lack regular social interaction like communication with family and friends, the prevalence of common mental disorders is frequently found to be higher among prisoners compared to the general population. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence of common mental disorders and their associated factors among prisoners in Ethiopia. Methods The primary published studies were searched by using different databases like PubMed, Google Scholar, CINHAL, and African Journal Online. A total of eight primary articles that assessed the prevalence and associated factors of common mental disorders among Ethiopian prisoners were included in this systematic review and meta-analysis. The data were extracted using the data extraction format in a Microsoft Excel spreadsheet and exported to Stata version 14 for further analysis. The statistical heterogeneity was assessed by the I2 test. Due to the presence of heterogeneity among included studies, a random effect meta-analysis model was employed. Egger's weighted regression test and funnel plots were used to check the presence of publication bias. Results A total of 8 primary studies with 3,585 study participants were included in this systematic review and meta-analysis. The pooled prevalence of common mental disorders among Ethiopian prisoners was 62.29% with a 95% CI (50.94, 73.65). The subgroup analysis based on regional state revealed that the pooled prevalence of common mental disorders in Amhara, Oromia, and the other two regions (Addis Ababa and SNNPR) was 72.4, 50.23, and 54.25%, respectively. History of mental illness (AOR = 6.21, 95% CI: 3.27, 11.80), poor social support (AOR = 3.90, 95% CI: 1.45, 10.51), and traumatic life events (AOR = 3.63, 95% CI: 1.04, 12.73) were significantly associated with a common mental disorder in this review. Conclusion In this systematic review and meta-analysis, the pooled prevalence of common mental disorders among prisoners was high. Therefore, improving the delivery of mental health services in correctional institutions has a major contribution to the reduction of the disorder, and incarcerated people require more attention and early intervention for common mental disorders.
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Miliauskas CR, Rocha C, Salomão F, Ferraz H, Fortes S. Telematriciamento em saúde mental na pandemia de COVID-19. REVISTA BRASILEIRA DE MEDICINA DE FAMÍLIA E COMUNIDADE 2022. [DOI: 10.5712/rbmfc17(44)3116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Problema: A demanda em saúde mental na Atenção Primária à Saúde (APS) é alta, e a capacitação das equipes para a detecção e o tratamento desses pacientes é fundamental, sendo o matriciamento, modelo de cuidado colaborativo desenvolvido no contexto brasileiro, uma ferramenta importante para a efetividade do cuidado em saúde mental na APS. Em março de 2020, com o isolamento social consequente à pandemia pelo novo coronavírus, houve necessidade de reorganização dos serviços. O objetivo deste artigo é descrever a experiência de telematriciamento e reorganização do apoio matricial em saúde mental em unidade da APS do município do Rio de Janeiro, nos primeiros meses de pandemia. Método: O Centro Municipal de Saúde Heitor Beltrão localiza-se na Zona Norte do Rio de Janeiro. Nos anos de 2017 a 2019, o matriciamento ocorreu por meio de consultas conjuntas, discussão de casos e grupo de psicotrópicos. No início da pandemia, o trabalho foi reorganizado em duas frentes: teleconsultas conjuntas síncronas e organização da lista de usuários com transtornos mentais. Resultados: Foram realizadas 50 teleconsultas conjuntas no período de 12 semanas, com média de 4,16 consultas/semana, sendo os diagnósticos mais frequentes transtornos depressivos e ansiosos seguidos de transtornos de personalidade e por uso de substâncias. O novo formato permitiu a manutenção do acesso de usuários da saúde mental ao serviço, a absorção de novos casos, a melhoria de acesso a usuários do grupo de risco para infecção por coronavírus e a continuidade do processo formativo em saúde com aquisição de novas competências e modernização do trabalho. As principais limitações foram a falta de equipamentos disponíveis e a dificuldade de acesso à internet. Conclusão: Esta experiência, desenvolvida em razão da pandemia de COVID-19, descreve os desafios e benefícios da utilização do telematriciamento e da criação da lista de usuários da saúde mental. Poderá auxiliar profissionais e gestores de outros serviços a desenvolver adaptações mais adequadas às realidades locais.
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Santana IGC, Almeida LDS, Moreira LKDS, de Carvalho FS, Menegatti R, da Rocha ALB, Mazurok TA, Vaz BG, Lião LM, Brito AF, Fajemiroye JO, Costa EA, Carvalho PG. Structure-activity relationship of three new piperazine derivates with anxiolytic-like and antidepressant-like effects. Can J Physiol Pharmacol 2022; 100:521-533. [PMID: 35395172 DOI: 10.1139/cjpp-2021-0729] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Anxiety and depression are common mental disorders affecting millions of people worldwide. Unsatisfactory clinical outcomes with the use of the available pharmacological interventions among some patients demand newer drugs with proven efficacy, safety, and tolerability profile. In this study, the LQFM211, LQFM213, and LQFM214 were designed from the piperazine scaffold and administered orally in mice. These mice were later evaluated in the open field, elevated plus maze, and forced swimming tests to assess the exploratory, anxiolytic, and antidepressant-like activities, respectively. The mechanism of action of these new derivatives was evaluated using Flumazenil (benzodiazepine antagonist) and WAY100635 (5-HT1A receptor antagonist). Unlike LQFM214, the LQFM211 and LQFM213 elicited anxiolytic and antidepressant-like effects. The blockade of the effect of LQFM213 by WAY100635 suggests the involvement of the serotonergic pathway. Keywords: anxiety, behavioral pharmacology, depression, medicinal chemistry.
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Affiliation(s)
| | | | | | | | - Ricardo Menegatti
- Universidade Federal de Goias, 67824, Faculty of Pharmacy, Goiania, GO, Brazil;
| | | | | | - Boniek Gontijo Vaz
- Universidade Federal de Goias, 67824, Chemistry Institute, Goiania, GO, Brazil;
| | - Luciano Morais Lião
- Universidade Federal de Goias, 67824, Chemistry Institute, Goiania, GO, Brazil;
| | - Adriane Ferreira Brito
- Goiânia Flamboyant Campus, Goiânia, Goiás, Brazil.,Universidade Federal de Goias, 67824, Department of Pharmacology, Goiania, GO, Brazil;
| | - James O Fajemiroye
- Universidade Federal de Goias, 67824, Department of Pharmacology, Goiania, GO, Brazil;
| | - E A Costa
- Universidade Federal de Goias, 67824, Goiania, GO, Brazil;
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Laurito LD, Loureiro CP, Faro L, Dias RV, Torres B, Moreira-de-Oliveira ME, Santos-Ribeiro SD, de Menezes GB, Fontenelle LF, Davis CH, Twohig MP. Acceptance and Commitment Therapy for obsessive compulsive disorder in a Brazilian context: Treatment of three cases. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2022. [DOI: 10.1016/j.jcbs.2022.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Treichel CADS, Campos RTO. Avaliação da atuação da rede comunitária de saúde mental em um município paulista de médio porte. SAÚDE EM DEBATE 2022. [DOI: 10.1590/0103-1104202213208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Tendo como norteadores as recentes mudanças na condução das políticas de saúde mental no País e as disparidades em saúde vivenciadas por pessoas que convivem com transtornos mentais, este estudo buscou avaliar a atuação de uma rede de saúde mental comunitária a partir de três componentes principais: 1) a caracterização do perfil dos usuários; 2) a identificação das ofertas terapêuticas; e 3) a identificação dos cuidados clínicos recebidos pelos usuários em cada um dos serviços estudados, a saber: Centro de Atenção Psicossocial-II; Centro de Atenção Psicossocial-AD; ambulatório; e 13 serviços de Atenção Básica. Trata-se de um estudo transversal baseado em documentos, realizado através da análise de 4582 prontuários. Foram evidenciadas diferenças importantes entre os serviços quanto ao seu funcionamento e diálogo com outros pontos da rede de atenção. As ofertas terapêuticas foram caracterizadas, principalmente, pela oferta de consultas médicas e consultas individuais com profissionais da equipe multidisciplinar. Houve baixa utilização dos recursos comunitários e das oficinas terapêuticas. Foi observada, ainda, baixa oferta de cuidados clínicos aos usuários dos serviços especializados, em contraponto com a Atenção Básica, que, por sua vez, mostrou-se como um serviço potente e necessário para o cuidado das pessoas com transtornos mentais.
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Tiguman GMB, Silva MT, Galvão TF. Prevalence of depressive and anxiety symptoms and their relationship with life-threatening events, tobacco dependence and hazardous alcohol drinking: a population-based study in the Brazilian Amazon. J Affect Disord 2022; 298:224-231. [PMID: 34715191 DOI: 10.1016/j.jad.2021.10.059] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 09/26/2021] [Accepted: 10/23/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND The burden of mental health disorders is high and may be particularly alarming in developing countries. We assessed the prevalence of depressive and anxiety symptoms and their relationship with life-threatening events, tobacco dependence, and hazardous alcohol drinking in the Brazilian Amazon. METHODS Cross-sectional population-based study conducted in Manaus in 2019 with adults selected by probabilistic sampling. Depressive symptoms were measured by the PHQ-9 instrument (cut-off ≥9) and anxiety symptoms by the GAD-7 scale (cut-off ≥10). Prevalence ratios (PRs) of depressive and anxiety symptoms were calculated by Poisson regression with robust variance with 95% confidence intervals (CI) following a hierarchical model. Partial least squares structural equation modeling was used to investigate the relationship between the outcomes and risk behaviors. RESULTS Out of the 2,321 participants, 24.3% (95%CI 22.2-26.5%) had depressive and 21.6% (95%CI 19.6-23.7%) had anxiety symptoms. Depressive symptoms were more frequent in women (PR=1.32; 95%CI 1.08-1.61), lower social class (PR=1.59; 95%CI 1.11-2.27), life-threatening events (PR=2.66; 95%CI 2.00-3.54), tobacco dependence (PR=1.84; 95%CI 1.37-2.47), worse health statuses (p<0.001), and chronic diseases (PR=1.63; 95%CI 1.33-2.00), but were lower in older adults (p=0.014). Anxiety symptoms were higher in women (PR=1.74; 95%CI 1.42-2.14), lower educational levels (PR=2.19; 95%CI 1.38-3.47), evangelical individuals (PR=1.28; 95%CI 1.05-1.57), having no religion (PR=1.72; 95%CI 1.24-2.38), life-threatening events (PR=3.26; 95%CI 2.41-4.41), tobacco dependence (PR=1.53; 95%CI 1.09-2.16), worse health statuses (p<0.001), and chronic diseases (PR=1.77; 95%CI 1.40-2.25). Depressive symptoms, anxiety symptoms, and life-threatening events were directly correlated with one another, while tobacco dependence and hazardous alcohol drinking were significantly intercorrelated (p<0.05). LIMITATIONS Cross-sectional design limits the assessment of causality. Recall bias was possible as responses were self-reported. GAD-7 scale was not validated in the Brazilian population. CONCLUSION Nearly a quarter of the population had depressive symptoms and one-fifth presented anxiety symptoms, which were associated with socioeconomic, behavioral, and health-related factors. Implementation of social well-being policies is required to minimize the burden of mental health disorders in the Amazonian population.
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Affiliation(s)
| | - Marcus Tolentino Silva
- Post-Graduate Program of Pharmaceutical Sciences, University of Sorocaba, Sorocaba, São Paulo, Brazil
| | - Taís Freire Galvão
- Faculty of Pharmaceutical Sciences, State University of Campinas, Campinas, São Paulo, Brazil
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Abdurahman S, Yadeta TA, Ayana DA, Kure MA, Ahmed J, Mehadi A. Magnitude of Depression and Associated Factors Among Patients on Tuberculosis Treatment at Public Health Facilities in Harari Regional State, Eastern Ethiopia: Multi-Center Cross-Sectional Study. Neuropsychiatr Dis Treat 2022; 18:1405-1419. [PMID: 35855750 PMCID: PMC9287458 DOI: 10.2147/ndt.s370795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 06/16/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Depression among tuberculosis patients remains a significant public health concern. Its burden and severity is increasing in low-income countries, especially in sub-Saharan Africa. Although it has negative impacts on quality of life, depression among tuberculosis patients is rarely studied in Ethiopia, particularly in the study area. Therefore, this study aimed to determine the magnitude of depression and associated factors among tuberculosis patients in Eastern Ethiopia. METHODS A facility-based cross-sectional study was conducted from April 15 to May 15, 2021, among 213 tuberculosis patients in public health facilities of the Harari Regional State, Eastern Ethiopia. Study participants were selected using a systematic sampling technique. Data were collected using interviewer-administered questionnaire. Depression was assessed using Patients Health Questionnaire-9 (PHQ-9). Epi-data and SPSS were used for data processing and analysis. Bi-variable and multivariable logistic regressions were employed to determine the effects of predictors on depression. Statistical significance was considered at a p-value <0.05. RESULTS The magnitude of depression among tuberculosis patients was 52.1% [95% CI (45.4, 58.8%)]. Patient's age of 25-34 years [AOR = 0.31, 95% CI (0.128, 0.75)], female sex [AOR = 5.04; 95% CI (2.18, 11.62)], intensive phase of tuberculosis treatment [AOR = 2.56; 95% CI (1.118, 5.876)], HIV-positive status [AOR = 7.143; 95% CI (1.55, 32.93)], smoking history [AOR = 9.08; 95% CI (3.35, 24.61)] and having poor social support [AOR = 4.13; 95% CI (1.29, 13.22)] were factors statistically associated with depression. CONCLUSION In this study, the magnitude of depression was relatively high as more than half of the participants had depression. Advanced age, female sex, intensive phase of tuberculosis treatment, HIV-positive status, smoking history, and poor social support were identified as associated factors with depression. Therefore, this result calls all stakeholders to give duly emphasis on incorporating and integrating mental health support programs as routine practice in tuberculosis follow-up clinics, as screening, early detection and treatment, and training for all health care providers are very crucial in tackling depression among tuberculosis patients.
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Affiliation(s)
- Shame Abdurahman
- Department of Public Health, Gorogutu Woreda Health Office, Kara-Mille, Oromia, Ethiopia
| | - Tesfaye Assebe Yadeta
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Dasalegn Admassu Ayana
- School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Mohammed Abdurke Kure
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Jemal Ahmed
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Ame Mehadi
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Grapiglia CZ, da Costa JSD, Pattussi MP, Paniz VMV, Olinto MTA. Factors associated with common mental disorders: a study based on clusters of women. Rev Saude Publica 2021; 55:77. [PMID: 34816980 PMCID: PMC8577533 DOI: 10.11606/s1518-8787.2021055003124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 12/07/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE to identify factors associated with common mental disorders (CMD) in a sample of adult women in Southern Brazil. METHODS This population-based study, composed of 1,128 women, investigated socioeconomic, behavioral and health/disease explanatory demographic variables. Five response groups were explored: one group with common mental disorders - cut-off point 6/7 in the Self-Reporting Questionnaire 20 (SRQ-20) - and four others corresponding to the different clusters found using the latent class clustering technique, also from the SRQ-20. These four clusters (low, medium-depressive, medium-digestive and high) were named (denominated) based on the mean scores in the SRQ-20 in each group and on the response patterns of the variables and factorial characteristics. The "low" cluster comprised women with lower SRQ-20 scores and, therefore less likely to present CMD. The "high" cluster, with high mean values in the SRQ-20, was related to higher psychiatric morbidity. We used the Poisson regression technique to compare the findings of the different groups. RESULTS We identified ten variables as factors associated with CMD. Age, education, smoking, physical activity, perception of health and number of medical appointments were the common variables for the cut-off point and cluster-based analyses. Heavy alcohol use was associated only when the sample was evaluated as a cut-off point. Social class, work situation and existence of chronic diseases were associated only when the sample was analyzed by clusters. There was a significant association in the "high" cluster with lower classes (D or E), smoking, physical inactivity, existence of chronic diseases and negative perception of health. CONCLUSION We identified different associated factors according to the response groups considered. New approaches allowing identification of subgroups of individuals with specific characteristics and associated factors may contribute for a more accurate understanding of CMD and provide the basis for health interventions.
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Affiliation(s)
- Cássio Zottis Grapiglia
- Universidade do Vale do Rio dos SinosPrograma de Saúde ColetivaSão LeopoldoRSBrasilUniversidade do Vale do Rio dos Sinos. Programa de Saúde Coletiva. São Leopoldo, RS, Brasil
| | - Juvenal Soares Dias da Costa
- Universidade do Vale do Rio dos SinosDepartamento de Saúde ColetivaSão LeopoldoRSBrasilUniversidade do Vale do Rio dos Sinos. Departamento de Saúde Coletiva. São Leopoldo, RS, Brasil
| | - Marcos Pascoal Pattussi
- Universidade do Vale do Rio dos SinosDepartamento de Saúde ColetivaSão LeopoldoRSBrasilUniversidade do Vale do Rio dos Sinos. Departamento de Saúde Coletiva. São Leopoldo, RS, Brasil
| | - Vera Maria Vieira Paniz
- Universidade do Vale do Rio dos SinosDepartamento de Saúde ColetivaSão LeopoldoRSBrasilUniversidade do Vale do Rio dos Sinos. Departamento de Saúde Coletiva. São Leopoldo, RS, Brasil
| | - Maria Teresa Anselmo Olinto
- Universidade do Vale do Rio dos SinosDepartamento de Saúde ColetivaSão LeopoldoRSBrasilUniversidade do Vale do Rio dos Sinos. Departamento de Saúde Coletiva. São Leopoldo, RS, Brasil
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14
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Perceptions of Patients’ Alcohol Use and Related Problems Among Primary Care Professionals in Rio de Janeiro. Int J Ment Health Addict 2021. [DOI: 10.1007/s11469-021-00648-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Bezerra HDS, Alves RM, Nunes ADD, Barbosa IR. Prevalence and Associated Factors of Common Mental Disorders in Women: A Systematic Review. Public Health Rev 2021; 42:1604234. [PMID: 34692182 PMCID: PMC8419231 DOI: 10.3389/phrs.2021.1604234] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 08/06/2021] [Indexed: 11/20/2022] Open
Abstract
Objectives: To identify the prevalence and factors associated with common mental disorders in adult women. Methods: Searches were carried out in the PubMed, Web of Science, Science Direct, Scopus, Cinahl, Google Scholar and Open Gray databases. The study protocol was registered with PROSPERO under number CRD42020168231. Cross-sectional studies showing the prevalence of common mental disorders in women over 18 years were included. Studies with men, children and pregnant women of another age group and with other mental disorders and other types of studies were excluded. The Joanna Briggs Institute checklist was used to assess the risk of bias. Results: Nineteen studies were included in this review. The prevalence of CMD ranged from 9.6% to 69.3%. The main associated factors were unemployment, indebtedness, low income, being a housewife, smoking, low education, poor self-rated health, being single, divorced or widowed. The risk of bias in the studies was classified as low and moderate. Conclusion: This review revealed a variable prevalence rate of CMD in adult women. Public policies are needed to create strategies to prevent the mental illness of these women.
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Martorell M, Lucas X, Alarcón-Zapata P, Capó X, Quetglas-Llabrés MM, Tejada S, Sureda A. Targeting Xanthine Oxidase by Natural Products as a Therapeutic Approach for Mental Disorders. Curr Pharm Des 2021; 27:367-382. [PMID: 32564744 DOI: 10.2174/1381612826666200621165839] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 05/08/2020] [Indexed: 11/22/2022]
Abstract
Mental disorders comprise diverse human pathologies, including depression, bipolar affective disorder, schizophrenia, and dementia that affect millions of people around the world. The causes of mental disorders are unclear, but growing evidence suggests that oxidative stress and the purine/adenosine system play a key role in their development and progression. Xanthine oxidase (XO) is a flavoprotein enzyme essential for the catalysis of the oxidative hydroxylation of purines -hypoxanthine and xanthine- to generate uric acid. As a consequence of the oxidative reaction of XO, reactive oxygen species (ROS) such as superoxide and hydrogen peroxide are produced and, further, contribute to the pathogenesis of mental disorders. Altered XO activity has been associated with free radical-mediated neurotoxicity inducing cell damage and inflammation. Diverse studies reported a direct association between an increased activity of XO and diverse mental diseases including depression or schizophrenia. Small-molecule inhibitors, such as the well-known allopurinol, and dietary flavonoids, can modulate the XO activity and subsequent ROS production. In the present work, we review the available literature on XO inhibition by small molecules and their potential therapeutic application in mental disorders. In addition, we discuss the chemistry and molecular mechanism of XO inhibitors, as well as the use of structure-based and computational methods to design specific inhibitors with the capability of modulating XO activity.
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Affiliation(s)
- Miquel Martorell
- Department of Nutrition and Dietetics, Faculty of Pharmacy, and Centre for Healthy Living, University of Concepcion, 4070386 Concepcion, Chile
| | - Xavier Lucas
- Roche Pharma Research and Early Development, Roche Innovation Center, Basel CH-4070, Switzerland
| | - Pedro Alarcón-Zapata
- Clinical Biochemistry and Immunology Department, Faculty of Pharmacy, University of Concepcion, 4070386 Concepcion, Chile
| | - Xavier Capó
- Research Group in Community Nutrition and Oxidative Stress, University of Balearic Islands & Health Research Institute of the Balearic Islands (IdISBa), E-07122, Palma, Balearic Islands, Spain
| | - Maria Magdalena Quetglas-Llabrés
- Laboratory of Neurophysiology, Department of Biology, University of Balearic Islands & Health Research Institute of the Balearic Islands (IdISBa), E-07122, Palma, Balearic Islands, Spain
| | - Silvia Tejada
- Laboratory of Neurophysiology, Department of Biology, University of Balearic Islands & Health Research Institute of the Balearic Islands (IdISBa), E-07122, Palma, Balearic Islands, Spain
| | - Antoni Sureda
- Research Group in Community Nutrition and Oxidative Stress, University of Balearic Islands & Health Research Institute of the Balearic Islands (IdISBa), E-07122, Palma, Balearic Islands, Spain
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Saraiva S, Bachmann M, Andrade M, Liria A. Bridging the mental health treatment gap: effects of a collaborative care intervention (matrix support) in the detection and treatment of mental disorders in a Brazilian city. Fam Med Community Health 2020; 8:fmch-2019-000263. [PMID: 32958519 PMCID: PMC7507894 DOI: 10.1136/fmch-2019-000263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Objective To analyse temporal trends in diagnosis and treatment of mental disorders in primary care following implementation of a collaborative care intervention (matrix support). Design Dynamic cohort design with retrospective time-series analysis. Structured secondary data on medical visits to general practitioners of all study clinics were extracted from the municipal electronic records database. Annual changes in the odds of mental disorders diagnoses and antidepressants prescriptions were estimated by multiple logistic regression at visit and patient-year levels with diagnoses or prescriptions as outcomes. Annual changes during two distinct stages of the intervention (stage 1 when it was restricted to mental health (2005–2009), and stage 2 when it was expanded to other areas (2010–2015)) were compared by adding year–period interaction terms to each model. Setting 49 primary care clinics in the city of Florianópolis, Brazil. Participants All adults attending primary care clinics of the study setting between 2005 and 2015. Results 3 131 983 visits representing 322 100 patients were analysed. At visit level, the odds of mental disorder diagnosis increased by 13% per year during stage 1 (OR 1.13, 95% CI 1.11 to 1.14, p<0.001) and decreased by 5% thereafter (OR 0.95, 95% CI 0.94 to 0.95, p<0.001). The odds of incident mental disorder diagnoses decreased by 1% per year during stage 1 (OR 0.99, 95% CI 0.98 to 1.00, p=0.012) and decreased by 7% per year during stage 2 (OR 0.93, 95% CI 0.92 to 0.93, p<0.001). The odds of antidepressant prescriptions in patients with a mental disorder diagnosis increased by 7% per year during stage 1 (OR 1.07, 95% CI 1.05 to 1.20, p<0.001); this was driven by selective serotonin reuptake inhibitor prescriptions which increased 14% per year during stage 1 (OR 1.14, 95% CI 1.12 to 1.18, p<0.001) and 9% during stage 2 (OR 1.09, 95% CI 1.08 to 1.10, p<0.001). The odds of incident antidepressant prescriptions did not increase during stage 1 (OR 1.00, 95% CI 0.97 to 1.02, p=0.665) and increased by 3% during stage 2 (OR 1.03, 95% CI 1.00 to 1.04, p<0.001). Changes per year were all significantly greater during stage 1 than stage 2 (p values for interaction terms <0.05), except for antidepressant prescriptions during visits (p=0.172). Conclusion The matrix support intervention may increase diagnosis and treatment of mental disorders when inter-professional collaboration is adequately supported. Competing demands to the primary care teams can subsequently reduce these effects. Future studies should assess clinical outcomes and identify active components and factors associated with successful implementation.
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Affiliation(s)
- Sonia Saraiva
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Max Bachmann
- Norwich Medical School, University of East Anglia, Norwich, Norfolk, UK
| | - Matheus Andrade
- Secretaria Municipal de Saúde (Municipal Health Department), Florianópolis, Brazil
| | - Alberto Liria
- Departamento de Especialidades Médicas, Facultad de Medicina y Ciencias de la Salud, Universidad de Alcalá, Alcalá de Henares, Spain
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Razzouk D, Cheli Caparroce D, Sousa A. Community-based mental health services in Brazil. CONSORTIUM PSYCHIATRICUM 2020; 1:60-70. [PMID: 38680388 PMCID: PMC11047271 DOI: 10.17650/2712-7672-2020-1-1-60-70] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 09/10/2020] [Indexed: 05/01/2024] Open
Abstract
Introduction The shift from the hospital-based model of care to community-based mental health services began three decades ago and is still an ongoing process in Brazil. Objectives To update data on the development of the community mental health services network in Brazil in relation to service availability and structure, manpower, pattern of service use, financing, epidemiological studies and the burden of mental disorders, research and national mental health policy. Methods Searches were constructed to collect data on indexed databases (Medline, Scielo), as well as governmental,NGOs and medical council sources, reports and the grey literature up until 30th March, 2019. Results Community mental health services are unevenly distributed in the country. Brazil leads the world in terms of the prevalence of anxiety disorders, ranking fifth for depression prevalence. Violence and suicide rates are two growing factors which exacerbate the prevalence of mental disorders prevalence. An increased reduction of the number of psychiatric beds in the country, in addition to the unbalanced growth of services in the community, has resulted in treatment gaps and the underutilization of services and barriers to treating people with the most severe psychosis. Investment in mental healthcare is still scarce. However, mental health funding is not addressed according to the population´s needs and scientific evidence, resulting in a waste of resources and inefficiency. Programmes and service interruptions are common according to each government mandate. Conclusion Successive changes in ideological perspectives have led to the introduction of policies which have caused fragmentation in the mental health system and services. A lack of evaluation and transparency of services and costs are the main barriers to integrating multiple services and planning long-term developmental phases.
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Affiliation(s)
- Denise Razzouk
- Centre of Mental Health Economics, Department of Psychiatry, Universidade Federal de Sao Paulo (Unifesp)
| | - Daniela Cheli Caparroce
- Centre of Mental Health Economics, Department of Psychiatry, Universidade Federal de Sao Paulo (Unifesp)
| | - Aglae Sousa
- Centre of Mental Health Economics, Department of Psychiatry, Universidade Federal de Sao Paulo (Unifesp)
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Carteri RB, Oses JP, Cardoso TDA, Moreira FP, Jansen K, Silva RAD. A closer look at the epidemiology of schizophrenia and common mental disorders in Brazil. Dement Neuropsychol 2020; 14:283-289. [PMID: 32973981 PMCID: PMC7500820 DOI: 10.1590/1980-57642020dn14-030009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Schizophrenia and common mental disorders are noteworthy social and economic
concern worldwide. Epidemiologic studies on the impact of specific mental
disorders in emerging countries are scarce.
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20
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Engidaw NA, Abdu Z, Chinani I. Prevalence and associated factors of common mental disorders among residents of Illu Ababore zone, southwest Ethiopia: a cross-sectional study. Int J Ment Health Syst 2020; 14:64. [PMID: 32817756 PMCID: PMC7425137 DOI: 10.1186/s13033-020-00394-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 08/04/2020] [Indexed: 11/10/2022] Open
Abstract
Background A common mental disorder is characterized by anxiety, depression, and unexplained somatic symptoms that usually encountered in community and primary care settings. Both short and long term bio psychosocial disabilities are inevitable if common mental disorder is not treated. Despite its impact, the prevalence of common mental disorder in the Illu Ababore zone is not well known. Therefore, this study aimed to assess the prevalence and associated factors of common mental disorder among Ilu Ababore zone residents, Southwest Ethiopia. Method A community based cross-sectional study was conducted from July 1 to August 30, 2018. A multi-stage sampling technique was applied to recruit participants. Self-Reporting Questionnaire (SRQ-20) was used to assess the presence of common mental disorder. The data were entered into Epidata version 3.1 and analyzed by using SPSS version 23 software. Bivariate and multivariate binary logistic regressions were computed to identify the associated factors. Statistical significance was considered at P value < 0.05. Result A total of 690 participants were enrolled in this study with a response rate of 91.39%. The prevalence of common mental disorder was 27.2% (95% CI, 23.9, 31.0%). Being female (AOR = 1.76, 95% CI = 1.15, 2.69), unable to read and write (AOR = 3.06, 95% CI = 1.37, 6.82), living in the rural area (AOR = 3.53, 95% CI = 2.01, 6.18), having a family member with mental illness (AOR = 2.68, 95% CI = 1.6, 4.5), having a chronic physical illness (AOR = 3.48, 95% CI = 2.26, 5.34) and lifetime alcohol use (AOR = 4.55, 95% CI = 2.93, 7.0) had a significant association with common mental disorder. Conclusion The current study showed that the proportion of the common mental disorder was high. Females showed a higher prevalence of the common mental disorder. Having a chronic physical illness, resides in the rural areas and history of lifetime alcohol use were also significantly associated with CMD. Psychological and social interventions with greater emphasis on females who have low educational status and residing in the rural area are recommended. Strategies that focus on the proper treatment of chronic physical illness can be also helpful to minimize the occurrence of common mental disorder.
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Affiliation(s)
- Nigus Alemnew Engidaw
- College of Health Sciences, Debre Berhan University, P.O. Box 445, Debre Berhan, Ethiopia
| | - Zakir Abdu
- Faculty of Public Health and Medical Science, Mettu University, Mettu, Ethiopia
| | - Ishwari Chinani
- Faculty of Public Health and Medical Science, Mettu University, Mettu, Ethiopia
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21
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Silva SN, Lima MG, Ruas CM. Uso de medicamentos nos Centros de Atenção Psicossocial: análise das prescrições e perfil dos usuários em diferentes modalidades do serviço. CIENCIA & SAUDE COLETIVA 2020; 25:2871-2882. [DOI: 10.1590/1413-81232020257.23102018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 10/26/2018] [Indexed: 11/22/2022] Open
Abstract
Resumo O objetivo deste artigo foi identificar o perfil dos usuários e a prescrição de medicamentos nos Centros de Atenção Psicossocial (CAPS) em uma região de Minas Gerais, Brasil. Foi realizado um estudo transversal em 11 CAPS de 5 diferentes modalidades. Dados sociodemográficos e informações sobre o uso de medicamentos foram obtidas por meio de entrevistas com os usuários, análise de prescrições e prontuários utilizando um formulário semiestruturado. O número médio de medicamentos prescritos por usuário dos CAPS foi de 3,38 (±1,76) e os valores foram 4,08 (±1,56), 3,54 (±1,64) e 2,00 (±1,66) para as modalidades de CAPS álcool e Drogas (CAPS ad), CAPS II e III e CAPS infantil, respectivamente. A classe terapêutica mais prescrita foi de antipsicóticos. Usuários que estavam na faixa etária economicamente ativa, frequentavam serviços de maior porte (24h) ou modalidade CAPS ad e relataram que já utilizaram os medicamentos de maneira inadequada, apresentaram maior prevalência de prescrições com 5 ou mais medicamentos. O uso de medicamentos nos CAPS diferiu segundo a modalidade do serviço, tendo sido observado um maior grau de utilização nos CAPS ad. As diferenças encontradas podem subsidiar a discussão de estratégias para a promoção do uso racional de medicamentos.
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22
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Moscovici L, Balco EM, Degani NC, Bolsoni LM, Marques JMA, Zuardi AW. Associations between primary health care strategies and outcomes of mental disorders. ACTA ACUST UNITED AC 2020; 42:360-366. [PMID: 32267338 PMCID: PMC7430389 DOI: 10.1590/1516-4446-2019-0659] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 12/12/2019] [Indexed: 01/05/2023]
Abstract
Objective: To investigate associations between the percentage and severity of mental disorders (MD) and three different primary health care (PHC) strategies in Brazil: traditional care (TC), the Family Health Strategy (FHS), and FHS with shared mental health care (FHS+SC). Methods: Random samples were selected from three different areas of a Brazilian city. Each area was served by a different PHC strategy (TC, FHS, or FHS+SC). Five mental health professionals, blinded to the type of PHC strategy delivered in each area, conducted interviews using the Mini International Neuropsychiatric Interview (MINI) and other specific instruments to assess the prevalence and severity of MD. Results: 530 subjects were interviewed. The TC strategy was significantly associated with a higher percentage of MD when compared to FHS and FHS+SC. These results were not affected by adjustment for sociodemographic variables. The difference in prevalence of MD between the two FHS areas (with and without SC) was not statistically significant. No significant differences in MD severity were observed across the three PHC strategies. Conclusion: Areas covered by FHS showed a lower percentage of MD than those covered by TC. Presence of SC did not influence the prevalence of MD, suggesting that mental-health training of FHS teams may have minimized the influence of SC.
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Affiliation(s)
- Leonardo Moscovici
- Departamento de Medicina Social, Faculdade de Medicina de Ribeirão Preto (FMRP), Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Estenifer M Balco
- Departamento de Medicina Social, Faculdade de Medicina de Ribeirão Preto (FMRP), Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Natalia C Degani
- Departamento de Medicina Social, Faculdade de Medicina de Ribeirão Preto (FMRP), Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Lívia M Bolsoni
- Departamento de Neurociências e Ciências do Comportamento, FMRP, USP, Ribeirão Preto, SP, Brazil
| | - João M A Marques
- Departamento de Medicina Social, Faculdade de Medicina de Ribeirão Preto (FMRP), Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Antonio W Zuardi
- Departamento de Neurociências e Ciências do Comportamento, FMRP, USP, Ribeirão Preto, SP, Brazil
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Saraiva SAL, Zepeda J, Liria AF. Componentes do apoio matricial e cuidados colaborativos em saúde mental: uma revisão narrativa. CIENCIA & SAUDE COLETIVA 2020; 25:553-565. [DOI: 10.1590/1413-81232020252.10092018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 06/27/2018] [Indexed: 11/22/2022] Open
Abstract
Resumo Cuidados colaborativos entre saúde mental e atenção primária são efetivos em melhorar desfechos de saúde. O apoio matricial tem semelhanças com cuidados colaborativos pouco exploradas na literatura. Este artigo compara os dois modelos e analisa o apoio matricial a partir de evidências sobre cuidados colaborativos. Revisão narrativa. Componentes de cada modelo (atividades e dimensões) foram identificados e comparados. Evidências sobre cuidados colaborativos informaram análise de componentes semelhantes do apoio matricial. Foram identificadas dimensões do apoio matricial – suporte educacional, cuidado especializado, regulação, cogestão – e dos cuidados colaborativos – cuidado multiprofissional, comunicação sistemática, cuidado estruturado, suporte organizacional. A principal semelhança entre os modelos está nas atividades colaborativas diretas em torno de problemas clínicos, relacionadas a efetividade em estudos sobre cuidados colaborativos. Atividades colaborativas diretas são ponto positivo do apoio matricial. Cuidado estruturado e suporte em nível organizacional devem ser encorajados. Futuros estudos devem refinar as categorias propostas e explorar seu uso para desenvolvimento do apoio matricial.
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Orellana JDY, Ribeiro MRC, Barbieri MA, Saraiva MDC, Cardoso VC, Bettiol H, Silva AAMD, Barros FC, Gonçalves H, Wehrmeister FC, Menezes AMB, Del-Ben CM, Horta BL. Mental disorders in adolescents, youth, and adults in the RPS Birth Cohort Consortium (Ribeirão Preto, Pelotas and São Luís), Brazil. CAD SAUDE PUBLICA 2020; 36:e00154319. [PMID: 32022176 DOI: 10.1590/0102-311x00154319] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 10/21/2019] [Indexed: 01/14/2023] Open
Abstract
Although depression and anxiety are known to result in disabilities and workplace and health system losses, population-based studies on this problem are rare in Brazil. The current study assessed the prevalence of mental disorders in adolescents, youth, and adults and the relationship to sociodemographic characteristics in five birth cohorts (RPS) in Ribeirão Preto (São Paulo State), Pelotas (Rio Grande do Sul State), and São Luís (Maranhão State), Brazil. Major depressive episode, suicide risk, social phobia, and generalized anxiety disorder were assessed with the Mini International Neuropsychiatric Interview. Bootstrap confidence intervals were estimated and prevalence rates were stratified by sex and socioeconomic status in the R program. The study included 12,350 participants from the cohorts. Current major depressive episode was more prevalent in adolescents in São Luís (15.8%; 95%CI: 14.8-16.8) and adults in Ribeirão Preto (12.9%; 95%CI: 12.0-13.9). The highest prevalence rates for suicide risk were in adults in Ribeirão Preto (13.7%; 95%CI: 12.7-14.7), and the highest rates for social phobia and generalized anxiety were in youth in Pelotas, with 7% (95%CI: 6.3-7.7) and 16.5% (95%CI: 15.4-17.5), respectively. The lowest prevalence rates of suicide risk were in youth in Pelotas (8.8%; 95%CI: 8.0-9.6), social phobia in youth in Ribeirão Preto (1.8%; 95%CI: 1.5-2.2), and generalized anxiety in adolescents in São Luís (3.5%; 95%CI: 3.0-4.0). Mental disorders in general were more prevalent in women and in individuals with lower socioeconomic status, independently of the city and age, emphasizing the need for more investment in mental health in Brazil, including gender and socioeconomic determinants.
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Affiliation(s)
| | | | - Marco Antonio Barbieri
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil
| | | | - Viviane Cunha Cardoso
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil
| | - Heloísa Bettiol
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil
| | | | - Fernando C Barros
- Faculdade de Medicina, Universidade Católica de Pelotas, Pelotas, Brasil
| | - Helen Gonçalves
- Faculdade de Medicina, Universidade Federal de Pelotas, Pelotas, Brasil
| | | | | | - Cristina Marta Del-Ben
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil
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Ribeiro IBDS, Correa MM, Oliveira G, Cade NV. Common mental disorders and socioeconomic status in adolescents of ERICA. Rev Saude Publica 2020; 54:04. [PMID: 31939577 PMCID: PMC9586442 DOI: 10.11606/s1518-8787.2020054001197] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Accepted: 05/03/2019] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Adolescence is a stage of great social, family and emotional demands, and the literature has related common mental disorder (CMD) with poor living conditions. OBJECTIVE To investigate the relationship between CMD and socioeconomic status in Brazilian adolescents aged 12 to 17 years. METHOD This is a cross-sectional study with data from the Study of Cardiovascular Risk in Adolescents (ERICA - Estudo de Riscos Cardiovasculares em Adolescentes). The outcome was CMD and the exposure was socioeconomic status assessed by race/skin color, maternal schooling, resident/room relationship, type of school, existence of maid and bathroom at home, and work activity. For the calculation of prevalence, the survey mode was used and, in the multivariate analysis, logistic regression with p < 5%, as well as the 95% confidence interval. RESULTS The prevalence of CMD in girls was 23.3%, and in boys, 11.1%. The variables associated with CMD in girls were age between 15 and 17 years (OR = 1.34; 1.17-1.51), studying in private school (OR = 1.13; 1.01-1.27), having a housemaid (OR = 1.15; 1.00-1.34) and, as a protective factor, unpaid work (OR = 0.64; 0.55-0.75). Boys also had a higher chance of CMD in the highest age group (OR = 1.42; 1.18-1.71) and when they had a housemaid (OR = 1.26; 1.02-1.57), whereas unpaid work decreased this chance (OR = 0.79; 0.67-0.95). CONCLUSION Socioeconomic variables that were associated with CMD were suggestive of higher economic class, whereas unpaid work favored the mental health of adolescents, results contrary to the literature on socioeconomic status and CMD.
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Affiliation(s)
| | - Marcia Mara Correa
- Universidade Federal do Espírito Santo. Hospital Universitário Cassiano Antônio de Moraes. Vitória, ES, Brasil
| | - Gabriela Oliveira
- Universidade Federal do Espírito Santo. Programa de Pós-Graduação em Saúde Coletiva. Vitória, ES, Brasil
| | - Nágela Valadão Cade
- Universidade Federal do Espírito Santo. Departamento de Enfermagem. Vitória, ES, Brasil
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Costa PHAD, Mendes KT. Colonização, Guerra e Saúde Mental: Fanon, Martín-Baró e as Implicações para a Psicologia Brasileira. PSICOLOGIA: TEORIA E PESQUISA 2020. [DOI: 10.1590/0102.3772e36nspe14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo O presente estudo teórico objetiva discorrer sobre as compreensões de Frantz Fanon e Ignacio Martín-Baró acerca da relação entre guerra, colonização e saúde mental e como podem contribuir ao entendimento de nossa realidade. Ademais, pretendemos refletir como tais subsídios se aplicam à Psicologia brasileira e seu projeto ético-político. Constatamos uma confluência nas análises dos autores, sobretudo a influência de Fanon para Martín-Baró, orientando-se para uma compreensão da saúde mental remetida ao nosso fazimento colonizado e como este se manifesta, é conformado e intensificado por guerras, mesmo que não formais. Finalmente, traçamos implicações para um projeto de Psicologia que aborde a saúde mental na perspectiva dos autores e, assim, transforme-se, contribuindo para o entendimento e mudança de nossa realidade.
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Farrag NS, El-Gilany AH, Abdelsalam SA. Prevalence and predictors of psychological distress among primary healthcare service users in Mansoura district, Egypt. HEALTH & SOCIAL CARE IN THE COMMUNITY 2019; 27:1451-1457. [PMID: 31368623 DOI: 10.1111/hsc.12816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 06/12/2019] [Accepted: 07/01/2019] [Indexed: 06/10/2023]
Abstract
The current study is a health facility-based cross-sectional study that aims to measure the prevalence of psychological distress and to determine its associated factors among primary healthcare (PHC) service users in Mansoura district, Egypt. The study included service users aged ≥18 years. A predesigned structured interviewer-administered questionnaire was used to collect data from participants during the period from January 2018 to November 2018. The questionnaire included four sections; sociodemographic characteristics, recent history of stressful life events, history of relevant health conditions and a validated Arabic version of General Health Questionnaire, that was used to screen for psychological distress. The total calculated sample size was 573. Data was analysed using SPSS V. 16. Results indicated that the prevalence of psychological distress among PHC service users was 72.2% (95% CI: 68.6%-75.9%). Being a female, non-working, or married increased the risk of high psychological distress [OR (95%CI): 1.6 (1.2-2.4), 1.8(1.2-2.8) and 1.7 (1.1-2.8) respectively], but these factors were insignificant in multiple regression. Exposure to domestic violence (DV) and being current smokers were the only independent significant predictors of psychological distress [adjusted OR (95%CI): 3.8 (1.7-8.1) and 0.7 (0.4-0.9) respectively]. Findings indicate that psychological distress is common among PHC service users. Exposure to DV significantly predicts psychological distress, while smoking is associated with lower stress. Screening of PHC service users for mental health problems should be integrated within the PHC system.
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Affiliation(s)
- Nesrine S Farrag
- Community Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Abdel-Hady El-Gilany
- Community Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Sherehan A Abdelsalam
- Community Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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Souza ÂCD, Amarante PD, Abrahão AL. Inclusion of mental health in primary health care: care strategy in the territory. Rev Bras Enferm 2019; 72:1677-1682. [PMID: 31644760 DOI: 10.1590/0034-7167-2018-0806] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 04/11/2019] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To analyze the strategies, challenges and possibilities of the articulation between mental health and primary health care from the perspective of health managers. METHOD Exploratory, qualitative research carried out with 28 managers of mental health and primary care. The data were collected through semi-structured interviews between July and November 2013 and submitted to thematic content analysis. RESULTS The inclusion of mental health actions in primary care made it possible, in the view of managers, to increase users' access to the care they need. This care strategy allows the extension of care practices in the territory, with matrix support as the main tool for the implementation of this care strategy. FINAL CONSIDERATIONS The articulation between primary care and mental health is a powerful device for psychosocial care, but it demands a new conformation of the Psychosocial Care Centers (Caps) and primary care services.
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Affiliation(s)
| | - Paulo Duarte Amarante
- Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, Rio de Janeiro, Brazil
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Lopes N, Dias LLS, Azulay-Abulafia L, Oyafuso LKM, Suarez MV, Fabricio L, Kobata CM, Cestari T, Gontijo B, Sabbag CY, Antonio JR, Romiti R, Pertel PC. Humanistic and Economic Impact of Moderate to Severe Plaque Psoriasis in Brazil. Adv Ther 2019; 36:2849-2865. [PMID: 31432463 PMCID: PMC6822973 DOI: 10.1007/s12325-019-01049-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Psoriasis is an immune-mediated, chronic, inflammatory disease, which has a substantial humanistic and economic burden. This study aimed to assess the impact of this disease on health-related quality of life (HRQoL), work productivity, and direct and indirect costs from a societal perspective among Brazilian patients. METHODS This is a cross-sectional, observational, multicenter study, enrolling patients with moderate to severe plaque psoriasis according to physician evaluation. Data collection was performed from December 2015 to November 2016 through face-to-face interviews using a structured questionnaire and five standardized patient-reported outcomes instruments. Direct costs were estimated by multiplying the amount of resources used (12-month recall period) by the corresponding unit cost. Indirect costs were grouped in two time horizons: annual costs (income reduction and absenteeism) and lifetime costs (demission and early retirement). RESULTS A total of 188 patients with moderate to severe plaque psoriasis were included, with mean age of 48.0 (SD 13.1). "Anxiety and depression" and "pain and discomfort" were the most impaired dimensions, according to the EuroQol Five-Dimension-Three-Level (EQ-5D-3L). The highest effect was found for "symptoms and feelings" [mean (SD) 2.4 (1.7)] Dermatology Life Quality Index (DLQI) subscale. Psoriatic arthritis (PsA) presence and biologic-naïve status were associated with worse HRQoL. Presenteeism was more frequent than absenteeism, according to the Work Productivity and Activity Impairment questionnaire-General Health (WPAI-GH) [17.4% vs. 6.3%], while physical demands and time management were the most affected Work Limitations Questionnaire (WLQ) subscales [means (SD) 23.5 (28.5) and 17.7 (24.9), respectively]. The estimated annual cost per patient was USD 4034. Direct medical costs accounted for 87.7% of this estimate, direct non-medical costs for 2.4%, and indirect costs for 9.9%. CONCLUSIONS Results evidenced that moderate to severe plaque psoriasis imposes substantial costs to society. Our data showed that this disease negatively affects both work productivity and HRQoL of Brazilian patients. Subgroups with PsA and biologic-naïve patients presented lower HRQoL, showing the impact of this comorbidity and the relevance of biologics in psoriasis treatment. FUNDING Novartis Biociências S.A.
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Affiliation(s)
| | | | | | | | | | | | | | - Tania Cestari
- Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | | | - Cid Y Sabbag
- CEPIC, Centro Paulista de Investigação Clínica e Serviços Médicos Ltda., São Paulo, Brazil
| | - João R Antonio
- Fundação Faculdade Regional de Medicina de São José do Rio Preto, São José do Rio Preto, Brazil
| | - Ricardo Romiti
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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Shirama FH, Silva TB, Dos Santos JC, de Oliveira PA, de Oliveira JI, Borges TL, Miasso AI. Factors associated with common mental disorders and use of psychiatric drugs in cancer outpatients. Arch Psychiatr Nurs 2019; 33:88-93. [PMID: 31711600 DOI: 10.1016/j.apnu.2019.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 05/10/2019] [Accepted: 06/13/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Considering the high incidence of cancer in Brazil and worldwide, the high prevalence and relevance of Common Mental Disorders (CMD) in the treatment of cancer patients, and the use of psychiatric drugs without reliably proven effectiveness, studies that contemplate this topic are needed to understand and provide rationale for the treatment of CMD in these individuals. OBJECTIVES This study identified prevalence and factors associated with Common Mental Disorders (CMD) and psychotropic use in cancer outpatients. METHOD This is a cross-sectional study with descriptive correlational design. It was developed in the chemotherapy sector of a hospital specialized in cancer. The tools used were: Self Reporting Questionnaire (SRQ-20) and structured questionnaires. FINDINGS Among 403 respondents, CMD prevalence was 31.5% and psychotropic use was 25.8%. CMD were associated with gender, education, family income, psychotropic use and cancer surgery. Psychotropic use was associated with gender, employment status, cancer surgery, treatment period and other physical health conditions. Logistic regressions showed CMD were associated with gender and other physical health conditions; psychotropic use was associated with gender, employment status and other conditions.
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Affiliation(s)
- Flávio Hiroshi Shirama
- University of São Paulo at Ribeirão Preto, College of Nursing - WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, São Paulo, Brazil
| | | | | | | | | | - Tatiana Longo Borges
- University of São Paulo at Ribeirão Preto, College of Nursing - WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, São Paulo, Brazil.
| | - Adriana Inocenti Miasso
- University of São Paulo at Ribeirão Preto, College of Nursing - WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, São Paulo, Brazil
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Barreto PA, Lopes CS, Silveira IHD, Faerstein E, Junger WL. Is living near green areas beneficial to mental health? Results of the Pró-Saúde Study. Rev Saude Publica 2019; 53:75. [PMID: 31553378 PMCID: PMC6752646 DOI: 10.11606/s1518-8787.2019053001008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 01/11/2019] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE To investigate the association between exposure to green areas in the surroundings of the residence and the presence of common mental disorders among adults, according to different income strata. METHODS Cross-sectional study with 2,584 participants from the Pró-Saúde Study (2006), residing in the city of Rio de Janeiro. Common Mental Disorders were measured using the General Health Questionnaire (GHQ-12) and exposure to green areas was measured using the normalized difference vegetation index, in buffers with radiuses between 100 and 1,500 meters around the residence. We used the mean and maximum normalized difference vegetation index categorized into quartiles. The study population was divided into three subgroups, according to the income: low, intermediate, and high. Odds ratios and their 95% confidence intervals were estimated with logistic regression models. The models were adjusted by sex and age, with and without inclusion of physical activity practice. RESULTS The proportion of common mental disorders was 30% and 39% among men and women, respectively. The results of the adjusted models showed an inverse association between the presence of green areas in the surroundings of the residence and the occurrence of common mental disorders, in the buffer of 200 meters in the intermediate-income group and in the buffers of 400 and 1,500 meters in the low-income group. The odds ratio ranged from 0.52 (buffer of 1,500 meters) to 0.68 (buffer of 200 meters). The association found was independent of physical activity practice. CONCLUSIONS The evidence found suggests the existence of a beneficial effect of urban green areas on the mental health of lower-income individuals. These findings can help in understanding how the urban environment can affect the mental health of the population.
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Affiliation(s)
- Patricia Amado Barreto
- Universidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Programa de Pós-Graduação em Saúde Coletiva. Rio de Janeiro, RJ, Brasil
| | - Claudia Souza Lopes
- Universidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Departamento de Epidemiologia. Rio de Janeiro, RJ, Brasil
| | - Ismael Henrique da Silveira
- Universidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Programa de Pós-Graduação em Saúde Coletiva. Rio de Janeiro, RJ, Brasil
| | - Eduardo Faerstein
- Universidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Departamento de Epidemiologia. Rio de Janeiro, RJ, Brasil
| | - Washington Leite Junger
- Universidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Departamento de Epidemiologia. Rio de Janeiro, RJ, Brasil
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Gaino LV, de Almeida LY, de Oliveira JL, Nievas AF, Saint-Arnault D, de Souza J. The role of social support in the psychological illness of women. Rev Lat Am Enfermagem 2019; 27:e3157. [PMID: 31340345 PMCID: PMC6687359 DOI: 10.1590/1518-8345.2877.3157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 02/19/2019] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE to analyze the relationship between perception of social support and emotional and physical symptoms associated with psychiatric conditions among women. METHOD a cross-sectional, quantitative study was carried out with a randomized random sample of 141 women attended at a Family Health Unit of the city of Ribeirão Preto/SP. A sociodemographic questionnaire, the Social Support Questionnaire and the Self-Report Questionnaire were used. RESULTS there was no association between sociodemographic characteristics and mental disorder, but between aspects such as low income and schooling. The exercise of professions culturally considered as of low prestige gave rise to some reflections related to gender inequality. There was a significant difference in the satisfaction scores between the women who reported or not the symptoms of tiredness and sadness and the number of supporters among those who reported or not the symptom of fatigue. Spouses and children were the most mentioned supporters, and having mental disorder was significantly associated with having no friends in the support network. CONCLUSION issues related to gender equity and satisfaction with social support are important aspects of care. For the promotion of mental health, efforts must be made to make women feel more connected and supported by the supporters available in their social environment.
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Affiliation(s)
| | - Letícia Yamawaka de Almeida
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão
Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em
Enfermagem, Ribeirão Preto, SP, Brasil
- Bolsista da Coordenação de Aperfeiçoamento de Pessoal de Nível
Superior (CAPES), Brasil
| | - Jaqueline Lemos de Oliveira
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão
Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em
Enfermagem, Ribeirão Preto, SP, Brasil
| | - Andreia Fernanda Nievas
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão
Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em
Enfermagem, Ribeirão Preto, SP, Brasil
| | | | - Jacqueline de Souza
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão
Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em
Enfermagem, Ribeirão Preto, SP, Brasil
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Santos MVFD, Campos MR, Fortes SLCL. Relationship of alcohol consumption and mental disorders common with the quality of life of patients in primary health care. CIENCIA & SAUDE COLETIVA 2019; 24:1051-1063. [PMID: 30892525 DOI: 10.1590/1413-81232018243.01232017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Accepted: 05/12/2017] [Indexed: 11/22/2022] Open
Abstract
The objective was to measure the Quality of Life (QoL) of the patients treated in Primary Health Care in the city of Rio de Janeiro and its own association with CMD, alcohol consumption and socio-demographic aspects. This is a cross-sectional study involving 624 patients in 2012/2013, using: General Health Questionnaire, Hospital Anxiety and Depression Scale, Screening for Somatoform Symptoms, Alcohol Use Disorder Identification Test e World Health Organization Quality of Life Instrument (bref version). There were conducted a bivariate analysis and a multiple linear regressions for each domain of QOL. The QoL score for the domains, physical, psychological, social relationships and environment were: 61,2; 62,6; 66 and 50,9. In multivariate analysis, the QOL was negatively associated to the CMD, especially in the psychological domain (β = -15,75; p-value = 0,00), and the dependence on physical (β = -5,38; p-value = 0,05). There was a positive and significant association of the QoL with the risk consumption (β = 5,77) and the harmful consumption (β = 6,15) in the environment domain, and with the first in the psychological domain (β = 7,08). CMD and alcohol dependence are associated with the loss of QOL, but other patterns of consumption, even being harmful are associated with higher QOL.
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Affiliation(s)
| | - Mônica Rodrigues Campos
- Escola Nacional de Saúde Pública, Fiocruz. R. Leopoldo Bulhões 1480, Manguinhos. 21041-210 Rio de Janeiro RJ Brasil.
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Arroyo LAH, Arcoverde MAM, Alves JD, Fuentealba-Torres M, Cartagena-Ramos D, Scholze AR, Ramos ACV, Arcêncio RA. Spatial analysis of cases of Tuberculosis with Mental Disorders in São Paulo. Rev Bras Enferm 2019; 72:654-662. [DOI: 10.1590/0034-7167-2017-0949] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 06/16/2018] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: To analyze the spatial distribution of Tuberculosis cases with Mental Disorders, identifying factors that determine its occurrence. Method: Ecological study, conducted in the municipalities of São Paulo State. Secondary data were used, with the incidence of Tuberculosis and Mental Disorders as dependent variables in the years 2012 to 2015 and independent variables, socioeconomic, health and income transfer data. The Geographically Weighted Regression was applied in this study. Results: It was observed a distinct distribution between cases of Tuberculosis and Mental Disorders in the municipalities of São Paulo State. Among the explanatory factors, the Primary Care Coverage, population of freedom and income inequality were spatially associated with Mental Illness (R2= 0.12); Alcoholism (R2= 0.12) Illicit Drugs (R2= 0.50) and Smoking (R2= 0.50). Conclusion / Final considerations: The study advances in knowledge by evidencing the spatial distribution of cases of Tuberculosis and Mental Disorders, evidencing the determining factors for its occurrence in São Paulo State.
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Santos-Veloso MAO, Melo MISLD, Cavalcanti RAN, Bezerra LS, Chaves-Markman ÂV, Lima SGD. Prevalence of depression and anxiety and their association with cardiovascular risk factors in Northeast Brasil primary care patients. Rev Assoc Med Bras (1992) 2019; 65:801-809. [DOI: 10.1590/1806-9282.65.6.801] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 11/25/2018] [Indexed: 11/22/2022] Open
Abstract
SUMMARY BACKGROUND: Depression and anxiety disorders (DAD) are the most prevalent mental health conditions worldwide. Among the adult population served in basic care, it is estimated that depression affects about 14.3% of these individuals worldwide, and between 21.4% and 31% in Brasil. Anxiety affects up to 33.7% of the population during their lifetimes. OBJECTIVES: estimate the prevalence proportions of DAD among patients in a municipality in Northeast Brasil and study the association between DAD and cardiovascular risk factors. METHODS: a cross-sectional study with the medical records of patients from primary care centers in Jaboatão dos Guararapes, Pernambuco. Patients aged ≥ 18 years and regularly followed-up were included. Exclusion criteria: a history of traumatic brain injury, alcohol or drug abuse, previous stroke, medical conditions or medications that mimic DAD symptoms. Subjects were divided into two groups depending on the presence or absence of DAD, and cardiovascular risk factors were compared between groups. RESULTS: A total of 1030 subjects were initially included, of whom 215 (20%) were excluded. No-DAD subjects had more history of myocardial infarction and alcoholism. The prevalence of depression was 10.3%, anxiety disorder was 27.1%, and mixed DAD represented 4.5%. There was a significant association between DAD and hypertension (OR = 2.11; 95%CI: 1.16 –3.84; p=0.01), obesity (OR = 4.47; 95%CI: 1.74 –11.46; p=0.002), and hyperlipidemia (OR = 3.88; 95%CI: 1.81-8.3; p<0.001). CONCLUSION: DAD were associated with an increased risk for arterial hypertension, obesity, and hyperlipidemia.
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Lorenzato CS, Santos RB, Fagundes GZZ, Ozelo MC. Haemophilia Experiences, Results and Opportunities (HERO study) in Brazil: Assessment of the psychosocial effects of haemophilia in patients and caregivers. Haemophilia 2019; 25:640-650. [DOI: 10.1111/hae.13774] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 04/25/2019] [Accepted: 04/26/2019] [Indexed: 12/27/2022]
Affiliation(s)
| | | | | | - Margareth C. Ozelo
- IHTC “Cláudio L P Correa”, INCT do Sangue Hemocentro UNICAMP University of Campinas Campinas Brazil
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The relationship between neighborhood-level socioeconomic characteristics and individual mental disorders in five cities in Latin America: multilevel models from the World Mental Health Surveys. Soc Psychiatry Psychiatr Epidemiol 2019; 54:157-170. [PMID: 30173317 PMCID: PMC6849376 DOI: 10.1007/s00127-018-1595-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Accepted: 08/20/2018] [Indexed: 01/30/2023]
Abstract
PURPOSE Our understanding of community-level predictors of individual mental disorders in large urban areas of lower income countries is limited. In particular, the proportion of migrant, unemployed, and poorly educated residents in neighborhoods of these urban areas may characterize group contexts and shape residents' health. METHODS Cross-sectional household interviews of 7251 adults were completed across 83 neighborhoods of Buenos Aires, Argentina; Medellín, Colombia; São Paulo, Brazil; Lima, Peru; and Mexico City, Mexico as part of the World Mental Health Survey Initiative. Past-year internalizing and externalizing mental disorders were assessed, and multilevel models were used. RESULTS Living in neighborhoods with either an above-average or below-average proportion of migrants and highly educated residents was associated with lower odds of any internalizing disorder (for proportion migrants: OR 0.75, 95% CI 0.62-0.91 for the bottom tertile and OR 0.79, 95% CI 0.67-0.94 for the top tertile compared to the middle tertile; for proportion highly educated: OR 0.76, 95% CI 0.64-0.90 for the bottom tertile and OR 0.58, 95% CI 0.37-0.90 for the top tertile compared to the middle tertile). Living in neighborhoods with an above-average proportion of unemployed individuals was associated with higher odds of having any internalizing disorder (OR 1.49, 95% CI 1.14-1.95 for the top tertile compared to the middle tertile). The proportion of highly educated residents was associated with lower odds of externalizing disorder (OR 0.54, 95% CI 0.31-0.93 for the top tertile compared to the middle tertile). CONCLUSIONS The associations of neighborhood-level migration, unemployment, and education with individual-level odds of mental disorders highlight the importance of community context for understanding the burden of mental disorders among residents of rapidly urbanizing global settings.
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Santos AGD, Monteiro CFDS. Domains of common mental disorders in women reporting intimate partner violence. Rev Lat Am Enfermagem 2018; 26:e3099. [PMID: 30517584 PMCID: PMC6280180 DOI: 10.1590/1518-8345.2740.3099] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Accepted: 09/24/2018] [Indexed: 12/14/2022] Open
Abstract
Objective to verify associations between the types of intimate partner violence and
the domains of common mental disorders in women. Method cross-sectional study with 369 women. The information was obtained through
the instruments Self-Reporting Questionnaire and Conflict Tactic Scales. To
analyze the data, Pearson’s Chi-Square test, Fisher’s exact test and Odds
Ratio were used. Results women who reported physical abuse with and without sequela were respectively
2.58 and 3.7 times more likely to have symptoms of anxious depressed mood.
The chances of experiencing symptoms of decreased vital energy increased by
2.27 times with psychological aggression, 3.06 times with physical abuse
without sequelae and 3.13 times with physical abuse with sequelae. Somatic
symptoms did not show statistical association with the types of violence.
The propensity to develop symptoms of depressive thoughts increased 3.11
times with psychological aggression, 6.13 times with physical aggression
without sequelae, 2.47 times with sexual coercion and 7.3 times with
physical aggression with sequelae. Conclusion the types of intimate partner violence are strongly associated with the
domains of common mental disorders in women. This finding may contribute to
more accurate interventions by health professionals to women victims of
violence.
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Affiliation(s)
- Ariane Gomes Dos Santos
- Universidade Federal do Piauí, Departamento de Enfermagem, Teresina, PI, Brasil.,Instituto Federal de Educação, Ciência e Tecnologia do Piauí, Departamento de Saúde, Teresina, PI, Brasil
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Castro-Silva KMD, Carvalho AC, Cavalcanti MT, Martins PDS, França JR, Oquendo M, Kritski AL, Sweetland A. Prevalence of depression among patients with presumptive pulmonary tuberculosis in Rio de Janeiro, Brazil. ACTA ACUST UNITED AC 2018; 41:316-323. [PMID: 30365672 PMCID: PMC6476682 DOI: 10.1590/1516-4446-2018-0076] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 08/01/2018] [Indexed: 01/14/2023]
Abstract
Objective: To estimate the prevalence of major depressive episode (MDE) in patients with presumptive pulmonary tuberculosis (pre-PTB, defined by cough lasting ≥ 3 weeks) and compare it between patients with pulmonary tuberculosis (PTB) and without PTB. Methods: Patients with pre-PTB (n=260) were screened for depression using the Patient Health Questionnaire (PHQ-9). Those individuals with scores ≥ 10 were subsequently assessed with the depression module of the Mini International Neuropsychiatric Interview (MINI-Plus) to confirm diagnosis. Associations of categorical variables with PTB and MDE were calculated using the chi-square test and OR. Results: PTB was confirmed in 98 patients (37.7%). A high proportion of both groups (active PTB and no PTB) screened positive for depression (60.2 vs. 62.1%, respectively). Among 159 patients who screened positive for depression, a subset of 97 (61.0%) were further evaluated with the MINI-Plus; current MDE was confirmed in 54.6% (53/97). On univariate and multivariate analysis, female sex was the only factor associated with the diagnosis of current MDE (p = 0.04). Conclusion: The prevalence of MDE was high among individuals with prolonged respiratory symptoms, independent of PTB diagnosis. This is consistent with other studies of depression in primary care in Brazil.
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Affiliation(s)
- Karina M de Castro-Silva
- Programa Acadêmico de Tuberculose, Faculdade de Medicina, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Anna C Carvalho
- Laboratório de Inovações em Terapias, Ensino e Bioprodutos (LITEB), Instituto Oswaldo Cruz (IOC), Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Maria T Cavalcanti
- Departamento de Psiquiatria, Faculdade de Medicina, UFRJ, Rio de Janeiro, RJ, Brazil
| | - Pedro da S Martins
- Laboratório de Inovações em Terapias, Ensino e Bioprodutos (LITEB), Instituto Oswaldo Cruz (IOC), Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, RJ, Brazil
| | - José R França
- Departamento de Psiquiatria, Faculdade de Medicina, UFRJ, Rio de Janeiro, RJ, Brazil
| | - Maria Oquendo
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Afrânio L Kritski
- Programa Acadêmico de Tuberculose, Faculdade de Medicina, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil.,Rede Brasileira de Pesquisas em Tuberculose (REDE-TB), Rio de Janeiro, RJ, Brazil
| | - Annika Sweetland
- Department of Psychiatry, Columbia College of Physicians & Surgeons, New York, NY, USA.,New York State Psychiatric Institute, New York, NY, USA
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Prevalence and correlates of common mental disorders among dental students in Brazil. PLoS One 2018; 13:e0204558. [PMID: 30261025 PMCID: PMC6160106 DOI: 10.1371/journal.pone.0204558] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Accepted: 09/11/2018] [Indexed: 11/19/2022] Open
Abstract
This study aimed to estimate prevalence of common mental disorders (CMD) and associated factors among dental students. In this cross-sectional study, 230 students answered a questionnaire and instruments to assess CMD (Self Reporting Questionnaire-20), hazardous alcohol consumption (Alcohol Use Disorder Identification Test), social support (Social Support Scale), perceptions of academic life (Dundee Ready Education Environment Measure), coping (Ways of Coping Inventory) and resilience (Resilience Scale). Bivariate analysis was conducted using the Chi-Square and Mann-Whitney tests. Logistic regression included all explanatory variableswith p<0.20 in the bivariate analysis, besides sex and academic year. The explanatory variables were analyzed in five successive blocks (backward-stepwise), until all variables presented statistical significance in the final model (p<0.05). The prevalence of CMD was 45.2% (95%CI: 38.7–51.6), with no significant differences between sexes. Students with no extracurricular activities, who had negatively self- assessed their health status and their academic performance, were about four times more likely to present CMD, followed by receiving psychological or psychiatric treatment during university (AOR: 2.65; 95%CI: 1.1–6.1) and those with high scores for confrontive coping (AOR: 1.20; 95%CI: 1.0–1.4). Resilience was a protective factor for CMD among dental students (AOR: 0.93; 95%CI: 0.9–1.0). Aspects related to academic performance, health status and confrontive coping strategies were risk factors to students’ mental health. Individuals with high levels of resilience showed lower prevalence of CMD. Further prospective studies could contribute to understanding the role of resilience among this population.
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Araujo JA, Campos MR, Santos MVFD, Gonçalves DA, Mari JDJ, Tófoli LF, Ballester D, Fortes S. Dor lombar e transtornos mentais comuns na Estratégia Saúde da Família: uma associação pouco reconhecida. REVISTA BRASILEIRA DE MEDICINA DE FAMÍLIA E COMUNIDADE 2018. [DOI: 10.5712/rbmfc13(40)1740] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Objetivo: Descrever o perfil sociodemográfico dos pacientes atendidos na Estratégia Saúde da Família de quatro capitais brasileiras (Rio de Janeiro, São Paulo, Porto Alegre e Fortaleza) com dor lombar e investigar a associação entre dor lombar e depressão, ansiedade e somatização. Métodos: Estudo de corte transversal com 1857 pacientes atendidos nos anos de 2009 (setembro a novembro) e 2010 (junho a agosto). Instrumentos: rastreio de somatização (SOMS-2), avaliação de ansiedade e depressão (HAD), Questionário Geral do Paciente, para dados sociodemográficos e o Formulário do Profissional Assistente, com as informações referentes as consultas. A dor lombar foi analisada a partir da frequência de três diferentes formas de apresentação: queixa autorreferida pelo paciente, sintoma registrado pelo médico e diagnóstico de lombalgia confirmado pelo médico. Resultados: 77,3% eram mulheres com mais de quatro anos de estudo e renda per capita inferior a um salário mínimo e meio. Encontramos associação significativa de queixa de dor lombar com ansiedade (OR=1,5, 95% IC 1,02-2,16) e somatização (OR=1,8, 95% IC 1,12-2,88), mas não com depressão. Pacientes que apresentavam queixa de dor lombar, porém sem registro do sintoma pelo médico, apresentaram associações ainda mais fortes com ansiedade (OR=1,6, 95% IC 1,03-2,63) e somatização (OR=2,3, 95% IC 1,33-3,99). A confirmação do diagnóstico de dor lombar pelo médico não se associou significativamente com nenhum transtorno. Conclusão: Considerando a dor lombar como uma das queixas de maior prevalência na Atenção Primária e sua associação significativa com ansiedade e somatização, recomenda-se a abordagem da ansiedade e somatização em pacientes com queixa de dor lombar.
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Aragão EIS, Campos MR, Portugal FB, Gonçalves DA, Mari JDJ, Fortes SLCL. Social Support patterns in Primary Health Care: differences between having physical diseases or mental disorders. CIENCIA & SAUDE COLETIVA 2018; 23:2339-2350. [PMID: 30020386 DOI: 10.1590/1413-81232018237.21012016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 08/06/2016] [Indexed: 11/22/2022] Open
Abstract
The social support network is a health protective factor involving physical, mental and psychological aspects, providing a better quality of life, favoring better adaptation to adverse conditions, promoting resilience and mobilizing resources for a more effective coping with negative life events that can lead to illness. We aimed to analyze the association between physical diseases, common mental disorders and the social support network of patients serviced at primary care facilities in the cities of Rio de Janeiro and São Paulo through a cross-sectional study with 1,466 patients in the 18-65 years age group. We used the Social Network Index (SNI) to assess the support network through the categories of isolation and integration. The doctor/nurse completed the questionnaire to evaluate the physical disease diagnosis, while the Hospital Anxiety and Depression Scale was used to detect mental disorders. We found that the pattern of social support was different depending on the presence of physical diseases or mental disorders. Negative associations were found between diabetes and isolation; integration and anxiety; integration and depression. Positive associations were identified between isolation and anxiety and isolation and depression.
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Affiliation(s)
- Ellen Ingrid Souza Aragão
- Universidade do Estado do Rio de Janeiro. R. Vinte e Oito de Setembro 77, Maracanã. 22000-000 Rio de Janeiro RJ
| | | | | | | | - Jair de Jesus Mari
- Departamento de Psiquiatria, Universidade Federal de São Paulo. São Paulo SP Brasil
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Luis MAV, Barbosa SP, de Souza J, Vedana KGG, Zanetti ACG, de Azevedo Marques JM. Mental Health Needs and Psychoactive Drug Use in a User Population of the Family Health Strategy (FHS) in Ribeirão Preto, São Paulo, Brazil. Community Ment Health J 2018; 54:664-671. [PMID: 29256105 DOI: 10.1007/s10597-017-0205-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 11/06/2017] [Indexed: 12/01/2022]
Abstract
This cross-sectional study was conducted in Family Health Care's field of Ribeirão Preto city, São Paulo, Brazil to identify the prevalence of substance-related disorders and mental distress among patients with mental disorders. We also aimed to identify sociodemographic and social support risk factors. The data collection was done using medical records, the Social Support Questionnaire (SSQ-6), Self Report Questionnaire (SRQ-20) and home visits. Of the 272 families studied, 211 contained individuals with mental disorders, and 61 included individuals who had substance-related disorders, or both. The mental disorders recorded in these families were most frequently mood disorders, followed by neurotic disorders, stress-related disorders and somatoform disorders. Women received twice as many psychotropic prescriptions associated with non-psychiatric medication. A significant relationship was established between education and mental distress as measured using the SRQ-20 (p = 0.024). The SSQ-6 revealed a family presence of social support in all of the conditions established by the six questions.
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Affiliation(s)
| | - Sara Pinto Barbosa
- University of São Paulo at College Nursing of Ribeirão Preto, Ribeirão Preto, SP, Brazil.
| | - Jacqueline de Souza
- University of São Paulo at College Nursing of Ribeirão Preto, Ribeirão Preto, SP, Brazil
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Santos AGD, Monteiro CFDS, Feitosa CDA, Veloso C, Nogueira LT, Andrade EMLR. Types of non-psychotic mental disorders in adult women who suffered intimate partner violence: an integrative review. Rev Esc Enferm USP 2018; 52:e03328. [PMID: 29846484 DOI: 10.1590/s1980-220x2017030203328] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 12/19/2017] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Identifying the types of non-psychotic mental disorders in adult women who suffered intimate partner violence in the literature. METHOD An integrative review carried out in the MEDLINE, CINAHL, LILACS, Web of Science and SCOPUS databases. RESULTS We selected 19 articles published in international journals in English, with a predominance of cross-sectional study studies (78.9%). The most common types of non-psychotic mental disorders were: depression (73.7%) and post-traumatic stress disorder (52.6%). It was observed that 78.9% of the articles presented a 2C level of evidence. CONCLUSION Studies have shown that adult women who are victims of intimate partner violence mostly suffer from depression and post-traumatic stress disorder, as well as other morbidities; a fact that highlights how devastating violence by an intimate partner can impact on the mental health of those who experience it.
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Affiliation(s)
- Ariane Gomes Dos Santos
- Programa de Pós-Graduação em Enfermagem, Universidade Federal do Piauí, Teresina, PI, Brasil
| | | | | | - Caique Veloso
- Programa de Pós-Graduação em Enfermagem, Universidade Federal do Piauí, Teresina, PI, Brasil
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Natacci L, M Marchioni D, C Goulart A, Nunes MA, B Moreno A, O Cardoso L, Giatti L, B Molina MDC, S Santos I, Brunoni AR, A Lotufo P, M Bensenor I. Omega 3 Consumption and Anxiety Disorders: A Cross-Sectional Analysis of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Nutrients 2018; 10:nu10060663. [PMID: 29882923 PMCID: PMC6024589 DOI: 10.3390/nu10060663] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 05/15/2018] [Accepted: 05/21/2018] [Indexed: 12/20/2022] Open
Abstract
Few studies have evaluated the association between diet and mental disorders, and it has been established that ω-3 (n-3) fatty acids may have a beneficial effect for sufferers of anxiety disorders. This study is part of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)—a population-based cohort study on diet and mental health—and searched for associations between anxiety disorders and consumption of n-3 polyunsaturated fatty acids (PUFA). The study had a cross-sectional design, with a total sample of 12,268 adults. Dietary exposure was measured by a quantitative food-frequency questionnaire, and mental diagnoses were assessed by the Clinical Interview Schedule—Revised Version and diagnosed according to the International Classification of Diseases (ICD-10). Logistic regression models were built using quintiles of n-3, ω 6 (n-6), n-6/n-3 ratio, and PUFA, using the 1st quintile as reference. Anxiety disorders were identified in 15.4% of the sample. After adjusting for sociodemographic variables, cardiovascular risk factors, diet variables, and depression, intakes in the 5th quintile were inversely associated with anxiety disorders for EPA (OR = 0.82, 95% CI = 0.69⁻0.98), DHA (OR = 0.83, 95% CI = 0.69⁻0.98), and DPA (OR = 0.82, 95% CI = 0.69⁻0.98). Participants in the fifth quintile of n-6/n-3 ratio had a positive association with anxiety disorders. Although results suggest a possible protective effect of n-3 fatty acids against anxiety, all associations lost significance after adjustment for multiple comparisons.
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Affiliation(s)
- Lara Natacci
- Postgraduate student, School of Medicine, University of São Paulo (USP), São Paulo SP 05508-000, Brazil.
| | - Dirce M Marchioni
- Department of Nutrition, School of Public health, University of São Paulo (USP), São Paulo SP 01246-904, Brazil.
| | - Alessandra C Goulart
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo (USP), São Paulo SP 05508-000, Brazil.
| | - Maria Angélica Nunes
- Postgraduate Program in Epidemiology, School of Medicine, Federal University of Rio Grande do Sul (UFRS), Porto Alegre RS 90035-003, Brazil.
| | - Arlinda B Moreno
- Department of Epidemiology and Quantitative Methods in Health, National School of Public Health Sérgio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro RJ 90035-003, Brazil.
| | - Letícia O Cardoso
- Department of Epidemiology and Quantitative Methods in Health, National School of Public Health Sérgio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro RJ 90035-003, Brazil.
| | - Luana Giatti
- Postgraduate Program in Public Health; General Hospital, School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte MG 30130-100, Brazil.
| | - Maria Del Carmen B Molina
- Departament of Nutrition, Federal University of Espírito Santo (UFES), Vitória ES 29043-900, Brazil.
| | - Itamar S Santos
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo (USP), São Paulo SP 05508-000, Brazil.
| | - André R Brunoni
- Laboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, University of São Paulo (USP), São Paulo SP 05403-010, Brazil.
| | - Paulo A Lotufo
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo (USP), São Paulo SP 05508-000, Brazil.
| | - Isabela M Bensenor
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo (USP), São Paulo SP 05508-000, Brazil.
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Barbosa ACDS, Pinho RCM, Vasconcelos MMVB, Magalhães BG, Dos Santos MTBR, de França Caldas Júnior A. Association between symptoms of depression and oral health conditions. SPECIAL CARE IN DENTISTRY 2018; 38:65-72. [PMID: 29509287 DOI: 10.1111/scd.12278] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS To investigate the symptoms of depression and oral health status in Brazilian public healthcare system users. MATERIALS AND METHODS Analysis of a cross-sectional study conducted with a sample of 776 individuals aged 15 years or older, in the urban areas of Recife (Brazil), obtained by multistage sampling. Committee on Ethics in Research with Human Beings (CAAE) 0538.0.172.172-11. Depression symptoms were verified by means of Axis II of the Research Diagnostic Criteria in Temporomandibular Disorder. For the socioeconomic level, the economic classification criteria of the Brazilian Association of Research Companies and clinical exam record charts were used to establish variables related to oral health conditions. RESULTS The variables discomfort on occlusion (OR = 1.882 CI = 1.384-2.560), gingival bleeding (OR = 1.384 CI = 1.002-1.912), and self-perception of oral health (OR = 1.549 CI = 1.054-2.277), remained in the regression model. CONCLUSION Discomfort on occlusion, self-perception of oral health, gingival bleeding, sex, and skin color were shown to be associated with the presence of depressive symptoms.
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Affiliation(s)
| | - Roberto Carlos Mourão Pinho
- PostDoc student, Teaching Staff Member, Postgraduate Program in Dentistry, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | | | - Bruno Gama Magalhães
- Assistant teacher, Dental surgeon, Dentistry College of FACIPE, Recife, Pernambuco
| | | | - Arnaldo de França Caldas Júnior
- PostDoc student, Teaching Staff Member, Postgraduate Program in Dentistry, Federal University of Pernambuco, Recife, Pernambuco, Brazil
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Anker E, Bendiksen B, Heir T. Comorbid psychiatric disorders in a clinical sample of adults with ADHD, and associations with education, work and social characteristics: a cross-sectional study. BMJ Open 2018; 8:e019700. [PMID: 29500213 PMCID: PMC5855175 DOI: 10.1136/bmjopen-2017-019700] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES Adults with attention-deficit hyperactive disorder (ADHD) report high rates of comorbid disorders, educational and occupational failure, and family instability. The aim of this study was to examine the prevalence of comorbid psychiatric disorders in a clinical population of adults with ADHD and to examine associations between educational level, work participation, social characteristics and the rates of psychiatric comorbidity. METHODS Out of 796 patients diagnosed with ADHD in a specialised outpatient clinic in Oslo, Norway, 548 (68%) agreed to participate in this cross-sectional study: 277 women and 271 men. ADHD was diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria. Comorbid disorders were diagnosed using the Mini-International Neuropsychiatric Interview. RESULTS In this clinical sample, 53.5% had at least one current comorbid psychiatric disorder. The most prevalent disorders were major depression, substance use disorders and social phobia. Women had more eating disorders than men, whereas men had more alcohol and substance use disorders. Education above high school level (>12 years) and work participation were associated with lower rates of comorbid disorders (adjusted ORs 0.52 and 0.63, respectively). Gender, age, marital status, living with children or living in a city were not associated with comorbidity. CONCLUSIONS Adult ADHD is associated with high rates of comorbid psychiatric disorders, irrespective of gender and age. It appears that higher education and work participation are related to lower probability of comorbidity.
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Affiliation(s)
| | | | - Trond Heir
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Wang XB, Li XL, Zhang Q, Zhang J, Chen HY, Xu WY, Fu YH, Wang QY, Kang J, Hou G. A Survey of Anxiety and Depressive Symptoms in Pulmonary Tuberculosis Patients With and Without Tracheobronchial Tuberculosis. Front Psychiatry 2018; 9:308. [PMID: 30072924 PMCID: PMC6060437 DOI: 10.3389/fpsyt.2018.00308] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 06/20/2018] [Indexed: 12/15/2022] Open
Abstract
Background and Objective: Anxiety/depression and tuberculosis are global public health problems. The incidence of psychiatric morbidities is high among tuberculosis patients. However, little is known about the prevalence of anxiety and depression among Chinese pulmonary tuberculosis (PTB) patients, especially those with tracheobronchial tuberculosis (TBTB). The goal of the present study was to explore the prevalence of and associated factors of anxiety and depressive symptoms among PTB patients with and without TBTB. Methods: A cross-sectional survey of PTB patients from three hospitals in Liaoning, China, was conducted using a structured questionnaire. Depression and anxiety were evaluated by using the Hospital Anxiety and Depression Scale (HADS) and the Patient Health Questionnaire-9 (PHQ-9). Results: According to HADS and PHQ-9, 17.73 and 18.13% of 1252 PTB patients, respectively, had significant depressive symptoms and based on HADS scale, 18.37% had significant anxiety symptoms. Approximately 70% of patients with probable depression also had significant anxiety symptoms, and vice versa, and 69.6% patients with anxiety symptoms were also diagnosed with probable depression in our study population. Dyspnea and TBTB were significantly associated with depressive symptoms. Other depressive symptoms-related factors included age, divorce, abnormal body mass index (BMI), and low income. Patients with lower incomes, symptoms of dyspnea, or a combination of ≥3 clinical symptoms had an increased risk of anxiety symptoms, while patients with occasional or frequent alcohol consumption had a reduced risk of anxiety symptoms. Conclusion: Depressive and anxiety symptoms are common among PTB patients, especially those with TBTB. Screening for depression and anxiety is essential for identifying patients who require further psychosocial assessment and support.
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Affiliation(s)
- Xiao-Bo Wang
- Department of Respiratory Medicine, The First Hospital of China Medical University, Shenyang, China
| | - Xue-Lian Li
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Qing Zhang
- Department of Endoscopy, Shenyang Thoracic Hospital, Shenyang, China
| | - Juan Zhang
- Department of Laboratory, Shenyang Thoracic Hospital, Shenyang, China
| | - Hong-Yan Chen
- Department of Laboratory, Shenyang Thoracic Hospital, Shenyang, China
| | - Wei-Yuan Xu
- Department of Respiratory Medicine, Anshan Central Hospital, Anshan, China
| | - Ying-Hui Fu
- The Fourth Department of Tuberculosis, Shenyang Thoracic Hospital, Shenyang, China
| | - Qiu-Yue Wang
- Department of Respiratory Medicine, The First Hospital of China Medical University, Shenyang, China
| | - Jian Kang
- Department of Respiratory Medicine, The First Hospital of China Medical University, Shenyang, China
| | - Gang Hou
- Department of Respiratory Medicine, The First Hospital of China Medical University, Shenyang, China
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Personal-Level and Group-Level Discrimination and Mental Health: the Role of Skin Color. J Racial Ethn Health Disparities 2017; 5:1033-1041. [PMID: 29270840 DOI: 10.1007/s40615-017-0451-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2017] [Revised: 11/05/2017] [Accepted: 11/08/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE This study investigates the association between personal-level and group-level discrimination and common mental disorders (CMDs) among Afro-Brazilian women, aiming to explore the role of skin color on this association. METHODS This is a cross-sectional study involving 1130 women who were participating in the Social Change, Asthma and Allergy in Latin America (SCAALA) study, whose children were recruited from 24 geographical micro-regions representative of the population without sanitation. Measures of discrimination were defined by: experiences (personal-level) and concern about discrimination (group-level) using the Experiences of Discrimination Scale. Skin color was registered by self-declaration, being classified as white, brown, and black. The association between "self-reported" discrimination and CMDs was evaluated using Poisson regression analysis. RESULTS Prevalence of CMDs was high (38.3%), especially in the group exposed to discriminatory experiences and black women. Experiences and concern about discrimination were positive and significantly associated with mental health, before and after adjustment for potential confounders. The effect of discrimination on CMDs was lower among black women, suggesting the development of other strategies to confront racism. CONCLUSION This study emphasizes the use of both personal- and group-level discrimination measures, as well as skin color, for the evaluation of mental disorders in public health research. Further studies of health consequences of discrimination will require investigation of protective factors for mental disorders in the population suffering discrimination and racism.
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Impact of different approaches of primary care mental health on the prevalence of mental disorders. Prim Health Care Res Dev 2017; 19:256-263. [PMID: 29202891 DOI: 10.1017/s1463423617000743] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
AimTo compare the impact of three different approaches to primary care mental health on the prevalence of mental disorders. BACKGROUND Millions of people suffer from mental disorders. As entry point into the health service, primary healthcare plays an important role in providing mental health prevention and treatment. METHODS Random sample of households in three different areas of the city of Ribeirão Preto (state of São Paulo, Brazil) were selected, and 20 trained medical students conducted interviews using a mental health screening instrument, the Mini-Screening of Mental Disorders, and a socio-demographic datasheet. Primary care mental health was provided in each area through a specific approach. The influence of the area of residence and the socio-demographic variables on the prevalence of mental disorder was explored and analyzed by univariate binary logistic regression and then by a multiple logistic regression model.FindingsA total of 1545 subjects were interviewed. Comparison between the three areas showed a significantly higher number of people with mental disorders in the area covered by the primary care team that did not have physicians with specific primary care mental health training, even when this association was adjusted for the influence of age, education, and socio-economic status.Our results suggest that residing in areas with family physicians with mental health training is associated with a lower prevalence of mental disorders.
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