Navegando por Palavras-chave "Mental Disorders"
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- ItemAcesso aberto (Open Access)Accuracy of the Composite International Diagnostic Interview (CIDI 2.1) for diagnosis of post-traumatic stress disorder according to DSM-IV criteria(Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, 2012-07-01) Quintana, Maria Inês [UNIFESP]; Mari, Jair de Jesus [UNIFESP]; Ribeiro, Wagner Silva [UNIFESP]; Jorge, Miguel Roberto [UNIFESP]; Andreoli, Sergio Baxter [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)The objective was to study the accuracy of the post-traumatic stress disorder (PTSD) section of the Composite International Diagnostic Interview (CIDI 2.1) DSM-IV diagnosis, using the Structured Clinical Interview (SCID) as gold standard, and compare the ICD-10 and DSM IV classifications for PTSD. The CIDI was applied by trained lay interviewers and the SCID by a psychologist. The subjects were selected from a community and an outpatient program. A total of 67 subjects completed both assessments. Kappa coefficients for the ICD-10 and the DSM IV compared to the SCID diagnosis were 0.67 and 0.46 respectively. Validity for the DSM IV diagnosis was: sensitivity (51.5%), specificity (94.1%), positive predictive value (9.5%), negative predictive value (66.7%), misclassification rate (26.9%). The CIDI 2.1 demonstrated low validity coefficients for the diagnosis of PTSD using DSM IV criteria when compared to the SCID. The main source of discordance in this study was found to be the high probability of false-negative cases with regards to distress and impairment as well as to avoidance symptoms.
- ItemAcesso aberto (Open Access)Brazilian multicentre study of common mental disorders in primary care: rates and related social and demographic factors(Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, 2014-03-01) Gonçalves, Daniel Almeida [UNIFESP]; Mari, Jair de Jesus [UNIFESP]; Bower, Peter; Gask, Linda; Dowrick, Christopher; Tófoli, Luis Fernando; Campos, Monica; Portugal, Flávia Batista; Ballester, Dinarte; Fortes, Sandra; Universidade Federal de São Paulo (UNIFESP); University of Manchester Manchester Academic Health Science Centre; University of Liverpool Institute of Psychology, Health and Society; Universidade Estadual de Campinas (UNICAMP); Fundação Oswaldo Cruz Escola Nacional de Saúde Pública Sergio Arouca; Universidade do Vale do Rio dos Sinos; Universidade do Estado do Rio de Janeiro Faculdade de Ciências MédicasMental health problems are common in primary health care, particularly anxiety and depression. This study aims to estimate the prevalence of common mental disorders and their associations with socio-demographic characteristics in primary care in Brazil (Family Health Strategy). It involved a multicenter cross-sectional study with patients from Rio de Janeiro, São Paulo, Fortaleza (Ceará State) and Porto Alegre (Rio Grande do Sul State), assessed using the General Health Questionnaire (GHQ-12) and the Hospital Anxiety and Depression Scale (HAD). The rate of mental disorders in patients from Rio de Janeiro, São Paulo, Fortaleza and Porto Alegre were found to be, respectively, 51.9%, 53.3%, 64.3% and 57.7% with significant differences between Porto Alegre and Fortaleza compared to Rio de Janeiro after adjusting for confounders. Prevalence proportions of mental problems were especially common for females, the unemployed, those with less education and those with lower incomes. In the context of the Brazilian government's moves towards developing primary health care and reorganizing mental health policies it is relevant to consider common mental disorders as a priority alongside other chronic health conditions.
- ItemAcesso aberto (Open Access)Confiabilidade de instrumentos diagnósticos: estudo do inventário de sintomas psiquiátricos do DSM-III aplicado em amostra populacional(Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, 2001-12-01) Andreoli, Sergio Baxter [UNIFESP]; Blay, Sergio Luis [UNIFESP]; Almeida Filho, Naomar de; Mari, Jair de Jesus [UNIFESP]; Miranda, Cláudio Torres de [UNIFESP]; Coutinho, Evandro da Silva Freire; França, Josimar; Busnello, Ellis D'arrigo; Universidade Federal de São Paulo (UNIFESP); Universidade Federal da Bahia Instituto de Saúde Coletiva; Fundação Oswaldo Cruz Departamento de Epidemiologia e Métodos Quantitativos em Saúde; Universidade de Brasília Departamento de Clínica Médica; Universidade Federal do Rio Grande do Sul Faculdade de MedicinaThis study focused on the reliability of the DSM-III inventory of psychiatric symptoms in representative general population samples in three Brazilian cities. Reliability was assessed through two different designs: inter-rater reliability and internal consistency. Diagnosis of lifetime (k = 0.46) and same-year generalized anxiety (k = 1.00), lifetime depression (k = 0.77), and lifetime alcohol abuse and dependence (k = 1.00) was consistently reliable in the two methods. Lifetime diagnosis of agoraphobia (k = 1.00), simple phobia (k = 0.77), non-schizophrenic psychosis (k = 1.00), and psychological factors affecting physical health (1.00) showed excellent reliability as measured by the kappa coefficient. The main reliability problem in general population studies is the low prevalence of certain diagnoses, resulting in small variability in positive answers and hindering kappa estimation. Therefore it was only possible to examine 11 of 39 diagnoses in the inventory. We recommend test and re-test methods and a short time interval between interviews to decrease the errors due to such variations.
- ItemAcesso aberto (Open Access)Early intervention in psychosis: a map of clinical and research initiatives in Latin America(Associação Brasileira de Psiquiatria - ABP, 2011-10-01) Brietzke, Elisa [UNIFESP]; Gadelha, Ary [UNIFESP]; Dias, Alvaro Machado [UNIFESP]; Mansur, Rodrigo Barbachan [UNIFESP]; Bressan, Rodrigo Affonseca [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: This article aims to review Latin America's early intervention services in psychosis and to shed light into their challenges and particularities. METHOD: An internet-based search comprising medical societies' websites, published articles, and major universities' websites was conducted and the results were critically discussed. RESULTS: Latin American countries are profoundly deficient in specialized early intervention services. Our search found seven target services, four of which are based in urban areas of Brazil, inside tertiary hospitals or universities. Among the initiatives advanced by these centers, there are partnerships with the public educational system and other community-based efforts toward knowledge transfer. On the other hand, several challenges remain to be overcome, especially in relation to their expansion, which is necessary to match the existing demand.
- ItemAcesso aberto (Open Access)The mental health of Korean immigrants in São Paulo, Brazil(Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, 2009-04-01) Kang, Sam [UNIFESP]; Razzouk, Denise [UNIFESP]; Mari, Jair de Jesus [UNIFESP]; Shirakawa, Itiro [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)This study investigated the frequency of lifetime mental disorders among Korean immigrants in the city of São Paulo, Brazil. Snowball sampling with multiple focuses was used to recruit Korean immigrants older than 18 years and living in São Paulo. A total of 324 Korean immigrants were selected and their mental status was evaluated using a structured interview, namely the Portuguese or the Korean version of the Composite International Diagnostic Interview 2.1. The diagnoses of mental disorders were made according to the ICD-10. The frequency of any lifetime psychiatric disorder was 41.9%. The frequencies of main disorders were: anxiety disorder, 13% (post-traumatic stress disorder, 9.6%); mood disorder, 8.6%; somatoform disorders, 7.4%; dissociative disorder, 4.9%; psychotic disorder, 4.3%; eating disorder, 0.6%; any substance (tobacco, alcohol, drugs) use disorder, 23.1%. The frequency of any psychiatric disorder except alcohol and tobacco use disorders was 26.2%. Korean immigrants have more psychiatric disorders than the Korean population in Korea, particularly post-traumatic stress disorder, and almost the same rate as the Brazilian population. Mental health authorities should promote a healthier integration and the development of culturally sensitive mental health programs for Korean immigrants.
- ItemSomente MetadadadosThe mental health of Korean immigrants in Sao Paulo, Brazil(Cadernos Saude Publica, 2009-04-01) Kang, Sam [UNIFESP]; Razzouk, Denise [UNIFESP]; Mari, Jair Jesus de [UNIFESP]; Shirakawa, Itiro [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)This study investigated the frequency of lifetime mental disorders among Korean immigrants in the city of Sao Paulo, Brazil. Snowball sampling with multiple focuses was used to recruit Korean immigrants older than 18 years and living in Sao Paulo. A total of 324 Korean immigrants were selected and their mental status was evaluated using a structured interview, namely the Portuguese or the Korean version of the Composite International Diagnostic Interview 2.1. The diagnoses of mental disorders were made according to the ICD-10. The frequency of any lifetime psychiatric disorder was 41.9%. The frequencies of main disorders were: anxiety disorder, 13% (post-traumatic stress disorder, 9.6%); mood disorder, 8.6%; somatoform disorders, 7.4%; dissociative disorder, 4.9%; psychotic disorder, 4.3%; eating disorder, 0.6%; any substance ( tobacco, alcohol, drugs) use disorder, 23.1%. The frequency of any psychiatric disorder except alcohol and tobacco use disorders was 26.2%. Korean immigrants have more psychiatric disorders than the Korean population in Korea, particularly post-traumatic stress disorder, and almost the same rate as the Brazilian population. Mental health authorities should promote a healthier integration and the development of culturally sensitive mental health programs for Korean immigrants.
- ItemSomente MetadadadosPercepção Dos Indivíduos Com Transtornos Mentais Sobre O Estigma Social Que Recebem(Universidade Federal de São Paulo (UNIFESP), 2017-04-27) Franco, Talita Cristina Marques [UNIFESP]; Marcolan, Joao Fernando [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Prejudice and stigma directed to individuals with mental disorders bring serious harm and damage to their lives, for this as a general objective, this research analyzed the perception of these individuals on the prejudice and stigma that victimize them. As specific objectives were analyzed the factors that lead society to such practices, even in the face of many advances in concepts and was identified the psychic suffering generated by prejudice and stigma, as well as the way these individuals faced the situation. This research was carried out in Álvares Machado, São Paulo State, in the only Basic Health Unit to perform psychiatric care. Twenty-one participants were interviewed, nineteen women and two men, who were between the ages of eighteen and seventy years old, all in treatment processes. The research used the qualitative approach and a semi-structured questionnaire was used, with guiding questions to evaluate the participants' perception. Data analysis was performed based on the Bardin content analysis method. The research was authorized by the Health department of Álvares Machado, São Paulo State and by the Standing Committee on Research Ethics involving Human Subjects (CEP). It was verified that lack of knowledge about the mental disorder is the main cause for the prejudice, coming from the social, professional, religious, family and even the professionals responsible for the treatment, a fact that damages the process of the psychopathological situation, causing these Individuals feel inferior, incapable and ashamed of themselves, culminating all this with exclusion. The data also point to the suffering of the family, due to the lack of material resources or preparation to live with the family member with mental disorder, but on the other hand, showed that the family support to some of the individuals was not lacking. All the participants faced the situation in the hope of alleviating suffering; sometimes this confrontation was due to the isolation, crafts, walks and attendance in religious settings. The suffering caused by family, social, religious, scholastic, professional and in the treatment environment associated to problems caused by hospitalizations and social exclusion interfered in the treatment and aggravated the psychopathological situation. Society, in its prejudiced way, isolates individuals with mental disorders, preventing them from exercising their basic rights as citizens, and has the view that they are antisocial, violent and dangerous, as seen centuries ago. The changes arising from the Psychiatric Reform in Brazil have not yet had the desired effects, specifically regarding the change of mentalities about madness and insanity in the social context. Research has proven that prejudice and stigma-targeting individuals with mental disorders is a reality and cause more suffering to these individuals.
- ItemSomente MetadadadosPerfis de usuários de um Centro de Atenção Picossocial do Programa de Saúde Mental do município de Santos(Universidade Federal de São Paulo (UNIFESP), 2021) Ichikawa, Monica Atsuko [UNIFESP]; Oliveira-Monteiro, Nancy Ramacciotti de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)The First National Mental Health Conference of Brazil took place in Rio de Janeiro in 1978, bringing criticism to the mental health services of that time. The city of Santos (State of São Paulo), where the largest port in Latin America is located, became an example and a milestone in the Brazilian psychiatric reform process after an intervention in a psychiatric hospital in 1989, with the implementation of alternative proposals, like a network of substitutive care to the asylum. In the 1990s, the Psychosocial Care Centers (PCC) emerged in Brazil, the main strategy for the transformation of the asylums model of mental health care and to guarantee users' rights. Of a quantitative nature, this research aims to verify the characteristics of users of a PCC in São Paulo, from the study of medical records (which are not computerized so far). A total of 1624 medical records were surveyed for the period 2015 to 2019, systematized by gender andage group. From that, in a sample of 836 records were systematized the variables profession, education, marital status, neighborhood where they live, main complaints, diagnoses and past history of mental health condition. The data were submitted to descriptive statistical analysis. Descriptive results indicated more frequent attendances in women (62.1%) and 40 types of disorders diagnosed, the most recurrent being: Depressive Disorder (36.18%), Anxiety Disorder (19.59%), Bipolar Affective Disorder (9.86%), Schizophrenia (6.73%) and Personality Disorder (4.09%). In users, there was a predominance of the age group of 40-60 years and medium level of education. The results found may contribute to regional and contemporary estimates regarding the mental health of Brazilians, especially with regard to residents of urban areas in medium-sized cities.
- ItemSomente MetadadadosTranstorno mental comum e sintoma depressivo perinatal no estudo Mina-Brasil: ocorrência e fatores associados(Universidade Federal de São Paulo (UNIFESP), 2020-01-30) Silva, Bruno Pereira Da [UNIFESP]; Gabrielloni, Maria Cristina [UNIFESP]; Universidade Federal de São PauloObjective – This study aims to investigate the factors associated with the occurrence of common mental disorder (CMD) during pregnancy and perinatal depressive symptoms in women assisted by primary health care in Cruzeiro do Sul, Acre. Method - This is a prospective cohort study, nested with MINA-Brazil Study (Maternal Health and Infant Nutrition in Acre), conducted in 5 moments, two clinical evaluations during pregnancy, between the 16th-20th and 24th-28th. gestational week, and three evaluations at 3, 6 and 12 months postpartum, respectively. The first gestational assessment as the baseline (n=588) and the last postnatal assessment as the last observation (n=345). Pregnancy CMD was evaluated using the Self-Reported Questionnaire (SRQ-20), with a score ≥8 for positive cases, and postnatal depressive symptoms evaluated with the Edinburgh Postnatal Depression Scale (EPDS) assuming ≥10 score for positivity. Ordinal logistic regression was used to estimate the association between exposure and outcome and results with p<0.05 were considered significant. Results - The prevalence of CMD was 36.2% (95% CI 32.1-40.4) in the first evaluation and 24.5% (95% CI 20.6-28.6) in the second. When considering the pregnant women who participated in the two evaluations, a cumulative incidence of 9.2% (95% CI 6.1-13.1) and a persistence of CMD of 50.3% (95% CI 42.5-58.1) were observed. The frequencies of persistent CMD were expressive among pregnant women who received family allowance program (52.9%), with education between 0-9 years (60.9%), who do not live with a partner (56.1%), had ≤2 children (57.4%) and smoked during pregnancy (72.7%). Factors associated with the occurrence of CMD in the first and second gestational assessments, were low maternal education (OR 1.74; 95% CI 1.05-2.89) (OR 1.87; 95% CI 1.00-3,48) and alcohol consumption during pregnancy (OR 2.17; 95% CI 1.10-4.27) (OR 2.90; 95% CI 1.02-8.26) respectively, The occurrence of CMD was associated with unplanned pregnancy (OR 1.52; 95% CI 1.04-2.23) only at the first assessment and head of the family (OR 1.96; 95% CI 1.05-3.65) ) and have ≤2 children (OR 1.82; 95% CI 0.97-3.44) only in the second. The prevalence of postnatal depressive symptoms was 22.6% (95% CI 18.6-27.1) at 3 months, 20.9% (95% CI 16.7-25.7) at 6 months and 20, 6% (95% CI 16.4-25.2) at 12 months postnatal. An association was found between the occurrence of CMD eventually during pregnancy and the postnatal depressive symptom (OR 5.6; 95 % CI 5.50-12-60). Conclusion - High prevalence and persistence of CMD were found during pregnancy. The factors associated with the occurrence of CMD, in the first evaluation and in the second clinical evaluation, were low maternal education and unplanned pregnancy. Alcohol consumption in the first evaluation, being the head of the family at some point. The prevalence of postpartum depressive symptoms is within the values estimated in the literature and remains an important alert for women in low- and middle- income countries. The risk factors for the postpartum depressive symptom were belonging to the first quintile of goods index and alcohol consumption in the first assessment. And, a strong association between the postpartum depressive symptom and the occurrence of CMD at some point during pregnancy (OR 5.6; 95% CI 5.50-12.60). Final considerations - These results highlight the importance of knowing maternal perinatal mental health, with an emphasis on the necessity for screening for such disorders since the first prenatal consultation. They demand special attention from researchers and health professionals, making research necessary to determine paths for professional training and establish care protocols in Brazilian actuality.