Mental Disorders in Megacities: Findings from the São Paulo Megacity Mental Health Survey, Brazil

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dc.contributor.authorAndrade, Laura Helena
dc.contributor.authorWang, Yuan-Pang
dc.contributor.authorAndreoni, Solange [UNIFESP]
dc.contributor.authorSilveira, Camila Magalhaes
dc.contributor.authorAlexandrino-Silva, Clovis
dc.contributor.authorSiu, Erica Rosanna
dc.contributor.authorNishimura, Raphael
dc.contributor.authorAnthony, James C.
dc.contributor.authorGattaz, Wagner Farid
dc.contributor.authorKessler, Ronald C.
dc.contributor.authorViana, Maria Carmen
dc.contributor.institutionUniversidade de São Paulo (USP)
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionUniv Michigan
dc.contributor.institutionMichigan State Univ
dc.contributor.institutionHarvard Univ
dc.date.accessioned2016-01-24T14:17:55Z
dc.date.available2016-01-24T14:17:55Z
dc.date.issued2012-02-14
dc.description.abstractBackground: World population growth is projected to be concentrated in megacities, with increases in social inequality and urbanization-associated stress. São Paulo Metropolitan Area (SPMA) provides a forewarning of the burden of mental disorders in urban settings in developing world. the aim of this study is to estimate prevalence, severity, and treatment of recently active DSM-IV mental disorders. We examined socio-demographic correlates, aspects of urban living such as internal migration, exposure to violence, and neighborhood-level social deprivation with 12-month mental disorders.Methods and Results: A representative cross-sectional household sample of 5,037 adults was interviewed face-to-face using the WHO Composite International Diagnostic Interview (CIDI), to generate diagnoses of DSM-IV mental disorders within 12 months of interview, disorder severity, and treatment. Administrative data on neighborhood social deprivation were gathered. Multiple logistic regression was used to evaluate individual and contextual correlates of disorders, severity, and treatment. Around thirty percent of respondents reported a 12-month disorder, with an even distribution across severity levels. Anxiety disorders were the most common disorders (affecting 19.9%), followed by mood (11%), impulse-control (4.3%), and substance use (3.6%) disorders. Exposure to crime was associated with all four types of disorder. Migrants had low prevalence of all four types compared to stable residents. High urbanicity was associated with impulse-control disorders and high social deprivation with substance use disorders. Vulnerable subgroups were observed: women and migrant men living in most deprived areas. Only one-third of serious cases had received treatment in the previous year.Discussion: Adults living in São Paulo megacity had prevalence of mental disorders at greater levels than similar surveys conducted in other areas of the world. Integration of mental health promotion and care into the rapidly expanding Brazilian primary health system should be strengthened. This strategy might become a model for poorly resourced and highly populated developing countries.en
dc.description.affiliationUniv São Paulo, Sch Med, Dept & Inst Psychiat, Sect Psychiat Epidemiol LIM 23, São Paulo, Brazil
dc.description.affiliationUniversidade Federal de São Paulo, Dept Prevent Med, São Paulo, Brazil
dc.description.affiliationUniv Michigan, Inst Social Res, Ann Arbor, MI USA
dc.description.affiliationMichigan State Univ, Coll Human Med, Dept Epidemiol, E Lansing, MI 48824 USA
dc.description.affiliationUniv São Paulo, Sch Med, Dept & Inst Psychiat, Lab Neurosci LIM 27, São Paulo, Brazil
dc.description.affiliationHarvard Univ, Sch Med, Dept Hlth Care Policy, Boston, MA 02115 USA
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Dept Prevent Med, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipSecretaria de Segurança Pública of the State of São Paulo, Brazil
dc.description.sponsorshipUnited States National Institutes of Mental Health
dc.description.sponsorshipJohn D. and Catherine T. MacArthur Foundation
dc.description.sponsorshipPfizer Foundation
dc.description.sponsorshipUS Public Health Service
dc.description.sponsorshipFogarty International Center (FIRCA)
dc.description.sponsorshipPan American Health Organization
dc.description.sponsorshipEli Lilly
dc.description.sponsorshipCompany Foundation
dc.description.sponsorshipOrtho-McNeil Pharmaceutical, Inc.
dc.description.sponsorshipGlaxoSmithKline
dc.description.sponsorshipBristol-Myers Squibb
dc.description.sponsorshipShire
dc.description.sponsorshipFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)pt
dc.description.sponsorshipIDFAPESP: 03/00204-3pt
dc.description.sponsorshipIDUnited States National Institutes of Mental Health: R01MH070884
dc.description.sponsorshipIDUS Public Health Service: R13-MH066849
dc.description.sponsorshipIDUS Public Health Service: R01-MH069864
dc.description.sponsorshipIDUS Public Health Service: R01 DA016558
dc.description.sponsorshipIDFogarty International Center (FIRCA): R03-TW006481
dc.format.extent11
dc.identifierhttps://dx.doi.org/10.1371/journal.pone.0031879
dc.identifier.citationPlos One. San Francisco: Public Library Science, v. 7, n. 2, 11 p., 2012.
dc.identifier.doi10.1371/journal.pone.0031879
dc.identifier.fileWOS000302737400054.pdf
dc.identifier.issn1932-6203
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/34625
dc.identifier.wosWOS:000302737400054
dc.language.isoeng
dc.publisherPublic Library Science
dc.relation.ispartofPlos One
dc.rightsinfo:eu-repo/semantics/openAccess
dc.titleMental Disorders in Megacities: Findings from the São Paulo Megacity Mental Health Survey, Brazilen
dc.typeinfo:eu-repo/semantics/article
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