Suchergebnisse

BackgroundTo investigate the clinical epidemiological characteristics of a large data set of visits to outpatient children mental health services in Brazil, as well as to identify relevant relationships between age, sex and three common mental disorders in childhood: pervasive developmental disorders, ADHD and mild depressive disorders.
MethodsWe extracted data from a public repository, DATASUS, regarding child outpatient mental health services in Brazil, from 2008 to 2012. We performed an analysis of the number of visits per inhabitant and inferential analyses with logistic regressions for ADHD (F90.0), Pervasive Developmental Disorders (F84.0-F84.9), and Mild Depressive Episode (F32.0) as outcomes, controlling for age, year of the visit, number of new CAPSI stratified by region.
FindingsAttention-deficit hyperactivity disorder (ADHD) was the most common condition identified across the country. The analyses by region showed a high number of visits due to mental retardation in the Northeast and depressive episodes in the South. Regressions showed that older children are less likely to visit outpatient services with a diagnosis of ADHD (F90.0).
ConclusionsOur analysis shows the conditions which cause the most burden to the child psychiatry outpatient centers in Brazil and relevant differences between regions. This information has immediate use for the training of staff and allocation of resources in each region.
For collaborations please contact: Email: jacyra.paiva@fiocruz.brFor collaborations please contact: Email: jacyra.paiva@fiocruz.br

BackgroundAlmost twenty percent of women worldwide experience mental health disorders following childbirth. Despite their importance and consequences, postpartum psychiatric disorders are still under-investigated. In Brazil, studies are restricted to state capitals and are not representative of the country as a whole. Understanding the factors associated with postpartum psychiatric disorders can provide insights for adequate maternal mental health screening. This study was conducted with the objective of evaluating factors associated with postpartum psychiatric disorders in Brazil.
MethodsWe used Authorization of Outpatient Procedure data for women who used community mental health services in Brazil between 2008 and 2012. The dependent variable was the diagnosis of mental disorders and behavioural factors associated with the puerperium (ICD-10 code F53). Age categorized in quartiles and Psychosocial Care Centre (CAPS) coverage were covariates considered for the analysis. To partially neutralize the bias from repeated observations, we used the Proximity Index (PP), created through of geographic information for each visit to the level of the patient's neighbourhood. We used Generalized Additive Models for Location, Scale, and Shape (GAMLSS) with double Poisson distribution.
FindingsWe identified 6,802 records of mental and behavioural disorders associated with the puerperium diagnoses. Among them, 47.6% of the outpatient records were for diagnosis of ICD F53.1, and 32.09% for ICD-10 F53.0, which correspond to severe and mild mental disorders associated with the puerperium, respectively. Diagnosis for ICD-10 F53.0 was higher between the ages of 26 and 30 (10%), while diagnosis for ICD F53.1 was higher between the ages of 31 and 35 (12.7%). For each increment in the maternal age unit and CAPS coverage percentage, there is an increase of 1.01 (p<0.001) in the occurrence of postpartum psychiatric disorders.
ConclusionsOur results showed that increases in maternal age and municipal CAPS coverage heightened the risk of postpartum psychiatric disorders. With regards to severity, we found that diagnosis for ICD F53.0 (mild mental and behavioural disorders associated with the puerperium) was higher among women aged between 26 and 30, while diagnosis for ICD F53.1(severe mental and behavioural disorders associated with the puerperium) was higher among women aged between 31 and 35. Our findings support the need to improve knowledge of maternal mental health and to integrate routine screening into postnatal care settings, for the early identification of women who are at risk, and to apply timely preventive and therapeutic approaches.
For collaborations please contact: Email: flaviajosy1@gmail.com

BackgroundIt is known that the COVID-19 pandemic and social isolation has increased anxiety, depression, and gender-based violence. However, to the best of our knowledge no studies have evaluated differences in the association between anxiety and depression symptomatology with concern about becoming infected with COVID-19, and the differential risk of suffering from gender-based violence among women with a previous mental disorder, and black women.
MethodsWe conducted a cross-sectional study among adults living in Brazil during the COVID-19 lockdown (20th June-30th August 2020). We administered an online questionnaire containing questions on socioeconomic characteristics, risk perception, confinement, health conditions, and gender-based violence. We ran two ordinal logistic regression models. In the first, we considered having a previous mental disorder and sex as the predictors, and concern about becoming infected with COVID-19 as the outcome. In the second model, we considered previous mental disorders and race as the predictors, and gender-based violence as the outcome. Depressive symptomatology and anxiety symptomatology was assessed through PHQ-9 and GAD-7, respectively.
FindingsPeople who declared that they suffered from depression had a 2% less chance of concern about becoming infected with COVID-19, while those with anxiety had an 11% higher chance. Women had 19% more chance of being very concerned about becoming infected with COVID-19, compared to men. Women with previous mental health disorders had a 34% higher chance of suffering from gender-based violence, compared to women who did not declare having a previous mental health disorder. Black women had a 54% higher chance of suffering from gender-based violence during the COVID-19 pandemic, compared to white women.
ConclusionsThis is the first study to demonstrate that black women and those with mental health problems are more likely to suffer from gender- based violence during the pandemic. These findings could be used in the preparation of protection policies focused on women in situations of major vulnerabilities, optimising interventions and enhancing resource allocation for those most in need, especially during pandemics.

The COVID-19 pandemic has challenged researchers and policy makers to identify public safety measures forpreventing the collapse of healthcare systems and reducingdeaths. This narrative review summarizes the available evidence on the impact of social distancing measures on the epidemic and discusses the implementation of these measures in Brazil. Articles on the effect of social distancing on COVID-19 were selected from the PubMed, medRXiv and bioRvix databases. Federal and state legislation was analyzed to summarize the strategies implemented in Brazil. Social distancing measures adopted by the population appear effective, particularly when implemented in conjunction with the isolation of cases and quarantining of contacts. Therefore, social distancing measures, and social protection policies to guarantee the sustainability of these measures, should be implemented. To control COVID-19 in Brazil, it is also crucial that epidemiological monitoring is strengthened at all three levels of the Brazilian National Health System (SUS). This includes evaluating and usingsupplementary indicators to monitor the progression of the pandemic and the effect of the control measures, increasing testing capacity, and making disaggregated notificationsand testing resultstransparentand broadly available.