Moscovici Leonardo, de Azevedo-Marques Joao Mazzoncini, Bolsoni Lívia Maria, Rodrigues-Junior Antonio Luiz, Zuardi Antonio Waldo
1Department of Social Medicine,Ribeirão Preto Medical School,University of São Paulo,São Paulo,Brazil.
2Department of Neurosciences and Behavioral Sciences,Ribeirão Preto Medical School,University of São Paulo,São Paulo,Brazil.
Prim Health Care Res Dev. 2018 May;19(3):256-263. doi: 10.1017/S1463423617000743. Epub 2017 Dec 5.
AimTo compare the impact of three different approaches to primary care mental health on the prevalence of mental disorders.
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.
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.
目的 比较三种不同的初级保健心理健康方法对精神障碍患病率的影响。
数百万人患有精神障碍。作为医疗服务的入口,初级医疗保健在提供心理健康预防和治疗方面发挥着重要作用。
在巴西圣保罗州里贝朗普雷图市的三个不同区域随机抽取家庭样本,20名经过培训的医学生使用心理健康筛查工具《精神障碍简易筛查》和社会人口数据表进行访谈。每个区域通过特定方法提供初级保健心理健康服务。通过单变量二元逻辑回归,然后通过多元逻辑回归模型,探讨并分析居住区域和社会人口变量对精神障碍患病率的影响。
共访谈了1545名受试者。三个区域之间的比较显示,在由没有接受过初级保健心理健康专门培训的医生组成的初级保健团队覆盖的区域,患有精神障碍的人数明显更多,即使在对年龄、教育程度和社会经济地位的影响进行调整后也是如此。我们的结果表明,居住在有接受过心理健康培训的家庭医生的区域与较低的精神障碍患病率相关。