巴西成年人抑郁和自杀意念的情境危险因素：多层次分析。
Contextual risk factors of depression and suicidal thoughts in Brazilian adults: a multilevel analysis.
机构信息
Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas (UFPel), Pelotas, RS, Brazil.
Faculdade de Odontologia, UFPel, Pelotas, RS, Brazil.
出版信息
Braz J Psychiatry. 2019 Apr 15;41(5):433-436. doi: 10.1590/1516-4446-2018-0315. eCollection 2019.
OBJECTIVE
To evaluate the association between social and health contextual variables, and between major depressive episodes (MDE) and suicidal thoughts in Brazilian adults.
METHODS
This population-based cross-sectional study used data from the 2013 National Health Survey (Pesquisa Nacional de Saúde). The Patient Health Questionnaire was used to evaluate the presence of MDE and suicidal thoughts. We used number of Family Health Strategy teams (FHS) per 20,000 state population, number of Psychosocial Care Centers (Centros de Atenção Psicossocial [CAPS]) per 1,000 state population, gross domestic product (GDP), and Gini index for each Brazilian state as contextual variables. Multilevel logistic regression models were used to calculate OR and the intraclass correlation coefficient (ICC).
RESULTS
Prevalence of MDE and suicidal thoughts was 4.1% (95%CI 3.8-4.4) and 3.8% (95%CI 3.5-4.1), respectively. Multilevel regression models showed an ICC of 1.1% for MDE (95%CI 0.5-2.3) and 1.3% for suicidal thoughts (95%CI 0.6-2.6). Neither GDP, Gini, FHS, or CAPS showed evidence of association with the outcomes.
CONCLUSIONS
In general, contextual variables, within each Brazilian state, do not seem to affect the prevalence of MDE and suicidal thoughts.
目的
评估社会和健康背景变量与巴西成年人中重度抑郁发作（MDE）和自杀意念之间的关系。
方法
本横断面研究基于 2013 年全国健康调查（Pesquisa Nacional de Saúde）的数据。使用患者健康问卷评估 MDE 和自杀意念的存在情况。我们使用每 2 万名州人口的家庭健康战略团队（FHS）数量、每 1000 名州人口的心理社会关怀中心（CAPS）数量、国内生产总值（GDP）和每个巴西州的基尼指数作为背景变量。使用多水平逻辑回归模型计算比值比（OR）和组内相关系数（ICC）。
结果
MDE 和自杀意念的患病率分别为 4.1%（95%CI 3.8-4.4）和 3.8%（95%CI 3.5-4.1）。多水平回归模型显示 MDE 的 ICC 为 1.1%（95%CI 0.5-2.3），自杀意念的 ICC 为 1.3%（95%CI 0.6-2.6）。GDP、基尼系数、FHS 或 CAPS 均未显示与结果有关联的证据。
结论
总体而言，巴西各州内的背景变量似乎不会影响 MDE 和自杀意念的患病率。
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