Departamento de Medicina Social, Faculdade de Medicina de Ribeirão Preto (FMRP), Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil.
Departamento de Neurociências e Ciências do Comportamento, FMRP, USP, Ribeirão Preto, SP, Brazil.
Braz J Psychiatry. 2020 Aug;42(4):360-366. doi: 10.1590/1516-4446-2019-0659. Epub 2020 Apr 3.
To investigate associations between the percentage and severity of mental disorders (MD) and three different primary health care (PHC) strategies in Brazil: traditional care (TC), the Family Health Strategy (FHS), and FHS with shared mental health care (FHS+SC).
Random samples were selected from three different areas of a Brazilian city. Each area was served by a different PHC strategy (TC, FHS, or FHS+SC). Five mental health professionals, blinded to the type of PHC strategy delivered in each area, conducted interviews using the Mini International Neuropsychiatric Interview (MINI) and other specific instruments to assess the prevalence and severity of MD.
530 subjects were interviewed. The TC strategy was significantly associated with a higher percentage of MD when compared to FHS and FHS+SC. These results were not affected by adjustment for sociodemographic variables. The difference in prevalence of MD between the two FHS areas (with and without SC) was not statistically significant. No significant differences in MD severity were observed across the three PHC strategies.
Areas covered by FHS showed a lower percentage of MD than those covered by TC. Presence of SC did not influence the prevalence of MD, suggesting that mental-health training of FHS teams may have minimized the influence of SC.
探讨在巴西，三种不同的初级卫生保健（PHC）策略（传统保健（TC）、家庭健康策略（FHS）和 FHS 与共享心理健康保健（FHS+SC））与精神障碍（MD）的百分比和严重程度之间的关联。
从巴西一个城市的三个不同区域中随机抽取样本。每个区域都由不同的 PHC 策略（TC、FHS 或 FHS+SC）提供服务。五位心理健康专业人员在不知道每个区域提供的 PHC 策略类型的情况下，使用 Mini International Neuropsychiatric Interview（MINI）和其他特定工具进行访谈，以评估 MD 的患病率和严重程度。
对 530 名受访者进行了访谈。与 FHS 和 FHS+SC 相比，TC 策略与 MD 的百分比显著相关。这些结果不受社会人口统计学变量调整的影响。两个 FHS 区域（有和没有 SC）之间 MD 患病率的差异无统计学意义。在三种 PHC 策略中，MD 的严重程度没有观察到显著差异。
FHS 覆盖的区域 MD 的比例低于 TC 覆盖的区域。SC 的存在并未影响 MD 的患病率，这表明 FHS 团队的心理健康培训可能已经将 SC 的影响降到了最低。
