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巴西圣保罗常见精神障碍患者的就医行为。

Care seeking behavior of people with common mental disorders in São Paulo-Brazil.

作者信息

Dos Santos Gustavo de Brito Venâncio, Goldbaum Moisés, César Chester Luiz Galvão, Gianini Reinaldo José

机构信息

Medical and Health Sciences School-PUCSP, Sorocaba, Brazil.

Department of Preventive Medicine, University of São Paulo, Medicine School, São Paulo, Brazil.

出版信息

Int J Ment Health Syst. 2020 May 24;14:36. doi: 10.1186/s13033-020-00369-4. eCollection 2020.

Abstract

BACKGROUND

Mental health in developing countries is a keen area for improvements. Epidemiological research in this field helps to reinforce information, generate hypothesis and guide police makers. This study intends to analyze patterns of care seeking among cases of common mental disorders (CMD) in São Paulo city in 2015.

METHODS

The data is from the population-based survey ISA-Capital 2015 and the screening for common mental disorders follows the Self-reporting questionnaire (SRQ-20). The study analyses care seeking according to sociodemographic and health conditions.

RESULTS

The prevalence of CMD was 19.7% (95% CI 18.2-21.4%). There was a higher prevalence of CMD among who sought care in last 30 days (25.4%). Among CMD cases, care seeking presented significant different prevalence ratio (PR) for: women (PR 1.13; 95% CI 1.05-1.2); age 60 years or more (PR 1.13; 95% CI 1.05-1.22) and 30-44 years (PR 1.10; 95% CI 1.01-1.2); brown skin (PR 0.92; 95% CI 0.86-0.97); single or divorced (PR 0.93; 95% CI 0.89-0.99); unemployed (PR 1.06; 95% CI 1.01-1.12); last 15 days referred morbidity (PR 1.3; 95% CI 1.2-1.34); physical disability (PR 1.11; 95% CI 1.06-1.18); and chronic disease (PR 1.15; 95% CI 1.07-1.24).

CONCLUSION

Identifying vulnerable groups and developing proper public health actions is important to promote equity accessibility. Analysing care seeking behavior among people with CMD is a strong contribution.

摘要

背景

发展中国家的心理健康是一个亟待改善的关键领域。该领域的流行病学研究有助于加强信息、生成假设并指导政策制定者。本研究旨在分析2015年圣保罗市常见精神障碍(CMD)病例的就医模式。

方法

数据来自基于人群的2015年圣保罗市综合社会调查(ISA-Capital),常见精神障碍的筛查采用自填问卷(SRQ-20)。该研究根据社会人口统计学和健康状况分析就医情况。

结果

CMD的患病率为19.7%(95%置信区间18.2-21.4%)。在过去30天内寻求治疗的人群中CMD患病率更高(25.4%)。在CMD病例中,就医情况在以下方面呈现出显著不同的患病率比(PR):女性(PR 1.13;95%置信区间1.05-1.2);60岁及以上年龄(PR 1.13;95%置信区间1.05-1.22)和30-44岁(PR 1.10;95%置信区间1.01-1.2);棕色皮肤(PR 0.92;95%置信区间0.86-0.97);单身或离异(PR 0.93;95%置信区间0.89-0.99);失业(PR 1.06;95%置信区间1.01-1.12);过去15天有转诊发病情况(PR 1.3;95%置信区间1.2-1.34);身体残疾(PR 1.11;95%置信区间1.06-1.18);以及慢性病(PR 1.15;95%置信区间1.07-1.24)。

结论

识别弱势群体并制定适当的公共卫生行动对于促进公平可及性很重要。分析CMD患者的就医行为是一项有力贡献。

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