Institute of Collective Health, Federal University of Bahia, Salvador, Brazil.
Institute of Arts, Sciences and Humanities, Federal University of Bahia, Salvador, Brazil.
PLoS One. 2022 Sep 1;17(9):e0267795. doi: 10.1371/journal.pone.0267795. eCollection 2022.
Transgender women (TGW) are one of the most vulnerable groups, including higher prevalence of HIV and mental health disorders, such as anxiety and depression than in the general population. Major Depression Disorder (MDD) is one of the most important mental health conditions due to an increasing trend in prevalence in the general population. This study aims at describing the prevalence of symptoms of MDD (SMDD) and associated factors among TGW in capitals of three States in Northeast Brazil.
TGW n = (864) were selected from the cities of Salvador (n = 166), Recife (n = 350), and Fortaleza (n = 348) using Respondent Driven Sampling methodology. Symptoms of MDD were defined according to the Patient Health Questionnaire-9 scale. Multinomial logistic regression was used to compare those with mild/moderate or moderately severe/severe symptoms of depression with those with no depression, respectively, using complex sample design. Weighted Odds Ratio with 95% confidence interval were estimated.
51.1% of the sample was classified as mild/moderate and 18.9% as moderately severe/severe SMDD. Mild/moderate SMDD was associated with a history of sexual violence (OR = 2.06, 95%CI: 1.15-3.68), history of physical violence (OR = 2.09, 95%CI: 1.20-3.67),) and poor self-rated quality of life (OR = 2.14, 95%CI: 1.31-3.49).). Moderately severe/severe SMDD was associated with history of sexual violence (OR = 3.02, 95%CI: 1.17-7.77), history of physical violence (OR = 4.34, 95% CI:1.88-6.96), poor self-rated quality of life (OR = 3.32, 95%CI:1.804-6.12), lack of current social support (OR = 2.53, 95%IC: 1.31-4.88) and lack of family support in childhood (OR = 2.17, 95%IC 1.16-4.05)).
Our findings strengthens the evidence of a higher prevalence of SMDD among TGW as compared to the general population. Public health policies and actions that target social determinants of risk and protection for MDD among TGW must be urgently implemented.
跨性别女性（TGW）是最脆弱的群体之一，包括比普通人群更高的 HIV 感染率和心理健康障碍，如焦虑和抑郁。重度抑郁症（MDD）是最重要的心理健康问题之一，因为在普通人群中患病率呈上升趋势。本研究旨在描述巴西东北部三个州首府 TGW 中 MDD 症状（SMDD）的流行情况及其相关因素。
采用回应者驱动抽样方法，从萨尔瓦多（n = 166）、累西腓（n = 350）和福塔雷萨（n = 348）三市选取 TGW n = 864 名。根据患者健康问卷-9 量表定义 MDD 症状。采用多变量逻辑回归比较有轻度/中度或中重度/重度抑郁症状与无抑郁症状者，采用复杂样本设计。估计加权比值比及其 95%置信区间。
样本中 51.1%被归类为轻度/中度，18.9%为中重度/重度 SMDD。轻度/中度 SMDD 与性暴力史（OR = 2.06，95%CI：1.15-3.68）、身体暴力史（OR = 2.09，95%CI：1.20-3.67）和较差的自我报告生活质量（OR = 2.14，95%CI：1.31-3.49）相关。中重度/重度 SMDD 与性暴力史（OR = 3.02，95%CI：1.17-7.77）、身体暴力史（OR = 4.34，95%CI：1.88-6.96）、较差的自我报告生活质量（OR = 3.32，95%CI：1.804-6.12）、缺乏当前社会支持（OR = 2.53，95%CI：1.31-4.88）和童年缺乏家庭支持（OR = 2.17，95%CI：1.16-4.05）相关。
我们的研究结果表明，与普通人群相比，TGW 中 SMDD 的患病率更高。必须紧急实施针对 TGW 中 MDD 的风险和保护的社会决定因素的公共卫生政策和行动。
