Almeida-Filho N, Mari J de J, Coutinho E, França J F, Fernandes J, Andreoli S B, Busnello E D
Instituto de Saúde Coletiva at the Federal University of Bahia, Brazil.
Br J Psychiatry. 1997 Dec;171:524-9. doi: 10.1192/bjp.171.6.524.
Psychiatric morbidity studies in developing countries have used diagnostic procedures of low reliability, without a clinical definition of caseness, producing descriptive data with limited application for mental health planning.
A two-stage cross-sectional design (with a sample size of 6476) was conducted to estimate the prevalence of DSM-III psychiatric diagnoses in three metropolitan areas of Brazil (Brasília, São Paulo and Porto Alegre). All subjects were screened for the presence of psychopathology with a 44-item instrument (the QMPA) and a subsample was selected for a psychiatric interview.
Age-adjusted prevalence of cases potentially in need of care ranged from 19% (São Paulo) to 34% (Brasília and Porto Alegre). Anxiety disorders comprised the highest prevalences (up to 18%). Alcoholism yielded the most consistent prevalence levels, around 8% in all sites. Depression showed great variation between areas: from less than 3% (São Paulo and Brasília) to 10% (Porto Alegre).
Overall prevalences were high in comparison with previous studies conducted in Brazil. A female excess of non-psychotic disorders (anxiety, phobias, somatisation and depression) and a male excess for alcoholism were consistently found.
发展中国家的精神病发病率研究采用的诊断程序可靠性较低,且没有病例的临床定义,所产生的描述性数据在心理健康规划中的应用有限。
采用两阶段横断面设计(样本量为6476)来估计巴西三个大都市地区(巴西利亚、圣保罗和阿雷格里港)中符合《精神疾病诊断与统计手册》第三版(DSM-III)精神疾病诊断标准的患病率。所有受试者均使用一份包含44个条目的工具(QMPA)进行精神病理学筛查,并选取一个子样本进行精神科访谈。
经年龄调整后,可能需要护理的病例患病率在19%(圣保罗)至34%(巴西利亚和阿雷格里港)之间。焦虑症的患病率最高(高达18%)。酗酒的患病率最为稳定,在所有地区均约为8%。抑郁症在不同地区差异很大:从不到3%(圣保罗和巴西利亚)到10%(阿雷格里港)。
与此前在巴西开展的研究相比,总体患病率较高。一直发现非精神病性障碍(焦虑症、恐惧症、躯体化障碍和抑郁症)的女性患者多于男性,而酗酒的男性患者多于女性。