Mental Disorders in Megacities: Findings from the São Paulo Megacity Mental Health Survey, Brazil
Autor(a) principal: | |
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Data de Publicação: | 2012 |
Outros Autores: | , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNIFESP |
Texto Completo: | https://repositorio.unifesp.br/handle/11600/34625 https://dx.doi.org/10.1371/journal.pone.0031879 |
Resumo: | Background: World population growth is projected to be concentrated in megacities, with increases in social inequality and urbanization-associated stress. São Paulo Metropolitan Area (SPMA) provides a forewarning of the burden of mental disorders in urban settings in developing world. the aim of this study is to estimate prevalence, severity, and treatment of recently active DSM-IV mental disorders. We examined socio-demographic correlates, aspects of urban living such as internal migration, exposure to violence, and neighborhood-level social deprivation with 12-month mental disorders.Methods and Results: A representative cross-sectional household sample of 5,037 adults was interviewed face-to-face using the WHO Composite International Diagnostic Interview (CIDI), to generate diagnoses of DSM-IV mental disorders within 12 months of interview, disorder severity, and treatment. Administrative data on neighborhood social deprivation were gathered. Multiple logistic regression was used to evaluate individual and contextual correlates of disorders, severity, and treatment. Around thirty percent of respondents reported a 12-month disorder, with an even distribution across severity levels. Anxiety disorders were the most common disorders (affecting 19.9%), followed by mood (11%), impulse-control (4.3%), and substance use (3.6%) disorders. Exposure to crime was associated with all four types of disorder. Migrants had low prevalence of all four types compared to stable residents. High urbanicity was associated with impulse-control disorders and high social deprivation with substance use disorders. Vulnerable subgroups were observed: women and migrant men living in most deprived areas. Only one-third of serious cases had received treatment in the previous year.Discussion: Adults living in São Paulo megacity had prevalence of mental disorders at greater levels than similar surveys conducted in other areas of the world. Integration of mental health promotion and care into the rapidly expanding Brazilian primary health system should be strengthened. This strategy might become a model for poorly resourced and highly populated developing countries. |
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Andrade, Laura HelenaWang, Yuan-PangAndreoni, Solange [UNIFESP]Silveira, Camila MagalhaesAlexandrino-Silva, ClovisSiu, Erica RosannaNishimura, RaphaelAnthony, James C.Gattaz, Wagner FaridKessler, Ronald C.Viana, Maria CarmenUniversidade de São Paulo (USP)Universidade Federal de São Paulo (UNIFESP)Univ MichiganMichigan State UnivHarvard Univ2016-01-24T14:17:55Z2016-01-24T14:17:55Z2012-02-14Plos One. San Francisco: Public Library Science, v. 7, n. 2, 11 p., 2012.1932-6203https://repositorio.unifesp.br/handle/11600/34625https://dx.doi.org/10.1371/journal.pone.0031879WOS000302737400054.pdf10.1371/journal.pone.0031879WOS:000302737400054Background: World population growth is projected to be concentrated in megacities, with increases in social inequality and urbanization-associated stress. São Paulo Metropolitan Area (SPMA) provides a forewarning of the burden of mental disorders in urban settings in developing world. the aim of this study is to estimate prevalence, severity, and treatment of recently active DSM-IV mental disorders. We examined socio-demographic correlates, aspects of urban living such as internal migration, exposure to violence, and neighborhood-level social deprivation with 12-month mental disorders.Methods and Results: A representative cross-sectional household sample of 5,037 adults was interviewed face-to-face using the WHO Composite International Diagnostic Interview (CIDI), to generate diagnoses of DSM-IV mental disorders within 12 months of interview, disorder severity, and treatment. Administrative data on neighborhood social deprivation were gathered. Multiple logistic regression was used to evaluate individual and contextual correlates of disorders, severity, and treatment. Around thirty percent of respondents reported a 12-month disorder, with an even distribution across severity levels. Anxiety disorders were the most common disorders (affecting 19.9%), followed by mood (11%), impulse-control (4.3%), and substance use (3.6%) disorders. Exposure to crime was associated with all four types of disorder. Migrants had low prevalence of all four types compared to stable residents. High urbanicity was associated with impulse-control disorders and high social deprivation with substance use disorders. Vulnerable subgroups were observed: women and migrant men living in most deprived areas. Only one-third of serious cases had received treatment in the previous year.Discussion: Adults living in São Paulo megacity had prevalence of mental disorders at greater levels than similar surveys conducted in other areas of the world. Integration of mental health promotion and care into the rapidly expanding Brazilian primary health system should be strengthened. This strategy might become a model for poorly resourced and highly populated developing countries.Secretaria de Segurança Pública of the State of São Paulo, BrazilUnited States National Institutes of Mental HealthJohn D. and Catherine T. MacArthur FoundationPfizer FoundationUS Public Health ServiceFogarty International Center (FIRCA)Pan American Health OrganizationEli LillyCompany FoundationOrtho-McNeil Pharmaceutical, Inc.GlaxoSmithKlineBristol-Myers SquibbShireFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Univ São Paulo, Sch Med, Dept & Inst Psychiat, Sect Psychiat Epidemiol LIM 23, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Prevent Med, São Paulo, BrazilUniv Michigan, Inst Social Res, Ann Arbor, MI USAMichigan State Univ, Coll Human Med, Dept Epidemiol, E Lansing, MI 48824 USAUniv São Paulo, Sch Med, Dept & Inst Psychiat, Lab Neurosci LIM 27, São Paulo, BrazilHarvard Univ, Sch Med, Dept Hlth Care Policy, Boston, MA 02115 USAUniversidade Federal de São Paulo, Dept Prevent Med, São Paulo, BrazilFAPESP: 03/00204-3United States National Institutes of Mental Health: R01MH070884US Public Health Service: R13-MH066849US Public Health Service: R01-MH069864US Public Health Service: R01 DA016558Fogarty International Center (FIRCA): R03-TW006481Web of Science11engPublic Library SciencePlos OneMental Disorders in Megacities: Findings from the São Paulo Megacity Mental Health Survey, Brazilinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESPORIGINALWOS000302737400054.pdfapplication/pdf145489${dspace.ui.url}/bitstream/11600/34625/1/WOS000302737400054.pdfe40a6cc4c8192b09da5985b40ae5d99fMD51open accessTEXTWOS000302737400054.pdf.txtWOS000302737400054.pdf.txtExtracted texttext/plain75274${dspace.ui.url}/bitstream/11600/34625/2/WOS000302737400054.pdf.txtf1cdd7b055af96b43da18103fc785ce3MD52open access11600/346252023-02-15 09:21:21.194open accessoai:repositorio.unifesp.br:11600/34625Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestopendoar:34652023-05-25T12:30:38.012483Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.en.fl_str_mv |
Mental Disorders in Megacities: Findings from the São Paulo Megacity Mental Health Survey, Brazil |
title |
Mental Disorders in Megacities: Findings from the São Paulo Megacity Mental Health Survey, Brazil |
spellingShingle |
Mental Disorders in Megacities: Findings from the São Paulo Megacity Mental Health Survey, Brazil Andrade, Laura Helena |
title_short |
Mental Disorders in Megacities: Findings from the São Paulo Megacity Mental Health Survey, Brazil |
title_full |
Mental Disorders in Megacities: Findings from the São Paulo Megacity Mental Health Survey, Brazil |
title_fullStr |
Mental Disorders in Megacities: Findings from the São Paulo Megacity Mental Health Survey, Brazil |
title_full_unstemmed |
Mental Disorders in Megacities: Findings from the São Paulo Megacity Mental Health Survey, Brazil |
title_sort |
Mental Disorders in Megacities: Findings from the São Paulo Megacity Mental Health Survey, Brazil |
author |
Andrade, Laura Helena |
author_facet |
Andrade, Laura Helena Wang, Yuan-Pang Andreoni, Solange [UNIFESP] Silveira, Camila Magalhaes Alexandrino-Silva, Clovis Siu, Erica Rosanna Nishimura, Raphael Anthony, James C. Gattaz, Wagner Farid Kessler, Ronald C. Viana, Maria Carmen |
author_role |
author |
author2 |
Wang, Yuan-Pang Andreoni, Solange [UNIFESP] Silveira, Camila Magalhaes Alexandrino-Silva, Clovis Siu, Erica Rosanna Nishimura, Raphael Anthony, James C. Gattaz, Wagner Farid Kessler, Ronald C. Viana, Maria Carmen |
author2_role |
author author author author author author author author author author |
dc.contributor.institution.none.fl_str_mv |
Universidade de São Paulo (USP) Universidade Federal de São Paulo (UNIFESP) Univ Michigan Michigan State Univ Harvard Univ |
dc.contributor.author.fl_str_mv |
Andrade, Laura Helena Wang, Yuan-Pang Andreoni, Solange [UNIFESP] Silveira, Camila Magalhaes Alexandrino-Silva, Clovis Siu, Erica Rosanna Nishimura, Raphael Anthony, James C. Gattaz, Wagner Farid Kessler, Ronald C. Viana, Maria Carmen |
description |
Background: World population growth is projected to be concentrated in megacities, with increases in social inequality and urbanization-associated stress. São Paulo Metropolitan Area (SPMA) provides a forewarning of the burden of mental disorders in urban settings in developing world. the aim of this study is to estimate prevalence, severity, and treatment of recently active DSM-IV mental disorders. We examined socio-demographic correlates, aspects of urban living such as internal migration, exposure to violence, and neighborhood-level social deprivation with 12-month mental disorders.Methods and Results: A representative cross-sectional household sample of 5,037 adults was interviewed face-to-face using the WHO Composite International Diagnostic Interview (CIDI), to generate diagnoses of DSM-IV mental disorders within 12 months of interview, disorder severity, and treatment. Administrative data on neighborhood social deprivation were gathered. Multiple logistic regression was used to evaluate individual and contextual correlates of disorders, severity, and treatment. Around thirty percent of respondents reported a 12-month disorder, with an even distribution across severity levels. Anxiety disorders were the most common disorders (affecting 19.9%), followed by mood (11%), impulse-control (4.3%), and substance use (3.6%) disorders. Exposure to crime was associated with all four types of disorder. Migrants had low prevalence of all four types compared to stable residents. High urbanicity was associated with impulse-control disorders and high social deprivation with substance use disorders. Vulnerable subgroups were observed: women and migrant men living in most deprived areas. Only one-third of serious cases had received treatment in the previous year.Discussion: Adults living in São Paulo megacity had prevalence of mental disorders at greater levels than similar surveys conducted in other areas of the world. Integration of mental health promotion and care into the rapidly expanding Brazilian primary health system should be strengthened. This strategy might become a model for poorly resourced and highly populated developing countries. |
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2012 |
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2012-02-14 |
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2016-01-24T14:17:55Z |
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2016-01-24T14:17:55Z |
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Plos One. San Francisco: Public Library Science, v. 7, n. 2, 11 p., 2012. 1932-6203 WOS000302737400054.pdf 10.1371/journal.pone.0031879 WOS:000302737400054 |
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