A limited number of studies worldwide have investigated the prevalence of HIV, syphilis, and hepatitis B and C infection among psychiatric patients. However, prevalence of these infections in the population with chronic mental illness has not been clearly established. Most of the published papers are from developed countries and have derived from relatively small and non-representative samples. We performed a systematic review of the published literature to identify studies on these infectious diseases within psychiatric populations in Brazil and other developing countries. Overall, prevalence rates varied from 0% to 29% for HIV; 1.6% to 66% for HBV; 0.4% to 38% for HCV; and 1.1% to 7.6% for syphilis. Several risk factors were identified and discussed, although sampling limitations restrict the generalization of study findings. This review highlights the lack of information on the prevalence of sexually transmitted diseases and their associated factors among persons with chronic mental illness and identifies gaps in the knowledge base in both developing and developed countries.

Resumo Introdução: diante da pandemia da COVID-19, torna-se importante rever questões de proteção da saúde dos trabalhadores. Objetivo: discutir as condições de saúde e segurança dos trabalhadores que cuidam de pacientes com COVID-19, sob a perspectiva das informações levantadas por seus representantes de classe profissional e de recomendações institucionais. Métodos: levantamento de informações na literatura científica, em documentos e orientações de entidades oficiais de saúde, em fontes de entidades sindicais e de representação de classes de profissionais de saúde. Discussão: começamos pela descrição das características da infecção pelo SARS-CoV-2 no processo de trabalho em saúde; exemplificamos as iniciativas de organizações representativas dos trabalhadores para o enfrentamento da COVID-19; descrevemos o cenário do trabalho em saúde na pandemia no Brasil; apresentamos o relato das medidas de proteção e de enfrentamento da doença orientadas por entidades e organismos nacionais e internacionais. Finalizamos discutindo que a exposição desses trabalhadores pode levar a outros eventos em saúde, necessitando medidas de adequação em relação a número de profissionais, melhoria na organização e nas condições de trabalho, fornecimento de equipamentos de proteção individual em quantidade e qualidade adequadas e implantação de medidas que propiciem o fortalecimento das equipes para o enfrentamento da COVID-19.

Reliability and validity of a questionnaire on vulnerability to sexually transmitted infections among adults with chronic mental illness -PESSOAS Project Confiabilidade e validade de um questionário sobre vulnerabilidade para infecções sexualmente transmissíveis entre adultos com transtorno mental crônico -Projeto PESSOAS

BackgroundSchizophrenia is associated with significant economic burden. In Brazil, antipsychotic drugs and outpatient and hospital services are provided by the Brazilian National Health System (SUS) for patients with schizophrenia. However, few studies capture the cost of managing these patients within the Brazilian NHS. This is important to appraise different management approaches within universal healthcare systems.ObjectiveOur objective was to use real-world data to describe the costs associated with the treatment of schizophrenia in adults receiving atypical antipsychotics in Brazil from 2000 to 2010.MethodsWe integrated three national databases for adult patients with schizophrenia receiving one or more atypical antipsychotics. We assessed only direct medical costs and the study was conducted from a public-payer perspective. A multivariate log-linear regression model was performed to evaluate associations between costs and clinical and demographic variables.ResultsWe identified 174,310 patients with schizophrenia, with mean ± standard deviation (SD) annual costs of $US1811.92 ± 284.39 per patient. Atypical antipsychotics accounted for 79.7% of total costs, with a mean annual cost per patient of $US1578.74 ± 240.40. Mean annual costs per patient were $US2482.90 ± 302.92 for psychiatric hospitalization and $US862.96 ± 160.18 for outpatient psychiatric care. Olanzapine was used by 47.7% of patients and represented 62.8% of the total costs of atypical antipsychotics. Patients who used clozapine had the highest mean annual cost per patient for outpatient psychiatric care and psychiatric hospitalization.ConclusionsAtypical antipsychotics were responsible for the majority of the schizophrenia treatment costs, and psychiatric hospitalization costs were the highest mean annual cost per patient. Authorities should ensure efficient use of atypical antipsychotics and encourage outpatient psychiatric care over psychiatric hospitalization where possible.Electronic supplementary materialThe online version of this article (10.1007/s40258-018-0408-4) contains supplementary material, which is available to authorized users.

The prevalence of SV in the studied population was high, especially among women. Women have more behavior factors associated with SV and they need protection, especially those in isolation and socially deprived. However, men also suffer SV, usually more often during childhood than adulthood and special attention should be given to lifetime illegal drug use and earlier psychiatric hospitalization. Preventive actions beyond mental health are important, such as social and economic actions to improve the living conditions of PMI.

Hepatitis B is an important comorbidity among psychiatric patients in Brazil. Screening for HBV, effective prevention and intervention strategies, including universal HBV immunization, should be routine practices in these mental health services.

Objective: To assess health-related quality of life and associated factors in patients treated with atypical antipsychotics, as well as to determine utility values using the EuroQol-5D-3L instrument. Methods: A cross-sectional study was conducted at a state-run pharmacy in the Brazilian National Health System. Individuals were included if they were using a single atypical antipsychotic and completed the EuroQol-5D-3L. Sociodemographic, behavioral, and clinical data were collected. The dependent variable was the EuroQol-5D-3L utility score. Associations between the independent variables and the dependent variable were analyzed in a multiple linear regression model. Results: A total of 394 patients were included, and their mean utility score was 0.664±0.232. Patients treated with clozapine had the highest mean score (0.762 [0.202]), followed by olanzapine (0.687 [0.230]), risperidone (0.630 [0.252]), ziprasidone (0.622 [0.234]), and quetiapine (0.620 [0.243]). The following variables were related to higher utility scores: income, employment, clozapine use, no illicit psychoactive substance use, no suicide attempts, and no comorbidities. Conclusion: Evaluating health-related quality of life differences in the available atypical antipsychotics can facilitate the choice of treatment, improve health outcomes, and ensure rational prescriptions.

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