Objective: To provide a comprehensive picture of mental health problems (MHPs) in Brazilian medical students by documenting their prevalence and association with co-factors. Methods: We systematically searched the MEDLINE/PubMed, SciELO, LILACS, and PsycINFO databases for cross-sectional studies on the prevalence of MHPs among medical students in Brazil published before September 29, 2016. We pooled prevalences using a random-effects meta-analysis, and summarized factors associated with MHP. Results: We included 59 studies in the analysis. For meta-analyses, we identified the summary prevalence of different MHPs, including depression (25 studies, prevalence 30.6%), common mental disorders (13 studies, prevalence 31.5%), burnout (three studies, prevalence 13.1%), problematic alcohol use (three studies, prevalence 32.9%), stress (six studies, prevalence 49.9%), low sleep quality (four studies, prevalence 51.5%), excessive daytime sleepiness (four studies, prevalence 46.1%), and anxiety (six studies, prevalence 32.9%). Signs of lack of motivation, emotional support, and academic overload correlated with MHPs. Conclusion: Several MHPs are highly prevalent among future physicians in Brazil. Evidence-based interventions and psychosocial support are needed to promote mental health among Brazilian medical students.
Context The prevalence of depressive symptoms among medical students has been found to be higher than among other students because of their longer studying time, higher workload and larger financial burden. Despite the availability of reviews examining this, some have focused solely on one country, whereas others used databases containing papers of solely one language; therefore, the results from reviews might not be comprehensive. Against this background, this overview aims to synthesise the results from all the published systematic reviews of depression among medical students, in order to provide a more accurate result. Methods A systematic search was conducted of online databases for published systematic reviews or meta‐analyses examining the prevalence of depressive symptoms among medical students. The findings of individual studies included in these reviews were extracted and then combined with a random‐effects model. Subgroup analysis was conducted by regions. Results A total of 10 studies were selected in this overview, involving 249 primary studies and 162 450 medical students. MEDLINE was the most popular database used in these studies. The overlapping of primary studies in these reviews was appreciably high, except for three studies that focused on specific countries. The overall pooled prevalence was 27.0% (95% CI, 24.7–29.5%). Significant subgroup differences were detected (p < 0.001). The pooled prevalence among studies in the Western Pacific Region was the lowest, 18.9% (95% CI, 11.7–29.0%), whereas that in Africa (40.9%) was the highest (95% CI, 28.8–54.4%). The top five significant factors associated with depressive symptoms were: (i) year of study; (ii) gender; (iii) personal issues; (iv) family relations or issues, and (v) health status. Conclusions Depression affected around a quarter of medical students in general and 40.9% of students in Africa. It is suggested that medical schools and health authorities should introduce preventive measures to curb the high prevalence of depressive symptoms.
Respiratory diseases in children and adolescents: profiling primary care visits in Vitória/ES Objetivo: Identificar as principais causas de atendimento por doenças respiratórias na atenção primária, em Vitória, ES, nos residentes de 0-19 anos, relacionando a gravidade das mesmas com idade e nível socioeconômico, e verificar a variação temporal de frequência desses atendimentos. Métodos: Estudo transversal descritivo dos atendimentos realizados em 2014 nas 30 unidades básicas de saúde do município de Vitória, com dados do sistema de registros eletrônicos Rede Bem Estar. Realizou-se análise descritiva das variáveis sociodemográficas, grupos de diagnóstico e mês de atendimento e regressão logística entre topografia de acometimento do aparelho respiratório e variáveis sociodemográficas. Resultados: Dos 113.252 atendimentos de 0-19 anos, doenças respiratórias constituíram as causas mais frequentes (28.810, 25,43% do total, 40,18% dos atendimentos por doença), destacando-se "Infecções agudas das vias aéreas superiores" (61,35%), "Doenças crônicas das vias aéreas inferiores" (14,60%) e "Outras doenças das vias aéreas superiores" (8,69%). A proporção de atendimentos caiu com a idade e foi maior entre residentes em bairro de menor renda domiciliar média. As vias aéreas superiores foram mais acometidas em todas as faixas etárias, principalmente nas mais avançadas, e nos residentes em bairros de maior renda domiciliar média. Porém, apenas 6% da variância da distribuição segundo topografia de acometimento do aparelho respiratório foi explicada por faixa etária e nível socioeconômico. Observou-se crescimento dos atendimentos nos meses de março a novembro. Conclusões: Doenças respiratórias são agravos de grande impacto na população pediátrica em Vitória. Recomendam-se medidas de prevenção primária e secundária que levem em consideração a multicausalidade envolvida na determinação dessas doenças. www.rbmfc.org.br Resumo ARTIGOS DE PESQUISAS Enfermedades respiratorias en niños y adolescentes: un perfil de asistencia en la atención primaria en Vitória/ESObjective: To identify the main reasons for visiting a primary health care facility among 0-19 year old residents with respiratory diseases, as well as their frequency, and to associate the severity of those diseases with age and socioeconomic status. Methods: A descriptive cross-sectional study was conducted on all visits to any of the 30 basic health units of the city of Vitória, ES in 2014, using the electronic database Rede Bem Estar. A descriptive analysis was carried out on sociodemographic variables, diagnostic groups and the month of these visits, in addition to logistic regression between the topography of the impairment of the respiratory system and sociodemographic variables. Results: Respiratory diseases were the most frequent reason for visiting the primary health care facility among all 113,252 0-19 years old participants included in the study (28,810, corresponding to 25.43% of the total and 40.18% of visits due to illness), particularly "acute upper respiratory in...
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