Introduction Alcohol Use Disorders are frequently comorbid with personality disorders. However, the heterogeneity of the prevalence estimates is high, and most data come from high income countries. Our aim is to estimate the prevalence and association between alcohol use outcomes and the three DSM-5 clusters of personality disorders in a representative sample of the São Paulo Metropolitan Area. Materials and methods A representative household sample of 2,942 adults was interviewed using the WHO Composite International Diagnostic Interview and the International Personality Disorder Examination Screening Questionnaire. Lifetime PD diagnoses were multiply imputed, and AUD diagnoses were obtained using DSM-5 criteria. We conducted cross-tabulations and logistic regression to estimate the associations between AUDs and PDs. Results and discussion Our study did not find significant associations of PDs with heavy drinking patterns or mild AUD. Cluster B PD respondents tended to show the highest conditional prevalence estimates of most alcohol use patterns and AUD, including its severity subtypes. When alcohol outcomes were regressed on all PD Clusters simultaneously, with adjustment for sex and age, only cluster B was significantly associated with past-year alcohol use (OR 3.0), regular drinking (OR 3.2), and AUDs (OR 8.5), especially moderate and severe cases of alcohol use disorders (OR 9.7 and 16.6, respectively). These associations between Cluster B PDs and these alcohol outcomes were shown to be independent of other PD Clusters and individuals´ sex and age. Conclusion The main finding of our study is that AUDs are highly comorbid with PDs. The presence of Cluster B PDs significantly increases the odds of alcohol consumption and disorders and of more severe forms of AUDs. Considering the local context of poor treatment provision, more specific prevention and intervention strategies should be directed to this population.
Background Immigrants and refugees have specific mental health needs. Studies of immigrant psychiatric patients in Latin America are scarce. This article presents the profile of patients from an outpatient psychiatric service in Sao Paulo (Brazil) in order to better inform mental health service planning for immigrants and refugees.Methods Exploratory study to characterize demographic and mental health profile of refugees and immigrants attending service from 2003 to 2018. Chi-square tests and logistic regressions were used to examine the association of demographic variables, exposure to violence, and immigrant status with psychiatric diagnosis. Cluster Analysis was used to identify sub-groups within the sample. Results A total of 162 immigrants and refugees referred to the service obtained treatment, being 57·4% men, 59·8% refugees/asylum seekers, 51·9% black, 48·8% single, mean age of 35.9, 64·2% with ten years of education, 57·4% unemployed. Half of the sample (52·5%) were exposed to violence. The most common diagnosis was depression (54·2%) followed by PTSD (16·6%). Around 34% of the participants sought psychiatric care in six months upon arrival. Logistic regressions showed men were had decreased odds to present depression (OR= 0·34). Patients with PTSD were more likely to be refugees (OR= 3·9) and not having university degree (OR= 3·1). In cluster analysis, a cluster of patients with PTSD were almost all black refugee men exposed to violence. Most patients diagnosed with psychotic disorders were also black refugee men.Interpretation Data raises questions regarding sex differences and mental health care access. Refugees in Brazil are mainly black men, what might contribute to the profile found in the present study. Further investigation is needed to better understand treatment adherence and clarify the role of patient-health professional relationship in mental health outcomes.
Background Immigrants and refugees have specific mental health needs. Studies of immigrant/refugee psychiatric patients in Latin America are scarce. This article presents the profile of patients from an outpatient psychiatric service in Sao Paulo (Brazil) and aims to better inform mental health service planning for immigrants and refugees. Methods This was an exploratory study to characterize the sociodemographic and mental health profile of refugees and immigrants attending outpatient psychiatric service from 2003 to 2018. Chi-square tests and logistic regressions were used to examine the association of demographic variables, exposure to violence, and immigrant status with psychiatric diagnosis. Cluster analysis was used to identify subgroups within the sample. Results A total of 162 immigrants and refugees referred to the service obtained treatment. Of these patients, 57.4% were men, 59.8% were refugees/asylum seekers, 51.9% were Black, 48.8% were single, 64.2% had ten years of education, and 57.4% were unemployed; the mean age of the sample was 35.9. Half of the sample (52.5%) was exposed to violence. The most common diagnosis was depression (54.2%), followed by PTSD (16.6%). Approximately 34% of the participants sought psychiatric care within six months of arrival. Logistic regressions showed that men had lower odds of presenting with depression (OR= 0.34). Patients with PTSD were more likely to be refugees (OR= 3.9) and not have a university degree (OR= 3.1). In the cluster analysis, a cluster of patients with PTSD included almost all Black refugee men exposed to violence. Most patients diagnosed with psychotic disorders were also Black refugee men. Conclusion : Immigrants and refugees represent a vulnerable group. The majority of the sample was Black, refugee men, who were also more likely to present with PTSD. Future studies are needed to better understand issues in treatment adherence in relation to socioeconomic characteristics.
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