Confiabilidade diagnóstica dos transtornos mentais da versão para cuidados primários da Classificação Internacional das Doenças

Busnello, Ellis D'a; Tannous, Leila; Gigante, Luciana Petrucci; Ballester, Dinarte; Hidalgo, María Paz Loayza; Silva, Vilma da; Juruena, Mário F.; Dalmolin, Angela; Baldisserotto, Gabriela

doi:10.1590/s0034-89101999000500008

Cited by 5 publications

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“…For anxiety disorders, the increase in prevalence is even more significant, rising from 7% in the 80s [ 40 ] to 21% in 2007 [ 43 ]. Several factors may have contributed to an increase in the identification of cases in the community, both by individuals and by health professionals, such as better-defined diagnostic classifications [ 44 ], campaigns aimed at reducing stigma, and greater access to information about mental illness.…”

Section: Discussionmentioning

confidence: 99%

Psychotropic Drug Use in São Paulo, Brazil – An Epidemiological Survey

et al. 2015

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ObjectiveTo estimate the prevalence of one month psychotropic drug use in São Paulo, Brazil, and to assess the gap treatment between the presence of mental disorders and psychotropic drug users.MethodA probabilistic sample of non-institutionalized individuals from the general population of São Paulo (n = 2336; turnout: 84.5%) who were 15 years or older were interviewed by a trained research staff, applying the Composite International Diagnostic Interview 2.1 (CIDI WHO) (depression, anxiety-phobia, OCD\PTSD, alcoholism sections), and an inventory investigating psychotropic drug use during the 12-month and one-month periods immediately preceding the interview. Logistic models were fitted to investigate associations between psychotropic drug use as well as socio-demographic and clinical variables.ResultsThe one month prevalence of psychotropic drug use in São Paulo was 5.89%, the most commonly used drugs were antidepressants (3.15%) and tranquilizers (2.67%). A higher consumption of psychotropic drugs (overall, antidepressants and tranquilizers) was observed among women (OR:2.42), older individuals (OR:1.04), individuals with higher levels of formal education (1.06), and individuals with a family (OR:2.29) or personal history of mental illness (OR:3.27). The main psychotropic drug prescribers were psychiatrists (41%), followed by general practitioners (30%); 60% of psychotropic drugs were obtained through a government-run dispensing program. Most individuals who obtained a positive diagnosis on the CIDI 2.1 during the previous month were not using psychotropic medication (85%). Among individuals with a diagnosis of moderate to severe depression, 67.5% were not on any pharmacological treatment.ConclusionThere is a change in the type of psychotropic more often used in São Paulo, from benzodiazepines to antidepressants, this event is observed in different cultures. The prevalence of use is similar to other developing countries. Most of the patients presenting a psychiatric illness in the month prior to testing were not receiving any sort of psychiatric medication. This may be explained by a failure to identify cases in primary care, which could be improved (and access to treatment could be facilitated) if professionals received more specialized training in managing cases with mental health problems.

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Section: Discussionmentioning

confidence: 99%

Psychotropic Drug Use in São Paulo, Brazil – An Epidemiological Survey

et al. 2015

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“…The accuracy rates (sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio and accuracy) were evaluated through the software CATMAKER 15 . Concordance between the 2 methods was evaluated through the coefficient of agreement Kappa ( k ) 16 .…”

Section: Methodsmentioning

confidence: 99%

EUS-FNA versus ERCP for tissue diagnosis of suspect malignant biliary strictures: a prospective comparative study

Moura

Matuguma

et al. 2018

Endosc Int Open

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Background and study aims Biliary strictures are frequently a challenging clinical scenario and the anatomopathological diagnosis is essential in the therapeutic management, whether for curative or palliative purposes. The acquisition of specimens is necessary since many benign diseases mimic biliopancreatic neoplasms. Endscopic retrograde cholangiopancreatography (ERCP) is the traditionally used method despite the low sensitivity of biliary brush cytology and forceps biopsy. On the other hand, several studies reported good accuracy rates using endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). The aim of this prospective study was to compare, the accuracy of EUS-FNA and ERCP for tissue sampling of biliary strictures. Patients and methods After performing the sample size calculation, 50 consecutive patients with indeterminate biliary strictures were included to undergo ERCP and EUS on the same sedation.The gold-standard was surgery or 6 months’ follow-up. Evaluation of the diagnostic indices (sensitivity, specificity, positive and negative predictive value, positive and negative likelihood ratio), concordance and adverse events among the methods were performed. Also, subtype analyses of the techniques, anatomical localization and size of the lesion were included. Results The final diagnoses reported in 50 patients were 47 malignant, 1 suspicious and 2 benign lesions. 31 lesions were extraductal and 19 intraductal, 35 were distal and 15 proximal strictures. In the intention-to-treat analysis, the sensitivity and accuracy of EUS-FNA were superior than ERCP tissue sampling (93,8 %, 94 % vs. 60,4 %, 62 %, respectively) ( P = 0.034), with similar adverse events. There was no concordance between the methods and combining both methods improved the sensitivity and accuracy for 97.9 % and 98 %, respectively. In the subtype analyses, the EUS-FNA was superior, with a higher accuracy than ERCP tissue sampling in evaluating extraductal lesions (100 % vs. 54.8 %, P = 0.019) and in those larger than 1.5 cm (95.8 % vs. 61.9 %, P = 0.031), but were similar in evaluating intraductal lesions and lesions smaller than 1.5 cm. There was no significant difference between the methods in the analyzes of proximal, distal and pancreatic lesions. Conclusion EUS-FNA is better than ERCP with brush cytology and intraductal forceps biopsy in diagnosing malignant biliary strictures, mainly in the assessment of extraductal lesions and in those larger than 1.5 cm. Combining ERCP with tissue sampling and EUS-FNA is feasible, the techniques have similar complication rates, and the combination greatly improves diagnostic accuracy.

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“…24 Studies using current psychiatric classifications of somatization confirmed the difficulties involving these diagnoses, concerning both the inter-rater reliability and the suitability of assessment instruments, whose sensitivity to detect somatoform disorders is low. 27,32 3. Prevalence studies [35][36][37][38][39][40][41][42][43][44][45] …”

Section: This Decision Was Taken However With the Purpose Of Providmentioning

confidence: 99%

Somatização na América Latina: uma revisão sobre a classificação de transtornos somatoformes, síndromes funcionais e sintomas sem explicação médica

Tófoli

Andrade

Fortes

2011

Rev. Bras. Psiquiatr.

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Objective: medically unexplained symptoms are common and associated with mental illness in various contexts. Previous studies show that Latin American populations are prone to somatization. Given the reformulation of the International Classification of Diseases towards its ResumoObjetivo: Os sintomas sem explicação médica são frequentes e estão associados a sofrimento mental em vários contextos. Estudos prévios apontam que as populações latino-americanas são propensas à somatização. Diante da reformulação da Classificação Internacional de Doenças para sua 11ª edição, as particularidades dos nativos desta região do mundo devem ser levadas em consideração. O objetivo deste estudo é prover informações sobre somatização na população latinoamericana para a tomada de decisões quanto às categorias diagnósticas ligadas a sintomas sem explicação médica na Classificação Internacional de Doenças-11ª edição. Método: Revisão extensa da produção de 1995 a 2011 sobre somatização em populações de origem latino-americana. Resultados: A análise dos 106 estudos incluídos nesta revisão foi dividida em 15 categorias: revisões sistemáticas, revisões conceituais, prevalências, atenção primária, depressão e ansiedade, fatores de risco, violência, quadros orgânicos, relacionamento com profissionais e o sistema de saúde, etnia, síndromes ligadas à cultura, síndrome da fadiga crônica, fibromialgia, transtorno dismórfico corporal, e conversão e dissociação. Conclusão: Os estudos latino-americanos confirmam a dificuldade na definição categorial de quadros com sintomas sem explicação médica. O suposto "traço somatizador" das culturas latinas pode estar associado mais à expressão cultural e linguística do que a um caráter de natureza étnica, e tais particularidades devem estar na agenda na nova classificação destes fenômenos na Classificação Internacional de Doenças-11ª edição.

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Confiabilidade diagnóstica dos transtornos mentais da versão para cuidados primários da Classificação Internacional das Doenças

Abstract: VOLUME 33 NÚMERO 5 OUTUBRO 1999© Copyright Faculdade de Saúde Pública da USP. Proibida a reprodução mesmo que parcial sem a devida autorização do Editor Científico. Proibida a utilização de matérias para fins comerciais. All rights reserved.

Cited by 5 publications

References 5 publications

Psychotropic Drug Use in São Paulo, Brazil – An Epidemiological Survey

Psychotropic Drug Use in São Paulo, Brazil – An Epidemiological Survey

EUS-FNA versus ERCP for tissue diagnosis of suspect malignant biliary strictures: a prospective comparative study

Somatização na América Latina: uma revisão sobre a classificação de transtornos somatoformes, síndromes funcionais e sintomas sem explicação médica

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