Fatores relacionados à prevalência de morbidades psiquiátricas menores em mulheres selecionadas em um Centro de Saúde no Rio de Janeiro, Brasil

Abstract

The aim was to investigate factors potentially associated with minor psychiatric disorders, including maternal nutritional status variables. A cohort was studied with 479 women 15-45 years of age. The reduced General Health Questionnaire (GHQ-12 items) was applied at nine months post-partum with the 312 women who had completed follow-up. Minor psychiatric disorder was defined as a GHQ score of > or = 4 points and was treated as the response variable. Statistical analysis used hierarchical multivariate logistic regression models. The prevalence of minor psychiatric morbidity was 54.2% (95%CI: 48.6-59.7). According to the final model, the following variables remained statistically associated with minor psychiatric morbidity: level 1: total family income (1st quartile: OR = 2.71, 95%CI: 1.42-5.19; 2nd quartile: OR = 2.13; 95%CI: 1.13-4.04); level 3: body fat > or = 30% (OR = 1.66; 95%CI: 1.03-2.65). In conclusion, low income and obesity were the only factors potentially associated with minor psychiatric disorders, even after adjusting for confounding variables, while there are few studies relating maternal nutritional status and minor psychiatric morbidity.

Desigualdad socioeconómica y salud mental: revisión de la literatura latinoamericana

“…En la mayoría de los estudios (Tabla 1) se ha observado que en los adultos de países de América Latina el pertenecer a estratos socioeconómicos bajos se asocia con mayor riesgo de: intento de suicidio 38,39 , sintomatología depresiva evaluada mediante escalas psicométricas 40,41,42,43,44 , trastornos mentales comunes (básicamente depresión y ansiedad) evaluados a través de cuestionarios validados contra entrevistas psiquiátricas estandarizadas 45,46,47,48,49,50,51,52,53,54,55,56,57,58,59 y con trastornos mentales evaluados mediante entrevistas diagnósticas (e.g. CIDI) que permiten diferenciar cuadros clínicos específicos como trastornos del estado de ánimo, fobias 60,61,62,63,64,65,66,67 , ansiedad 68,69 , disfunción sexual y déficit cognitivo 70 .…”

“…Los trastornos del estado de áni-mo se han asociado con la baja escolaridad, pero no con los ingresos 64 . En una experiencia, el bajo ingreso -pero no la escolaridad -se relacionó con trastornos mentales comunes 59 . Al analizar la relación de trastornos mentales con escolaridad, ingreso, tipo de ocupación, analfabetismo, condiciones de vivienda y posesión de bienes, sólo se observó relación con los dos primeros 51,52 .…”

“…En una revisión 32 sobre encuestas desarrolladas en países industrializados se identificó que el indicador de la posición social que se asociaba en menos estudios fue la clase social ocupacional, mientras que los indicadores que más se relacionaron fueron la escolaridad, el desempleo y el ingreso. En el caso de América Latina, la escolaridad se ha asociado con síntomas de depresión 43,57 , intento de suicido 40,44 y trastornos mentales del estado de ánimo y ansiedad 62,63,64 y trastornos en general 49,50,51,52,53,54,55,68,69,70 ; otros tres estudios, aunque observaron la misma tendencia, no encontraron diferencias significativas 42,58,59 ; en dos estudios más dicho indicador no se relacionó con sínto-mas de depresión 46,65,66 , y en otras experiencias tampoco se vinculó la escolaridad con ideación e intento de suicido 38,39,73,74 . El desempleo por su parte, se ha relacionado con mayor riesgo de sín-tomas depresivos 43,44,67 , trastornos mentales comunes 49,50 e intento de suicidio 38,40 , aunque en dos estudios dicha variable no aumentó el riesgo de ideación suicida 73,74 .…”

Prevalence of common mental disorders in mothers in the semiarid region of Alagoas and its relationship with nutritional status

“…These authors stated that there was a paucity of studies correlating maternal nutritional status with CMD, and they suggested that further studies should be carried out. 16 The association between MMH and their impact on the nutritional status of children has been identified by some authors in studies conducted in several countries. In the study In a prospective study conducted by the same group in Pakistan, Rahman et al estimated that reducing the prevalence of maternal depression could reduce the growth retardation in children by up to 30%.…”

“…6 In Rio de Janeiro, Brazil, Kac et al found that the frequency of CMD was 54.2% among the mothers of children aged nine months of age. 16 In a literature review on the characteristics of the distribution of mental disorders in the general population in both urban and rural environments, Judd et al pointed out both the importance of and the difficulty in identifying the roles of urban and rural contexts as risk factors for mental disorders. 17 In the opinion of these authors, the most important issue would be to identify which topics were specific or more important in the rural setting compared with the urban environment.…”