Common mental disorders in Petrópolis-RJ: a challenge to integrate mental health into primary care strategies

Abstract

OBJECTIVE: Common mental disorders are present in more than 50% of patients attending primary care clinics. The main objectives of this study were to detect whether there is any special group of patients within the Family Health Strategy that should be considered to be in greater risk for common mental disorders and to recommend alternative interventions to aid these patients. METHOD: In 2002, a cross-sectional study on common mental disorders seen at Family Health Strategy centers was conducted in Petrópolis, State of Rio de Janeiro. RESULTS: Common mental disorders were associated with women (OR = 2.90; 95% CI 1.82-4.32), younger than 45 years of age (OR = 1.43; 95% CI 1.02-2.01), with a monthly per capita family income of less than US$40.00 (OR = 1.68; 95% CI 1.20-2.39), and without a partner (OR = 1.71; 95% CI 1.22-2.39). Illiteracy was associated with common mental disorders among patients who were not extremely poor. Social support networks such as going often to church (OR = 0.62; 95% CI 0.43-0.89); participating in artistic and sporting activities (OR = 0.42; 95% CI 0.26-0.70) and having at least four trusted relatives or friends (OR = 0.53; 95% CI 0.31-0.91) was inversely associated with common mental disorders. DISCUSSION: Poor women with little social support represent a special group at risk for common mental disorders in the primary care setting. Some countries have developed special interventions to treat patients with common mental disorders in primary care. CONCLUSION: Mental health care programs could include evidence-based psychosocial interventions to assist women in overcoming the vicious circle of poverty and dealing with their mental disorders.

Social support network, mental health and quality of life: a cross-sectional study in primary care

“…Analyzing Models 2, 3 and 4, CMD5 was the mental health variable that presented the highest β. CMD5 is characterized by non-specified and self-perceived suffering, which may present at the health service in the form of unexplainable medical complaints 6,36 . According to Tófoli et al 37 , unexplainable medical complaints expressed as diffuse physical symptoms, such as insomnia and fatigue, are generally associated with anxiety and depression syndromes, are quite common in Latin populations, and considered as a cultural representation of emotional distress 34 .…”

“…This issue points to the need for training primary care professionals in how to properly deal with emotional distress. Such training should address diagnosis, treatment and psychosocial interventions 6 .…”

“…The study conducted in Family Health Units in the city of Petrópolis, Rio de Janeiro State, Brazil, is an example of this. The study showed that going regularly to church, participating in sports/artistic activities and having at least four members in one's family on whom one can count is associated with a lower presence of common mental disorder 6 .…”

Prevalência de transtorno mental comum na atenção primária

“…(2) In Brazil, the prevalence varies between 28.7 and 50% and is considered by specialists to be high, especially among women and elderly people. (5)(6)(7)(8) This information demonstrates the importance of tracking actions for possible cases of common mental disorder within a community, particularly in the primary health care and family health programs. (7) Among the instruments used for its identification is the Self Reporting Questionnaire 20 (SRQ-20), because of its psychometric features in the breakdown of possible cases of common mental disorder within the community, as well as its capacity to identify emotional disorders and needs in mental health.…”

Common Mental Disorders: socio-demographic and pharmacotherapy profile

“…Research addressing CMDs in Brazil reveals prevalent rates that vary from 17% to 35% (4) , and even reach 50% (5) . In addition to a high prevalence in the population and the potential costs related to CMDs, some studies also report an association between CMDs and the use of medication and chronic comorbidities, such as high blood pressure, diabetes, and thyroid diseases (4,6) .…”