São Paulo Megacity Mental Health Survey - a population-based epidemiological study of psychiatric morbidity in the São Paulo metropolitan area: aims, design and field implementation

Abstract

The São Paulo Megacity Mental Health Survey is a population-based cross-sectional survey of psychiatric morbidity, assessing a probabilistic sample of household residents in the São Paulo Metropolitan Area, aged 18 years and over. Respondents were selected from a stratified multistage clustered area probability sample of households, covering all 39 municipalities, without replacement. Respondents were assessed using the World Mental Health Survey version of the World Health Organization Composite International Diagnostic Interview (WMH-CIDI), which was translated and adapted into the Brazilian-Portuguese language. Data was collected between May 2005 and April 2007 by trained lay interviewers. The World Mental Health Survey version of the Composite International Diagnostic Interview comprises clinical and non-clinical sections, arranged as Part I and Part II, producing diagnoses according to the Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition, and the International Classification of Diseases - 10th Revision. Mood, anxiety, impulse-control and substance use disorders, and suicide-related behavior, considered core disorders, as well as socio-demographic information, were assessed in all respondents. Non-clinical modules and non-core clinical sections (obsessive-compulsive disorder, post-traumatic stress disorder, gambling, eating disorders, neurasthenia, pre-menstrual disorders, psychotic symptoms and personality traits) were assessed in a sub-sample (2,942 respondents), composed by all respondents with at least one core disorder and a 25% random sample of those who were non-cases. A total of 5,037 individuals were interviewed, with a global response rate of 81.3%. Saliva samples were collected from 1,801 respondents, with DNA extracted stored pending further investigations.

Prevalence of depression morbidity among Brazilian adults: a systematic review and meta-analysis

“…Most of the surveys included persons 18 years old and older. [22][23][24][25][26][27][28][29][36][37][38]40,41,43,44,[50][51][52][55][56][57][58][59][60][61][62][63] Three studies did not primarily aim to assess the prevalence of depression. 30,35,47 Six national studies were included.…”

“…30,35,47 Six national studies were included. [23][24][25][26][27][28][29][30] Nine studies were conducted in the Southeast region, 22,[31][32][33][43][44][45][50][51][52][53][54][55][56][57][58][59][60][61][62][63] eight in the South region, [31][32][33][34][35][36][37][38][39][40][41][42]46 two in the Northeast region [47][48][49] and one in the Mid-West region of Brazil. [31][32][33] Eight studies were conducted i...…”

“…[23][24][25][26][27][28]30,35,45,48,49,53,62,63 To screen for the prevalence of depressive symptoms, nine studies considered self-reported depression, [23][24][25][26][27][28]30,34,46,47,53 and 11 used the following tools: 1) Adult Psychiatric Morbidity Questionnaire (Questioná rio de Morbidade Psiquiá trica de Adultos, QMPA) [31][32][33]48,49 ; 2) Beck Depression Inventory (BDI) 35,62,63 ; 3) Center for Epidemiologic Studies Depression Scale (CES-D) 29 ; 4) Composite International Diagnostic Interview ShortForm (CIDI SF) 54 ; 5) Edinburgh Postnatal Depression Scale (EPDS) 42 ; 6) Patient Health Questionnaire (PHQ-9) 40 ; and 7) Primary Care Evaluation of Mental Disorders (PRIME-MD). 45 The seven studies that screened for major depressive disorder used the following tools: the Composite International Diagnostic Interview (CIDI), 22,43,44,[50][51][52]…”

“…22,43,44,[50][51][52][55][56][57][58][59][60][61] All five studies used the CIDI as a screening tool. The prevalence was higher among women (11.3%; 95%CI 9.4-13.2; I 2 = 81.7%) and lower among men (4.0%; 95%CI 2.8-5.3; I 2 = 76.1%).…”

“…The lifetime prevalence of major depressive disorder was assessed in four studies: three used the CIDI as a screening tool, 43,44,[55][56][57][58][59][60][61] and one used the DSM-IV. 41 Figure 1 Study search, selection, and inclusion flowchart.…”