Abstract
Mental health problems are common in primary health care, particularly anxiety and depression. This study aims to estimate the prevalence of common mental disorders and their associations with socio-demographic characteristics in primary care in Brazil (Family Health Strategy). It involved a multicenter cross-sectional study with patients from Rio de Janeiro, São Paulo, Fortaleza (Ceará State) and Porto Alegre (Rio Grande do Sul State), assessed using the General Health Questionnaire (GHQ-12) and the Hospital Anxiety and Depression Scale (HAD). The rate of mental disorders in patients from Rio de Janeiro, São Paulo, Fortaleza and Porto Alegre were found to be, respectively, 51.9%, 53.3%, 64.3% and 57.7% with significant differences between Porto Alegre and Fortaleza compared to Rio de Janeiro after adjusting for confounders. Prevalence proportions of mental problems were especially common for females, the unemployed, those with less education and those with lower incomes. In the context of the Brazilian government's moves towards developing primary health care and reorganizing mental health policies it is relevant to consider common mental disorders as a priority alongside other chronic health conditions.
Highlights
Common mental disorders are associated with disability [1,2,3], poor prognosis of comorbid diseases [4,5] and impacts on health care costs and economic productivity [6,7,8]
This study aims to estimate the prevalence of common mental disorders and their associations with socio-demographic characteristics in primary care in Brazil (Family Health Strategy)
The present study found the highest prevalence proportions of “probable anxiety” (37.6%) which is consistent with a recent epidemiological study that found a community prevalence of 19.9% in São Paulo – the highest compared with 23 other countries studied in the same survey 12
Summary
Common mental disorders are associated with disability [1,2,3], poor prognosis of comorbid diseases [4,5] and impacts on health care costs and economic productivity [6,7,8]. A significant proportion of the global health burden is attributable to mental health 9. Recent epidemiological research among adults in the megacity of São Paulo showed a one-year prevalence of 19.9% for anxiety disorders, 11% for mood disorders, 4.3% for impulse-control disorders and 3.6% for substance abuse. These represented some of the highest prevalence estimates among cities around the world 12. It is proposed that the substantial burden of mental disorders can be reduced by integrating mental health into primary care, in places with high levels of inequality and socioeconomic deprivation 14. Each team comprises one doctor and one nurse, two nurse assistants and six community health workers (in some teams there is a dentist)
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