Abstract
Purpose: To analyze how individual characteristics and the social context are associated with mental distress symptoms in the Brazilian population.Method: A multilevel cross-sectional study with data from the 2013 National Health Survey. There were two dependent variables: (a) decreased vital energy and somatic symptoms, (b) the presence of depressive thoughts. The independent variables were biological characteristics, education and income, habits and lifestyle, and context variables. Bivariate analysis was performed, and Prevalence Ratios calculated in a Poisson Regression (95% CI). A multilevel Poisson Regression was performed to verify the effect of individual and contextual variables.Results: Regarding depressive thoughts, young and middle-aged individuals, low education, women, absence of partner, smokers or former smokers, and absence of health insurance were the categories at highest risk; belonging to classes D-E and living in states with lower expected years of schooling proved to be protective factors. Similar results were found for the second outcome.Conclusions: Symptoms of mental distress were associated with the individual characteristics and contextual aspects of the federation unit. These findings indicate the importance of strengthening psychosocial care aimed at vulnerable groups.
Highlights
Characterized by depressive symptoms, anxiety state, and a set of non-specific somatic complaints (Goldberg and Huxley, 1992), mental distress has been understood as a public health problem and object of discussion among health researchers due to alarming rates, for it has become the main source of disability adjusted life year (DALY) for women aged 15–24 (Senicato et al, 2018)
In 2015, mental disorders accounted for 9.5% of the total DALY, occupying the 3rd and 1st position in the classification of DALY and years lived with disability (YLD) in the world, respectively, with emphasis on depressive and anxiety disorders (Bonadiman et al, 2017)
This is an association study between dependent variables that express the presence of symptoms related to common mental distress and individual and contextual independent variables fitted in a Multilevel Poisson Regression model, where the first level corresponds to individual variables and the second to the contextual variables related to the Federation Unit
Summary
Characterized by depressive symptoms, anxiety state, and a set of non-specific somatic complaints (Goldberg and Huxley, 1992), mental distress has been understood as a public health problem and object of discussion among health researchers due to alarming rates, for it has become the main source of disability adjusted life year (DALY) for women aged 15–24 (Senicato et al, 2018). The worldwide prevalence is 3.6% and Brazil has the highest number of cases among all countries in the world, affecting 9.3% of the population (World Health Organization, 2017a). Common Mental Disorders (CMD) are characterized by depressive symptoms, states of anxiety, irritability, fatigue, insomnia, memory and concentration problems, and somatic complaints (Goldberg and Huxley, 1992). And correct diagnosis of this disorder is essential to avoid physical and psychological damage to individuals and burden to the health system (Alves et al, 2015; Nunes et al, 2016)
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