Prevalence and trends of mental disorders requiring inpatient care in the city of Porto Alegre: a citywide study including all inpatient admissions due to mental disorders in the public system from 2013-2017.

Giovanni Abrahão Salum ,João Ricardo Sato,Eduardo Osório,Lucas Spanemberg,Tatiana Breyer,Márcio Rodrigues,Erno Harzheim,Natan Katz,Thiago Frank,Jorge Osório,Sara Evans‐Lacko ,Sara Jane Escouto Dos Santos ,Fernanda Lúcia Capitanio Baeza ,Paulo Ricardo Dos Santos,Pablo De Lannoy Stürmer ,Gabriel Da Silva Mazzini ,Cláudia Rodrigues,Adriani Oliveira Galão ,Loiva Dos Santos Leite ,Giordana De Cássia Pinheiro Da Motta ,Ângela Maria Grando Machado,Eliana Da Silva,Kelma Nunes Soares,Diane Moreira Do Nascimento ,Silvia Bassani Schuch ,Christiane Nunes,Juliana Nunes Pfeil

doi:10.1590/2237-6089-2018-0115

Abstract

To investigate the 5-year prevalence of patients admitted to public inpatient care units due to a mental disorder, stratifying them by age group and diagnosis, and to assess trends of admissions over this time period in Porto Alegre. All admissions to the public mental health care system regulated by the city-owned electronic system Administração Geral dos Hospitais (AGHOS) were included in the analysis. The total population size was obtained by estimations of Fundação de Economia e Estatística (FEE). General information about 5-year prevalence of inpatient admissions, time-series trends e prevalence by age groups and diagnosis were presented. There were 32,608 admissions over the 5-year period analyzed. The overall prevalence of patients was 1.62% among the total population, 0.01% among children, 1.12% among adolescents, 2.28% among adults and 0.93% among the elderly. The most common diagnosis was drug-related, followed by mood, alcohol-related and psychotic disorders. There was a linear trend showing an increase in the number of admissions from 2013 to the midst of 2014, which dropped in 2015. Admissions due to mental disorders are relatively common, mainly among adults and related to drug use and mood disorders. Time trends varied slightly over the 5 years. Prevalence rates in real-world settings might be useful for policymakers interested in planning the public mental health system in large Brazilian cities.

Highlights

A minority of individuals affected by mental disorders around the world have access to treatment.[1]
The prevalence of mental disorders among individuals admitted to a hospital varied according to age (Table 1 and Figures S1 and S2, available as onlineonly supplementary material)
Over the past 5 years, inpatient admissions due to mental disorders were relatively common in adolescents, adults and in the elderly, but rare in children

Summary

Introduction

A minority of individuals affected by mental disorders around the world have access to treatment.[1]. In LMICs, one of the barriers to building effective mental health systems is the scarcity of credible data that reflect population needs, including of those individuals who would benefit most from specialized mental health care. The need for psychiatric admission reflects to a great extent the severity of a mental health disorder and limited functionality. After the first psychiatric admission there is a significant increase in the risk of premature all-cause mortality and a strong increase in the number of deaths, especially by suicide.[5] These findings reinforce the importance of focusing on patients requiring psychiatric inpatient care as a key population that needs attention from a public health perspective. Understanding the demands of the population with the greatest need for care can reveal important information toward preventive efforts

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