Minor Psychiatric Disorders Research Articles

Prevalência de transtornos psiquiátricos menores em trabalhadores da atenção primária à saúde das regiões Sul e Nordeste do Brasil

Mental health problems are among the most prevalent conditions in health workers. We evaluated the prevalence of minor psychiatric disorders and associated factors among primary healthcare workers. The study design was cross-sectional and services-based, in 240 primary healthcare units in 41 municipalities (counties) with more than 100 thousand inhabitants in seven States in the South and Northeast regions of Brazil. A total of 4,749 primary healthcare workers were interviewed, and prevalence of minor psychiatric disorders was 16%, with no statistical differences according to region or primary care model. The rate was higher in community health workers and other workers with secondary education (18%) and lower in health professionals with university training (10%); while physicians (15%) and nurses and nurse technicians (14.6%) were in an intermediate situation (p < 0.001). Occupational characteristics showed the strongest association with the occurrence of minor psychiatric disorders according to the adjusted analysis, suggesting that their reduction requires improvements in work conditions in primary healthcare and in the management of the Unified National Health System.

Minor psychiatric disorders among nurses university faculties

This cross-sectional study addresses 130 nursing faculty members in federal universities from Rio Grande do Sul, Brazil. It investigated the psychological demands and decision latitude (the Demand-Control Model by Karasek) and their association with Minor Psychological Disorders (MPDs). The Brazilian versions of the Self-Report-Questionnaire-20 and the Job Stress Scale were used. MPDs were prevalent in 20% of the studied individuals. After adjusting for potential confounders, the chances of participants presenting mental disorders were higher in the quadrant 'active strain jobs' (OR=14.23, 95% CI 1.55 to 130.73), followed by the 'high strain jobs' quadrant (OR=10.05, 95% CI 1.23 to 82.44), compared to nursing professors classified in the 'low strain jobs' quadrant. We conclude that high psychological demands and low control over work can cause disorders in nursing professors, among them, MPDs.

Minor psychiatric disorders among nursing workers – is there an association with current or former night work?

We aimed at analyzing whether Minor Psychiatric Disorders (MPD) is associated to night work either currently or in the past. A cross-sectional study was conducted at three public hospitals in Brazil, with female nursing workers. Data collection (N=1,134) was based on a comprehensive questionnaire that included the self-reported questionnaire (SRQ-20) for screening of MPD. Former night workers were subdivided into three groups according to their reasons for leaving night work: (i) directly related to work, (ii) related to better reconcile with studies or another job, and (iii) related to health, sleep, fatigue or stress. Binomial logistic regression was performed, with adjustment for potential confounders. A dose response gradient was observed between current night work and MPD (OR=1.5; 95% CI: 1.1-2.2 and OR=2.1; 95%CI: 1.5-3.1 for those who worked up to five nights and six or more nights per 2-week span, respectively). Potential detrimental effects of night work were confirmed. The association between working at night and MPD was not restricted to current night workers as workers who left night work for health/fatigue/sleep/strain also showed higher chances of reporting MPD (OR=1.8;95%CI:1.14-2.90). Results contribute to the scientific debate on the impact of night work on health and wellbeing.

Transtornos psiquiátricos menores em cuidadores familiares de usuários de Centros de Atenção Psicossocial do Sul do Brasil

A cross-sectional study was conducted with 936 family caregivers of users of Psychosocial Care Centers (CAPS) with the aim of describing the prevalence of minor psychiatric disorders and the association with socio-demographic variables, self-reported overload, and stressful events. Minor psychiatric disorder was identified with the Self-Reporting Questionnaire (SRQ-20), using as case definition a cutoff of eight or more positive answers for women and six or more for men. Bivariate and multivariate analyses were conducted by Poisson regression. Prevalence of minor psychiatric disorders was 49% (95%CI: 46%-52%). In the adjusted analysis, higher prevalence was observed in families with less schooling, health problems, more stressful life events, retirees, and single caregivers who reported overload. The results indicate a high prevalence of minor psychiatric disorders, besides identifying some associations. Such information provides important support for planning mental health services and primary care.

Obsessive-compulsive disorder in disguise—Case report

Obsessive-compulsive disorder (OCD) may mimic other minor and major psychiatric disorders or symptoms. Psychomotor disturbances may also be seen in OCD. Symptoms and complaints could be misinterpreted. Differential diagnostic assessments would be difficult either if the person has OCD or another diagnostic entity with OCD related symptoms. If clinicians in residential or outpatient settings do not realize this, the patients may suffer from inadvertent pharmacological treatment efforts, to no avail. A representative case of the former is presented. Withdrawal of all psychotropic medications cold turkey did not increase symptom load during the following weeks, indicating little benefit from medications. Because of continued complaints from the patient, psychotropic medications were gradually reintroduced, without any improvement. OCD patients may not be helped by extensive use of psychotropics and doctors responsible for them should employ other methods of reducing OCD symptoms than lumping together diverse psychotropics. There is evidence for the value of intensive cognitive behaviour therapy, but also for addressing the social conditions of the patients.

P2-77 Behaviour problems and prevalence of asthma symptoms among Brazilian children

IntroductionAsthma is the most common chronic disease in childhood and has been designated a public health problem due to the increase in its prevalence in recent decades, the amount of...

Highlights in this issue

The incidence of psychiatric diseases was investigated by a register study based on about 1.5 million persons born 1974–1996. The odds rate of major psychiatric disorders was 1.88 among individuals born below 27 weeks compared to those who were born full-term. Similar ratios were found for minor psychiatric disorders or use of psychotropic drugs. The risk increased in proportion to the degree of prematurity. However, the incidence of psychiatric disorders was relatively small compared to cerebral palsy or cognitive deficits. This is reported by René Mathiasen et al., pp. 691–699. See also article by Phyllis Zelkowitz et al., showing that early intervention programmes targeting anxious mothers promote optimal developmental outcome, pp. 700–704. Prone sleeping has been found to increase oxygen saturation both in preterm infants and also adults in intensive care. However, prone sleeping should be avoided among infants, and parents can be confused if they must change the position of the baby when the preterm baby is discharged. Dawn Elder et al. have now reinvestigated oxygenation in prone and supine position. They found no disadvantage for preterm infants sleeping in supine position before discharge. See pp. 661–665. Playing music for babies in the NICU may be pleasant but is it also good for the health? This has been investigated by Monica Olischar et al. in Melbourne. They analyzed the impact of music on the quality of sleep-wake cycles and quiet sleep in term and near-term infants. Although they did not find any statistical significance, they found a trend of easier discernibility of sleep-wake cycling among those infants who were exposed for music. Although this is a small study with a limited number of infants, it indicates that music can be good for the baby (pp. 670–675). Malignant solid tumours constitute about 40% of all cancer among children. The overall annual incidence was found to be 65/million children. The survival rate has increased from 76% to 82% during the two last decades. The incidence is stable. See article by Gustaf Ljungman et al., pp. 750–757. Malnutrition during early life alters gene expression and programmes the body structure function for life. This so called Barker hypothesis is now well established. Nicola Winder, David Barker et al. now show that the size and shape of the placental surface predict childhood blood pressure. Factors like implantation, expansion of the chorionic surface, and compensatory mechanisms may explain this (pp. 653–660).

School performance and risk of suicide in early adulthood: Follow-up of two national cohorts of Swedish schoolchildren

BackgroundPoor school performance and low IQ are associated with an increased risk of suicide in males; it is uncertain whether cognitive performance is a risk factor for suicide in females and whether severe mental illness influences these associations. MethodRecord linkage study of Swedish education, population and census data with mortality and inpatient registers. Data were available for 95,497 males and 91,311 females born in 1972 and 1977 and followed up until 31 December 2005. Results230 males and 90 females died from suicide over the follow-up period. There were strong inverse associations between school performance at age 16 and subsequent suicide risk in males (fully adjusted hazard ratio (HR) per SD increase in school performance score: 0.6 (95% CI 0.6 to 0.7; p<0.001)) but not females: adjusted HR. 1.1 (CI 0.9 to 1.4 p=0.50). In males there were almost four fold differences in suicide risk between children in the top and bottom fifths of the range of school grade scores. Similar associations were seen with upper secondary school performance (age 18/19years). There was no strong evidence that deterioration in school performance between ages 16 and 18 was associated with increased suicide risk. Amongst men who developed severe psychiatric illness school performance was not associated with suicide risk. LimitationsWe had limited information on the prevalence of minor psychiatric disorder in cohort members and no data on IQ for the cohort as a whole. ConclusionsGood performance in secondary (age 16) and upper secondary (age 18) school is associated with a reduced risk of suicide in men but not women. This protective effect is not seen amongst those who develop severe psychiatric illness. These differences indicate that the aetiology of suicide differs in males and females and in those with and without severe mental illness.

Produção científica sobre os distúrbios psíquicos menores a partir do self report questionnarie

Objetivo: conhecer a produção científica publicada no Brasil em bases de dados eletrônicas sobre os Distúrbios Psíquicos Menores a partir do Self Report Questionarie, bem como identificar possíveis relações entre distúrbios psíquicos menores e trabalho. Método: realizou-se um levantamento bibliográfico nas bases de dados LILACS, MEDLINE e SCIELO, nos últimos dez anos, com as palavras-chave: transtornos mentais comuns, distúrbios psíquicos menores, morbidades psiquiátricas menores, problemas psiquiátricos menores. Resultados: obteve-se 41 estudos, sendo 38 artigos científicos e três dissertações. Observa-se um aumento de publicações do ano de 2004 (2,4%) para o de 2005 (14,6%). O periódico com maior número de publicações foi o Caderno de Saúde Pública (24,4%). Os estudos investigaram populações com idade maior ou igual a 14 anos (48,8%); trabalhadores da saúde (19,5%), trabalhadores de outras áreas (19,5%) e estudantes (12,2%). Conclusão: evidenciou-se que os distúrbios psíquicos menores estão presentes em diversas populações, de variadas regiões do país, apontando para a necessidade de novos estudos que investiguem a associação entre DPM e as condições de trabalho.

The risk of psychiatric disorders in individuals born prematurely in Denmark from 1974 to 1996

To investigate the risk of developing psychiatric disorders in individuals born prematurely (born before 37 weeks of gestation). The study is a longitudinal register-based study including all live-born individuals in Denmark from 1974 to 1996. Poisson regression models including well-known confounders were used to investigate the rate ratio of psychiatric disorders at the age of 11-34 years in the individuals born prematurely. A total of 1,545,641 individuals were born from 1974 to 1996. Of these, 1,348,106 live-born individuals constituted the study cohort. Rate ratios of psychiatric disorders, in total, increased in proportion to the degree of prematurity. The rate ratio of major psychiatric disorder was increased in individuals born with a gestational age below 28 weeks compared to persons born with a gestational age of 39-45 weeks (RR = 1.88 (95% CI: 1.25-2.83)). Similarly, the rate ratios of minor psychiatric disorder (RR = 1.63 (95% CI: 1.29-2.06)) and psychotropic drugs purchased (RR = 1.35 (95% CI: 0.98-1.86)) were increased. The risk of minor as well as major psychiatric disorders during adolescence and young adulthood increases in proportion to the degree of prematurity. The relative risk, however, is small compared to the risks of cerebral palsy or low intelligence.

Identifying the ′mentally disabled′ in the community: How much more is to be imparted to the internees in training?

Background:Studies have been conducted on the skills of physicians in general hospitals in identifying mental disorders,but there are no studies assessing the proficiency of internees in identifying mental disorders.Aim:To confirm the diagnosis of the cases identified by 40 internees in the community as ‘mentally disabled’.Materials and Methods:Of 15,583 people,29 were identified in the community by the internees as ‘mentally disabled’. This was followed by home visits to the houses of these 29 individuals conducted by two qualified psychiatrists and one clinical psychologist, and these cases were screened for their psychiatric status using MINI Plus.Results:Most of the cases identified by internees as having ‘mental disability’ were cases of mental retardation and the others were mood and psychotic disorders and epilepsy. Cases of mental retardation and mental disorders other than those identified by the internees could also be identified while visiting the respective geographical areas.Conclusions:There is a need to hone the skills of the medical students during the course of their training in identifying cases of mental retardation, severe as well as minor psychiatric disorders, as a part of their training. There is also a need for the use of structured scales for the same.

Adverse psychosocial working conditions and minor psychiatric disorders among bank workers

BackgroundIn most countries, the financial service sector has undergone great organizational changes in the past decades, with potential negative impact on bank workers' mental health. The aim of this paper is to estimate the prevalence of minor psychiatric disorders (MPD) among Brazilian bank workers and to investigate whether they are associated with an adverse psychosocial working environment.MethodsA cross-sectional study of a random sample of 2,500 workers in a Brazilian state bank in 2008. The presence of MPD was determined by the General Health Questionnaire.(GHQ). Psychosocial work conditions were assessed by means of the Effort-Reward Imbalance (ERI) and Job Content Questionnaire (JCQ). The presence and magnitude of the independent associations between MPD and adverse psychosocial working conditions were determined by Prevalence Ratios, obtained by Poisson regression.ResultsFrom 2,337 eligible workers, 88% participated. The prevalence of MPD was greater among women (45% vs. 41%; p > 0.05). In the multivariate analysis, the prevalence of MPD was twice as high among bank workers exposed to high psychological demand and low control at work and under high effort and low reward working conditions. The lack of social support at work and the presence of over-commitment were also associated with higher prevalence of MPD. A negative interaction effect was found between over-commitment and effort-reward imbalance.ConclusionThe prevalence of MPD is high among bank workers. The results reinforce the association between MPD and adverse psychosocial working conditions, assessed by the JCQ and ERI models. The direction of the interaction observed between over-commitment and ERI was contrary to what was expected.

Morningness–eveningness, use of stimulants, and minor psychiatric disorders among undergraduate students

Morningness-eveningness dimension in humans have been indicated to influence social behavior and individual health. The aim of the present study was to investigate the association of the morningness-eveningness dimension with behavioral and health aspects in a sample of undergraduate students. We assessed demographic data; the Pittsburgh Sleep Quality Index was used to evaluate sleep quality; the Morningness/Eveningness Questionnaire to determine morningness-eveningness, and the Self-Reporting Questionnaire to assess minor psychiatric disorders. A total of 372 students (66.7% females), on average 21.6 years old, participated in this study. Among them, 92.2% did not smoke, 58.9% engaged in physical activities, and 19.7% were night-shift workers. In regard to morningness-eveningness, 55.9% of the participants were intermediate between evening (39.5%) and morning (4.6%) types. Poor sleep quality (OR = 1.89), minor psychiatric disorders (OR = 1.92), and tobacco consumption (OR = 3.65) predominated among evening types. Evening types were predominantly males (OR = 1.72). This study suggests that evening types are more vulnerable to sleep and psychiatric disturbances, and tend to smoke more than morning types.

Correlation of shift work and waist circumference, body mass index, chronotype and depressive symptoms

Correlate shift work with body mass index (BMI), waist circumference, chronotype and depressive symptoms. This study comprising 14 shift workers and 13 day workers. Subjects were workers from the health area aged 25 to 60 years. Minor psychiatric disorders were accessed by Self Report Questionnaire (SRQ-20) and depressive symptoms by Beck Depression Inventory (BDI). Chronotype was accessed using Morningness-Eveningness Questionnaire (MEQ). Anthropometric measures were taken. Shift workers presented higher BMI (P = 0.03) and waist circumference (P = 0.004) than day workers. Years on shift work were significantly correlated to waist circumference (r = 0.43; P = 0.03) and age (r = 0.47; P = 0.02). Shift work was not correlated with depressive symptoms and chronotype. These results may suggest a role played by shift work on the development and/or the early clinic manifestations of metabolic disturbances, becoming a risk factor to metabolic syndrome.

Early determinants of attention and hyperactivity problems in adolescents: the 11-year follow-up of the 1993 Pelotas (Brazil) birth cohort study

The aim of this study was to assess early determinants of attention and hyperactivity problems in adolescents. In 1993, all hospital births in the city of Pelotas, Rio Grande do Sul State, Brazil, were monitored and mothers were interviewed (N = 5,249). At 11 years of age, 4,423 mothers answered the Strengths and Difficulties Questionnaire (SDQ) in order to evaluate attention and hyperactivity problems in the adolescents. Crude and adjusted prevalence ratios were calculated using Poisson regression. Prevalence of attention and hyperactivity problems was 19.9%. Factors associated with the outcome in the adjusted analysis were: male gender, low family income, smoking during pregnancy, minor psychiatric disorders in the mother, and history of child's behavioral/emotional problems at four years of age. Early life events impacted attention and hyperactivity problems in adolescence. Risk factors for attention and hyperactivity problems found in this study were similar to those reported in other cultures.

Prevalência e fatores associados a porte de arma e envolvimento em agressão física entre adolescentes de 15 a 18 anos: estudo de base populacional

This cross-sectional, population-based study aimed to evaluate the prevalence of weapons possession and associated factors and involvement in physical aggression among adolescents 15 to 18 years of age (n = 960) in the city of Pelotas, Rio Grande do Sul State, Brazil. Ninety of the city's 448 census tracts were selected, and 86 houses in each tract were visited. The statistical analysis used Poisson regression. Prevalence rates in the sample were 22.8% for involvement in fights with physical aggression and 9.6% for weapons possession in the previous 12 months. The study concluded that young males that use alcohol and/or illegal drugs and present minor psychiatric disorders show a higher probability of weapons possession and involvement in physical fights.

Correlates and psychiatric disorders associated with psychotropic drug use in Taiwan

We used the population-based National Health Insurance database to investigate correlates and psychiatric disorders associated with psychotropic drug use in Taiwan. The National Health Research Institute provided a database of 200,000 random subjects for study. We obtained a random sample of 145,304 subjects aged 18 years or older in 2004. Study subjects who had made at least two psychotropic drug prescriptions during this year were identified. We detected factors associated with psychotropic drug use. In addition, we examined the prevalence of antipsychotic, antidepressant, mood stabilizer, sedative-hypnotic-anxiolytic (SHA) agent, and any psychotropic drug use according to psychiatric disorders. Higher prevalence of any psychotropic drug use was found in the 25-44, 45-64, and 65 or older age groups, females, aborigine, with a lower premium, with disability, and among those who lived in central region, suburban or rural area. Among those subjects with any major psychiatric disorders, the prevalence of antipsychotic, antidepressant, mood stabilizer, SHA agent, and any psychotropic drug use were 59.3, 49.7, 17.9, 78.6, and 92.0%, respectively. Among those subjects with any minor psychiatric disorders, the prevalence of antipsychotic, antidepressant, mood stabilizer, SHA agent and any psychotropic drug use were 17.5, 41.8, 4.0, 85.5, and 89.4%, respectively. Thus, those subjects with any psychiatric disorders had a high percentage of any psychotropic drug use in National Health Insurance program in Taiwan. Future studies should focus on the outcome evaluation and correlates associated with individual psychotropic use.

Mental health and quality of life among doctors, nurses and other hospital staff

AbstractNumerous studies have shown that doctors, nurses or other hospital staff may suffer from tremendous stress at work. A high level of work‐related stress might increase vulnerability to mental illness and result in a poor quality of clinical care. This study was conducted in a Taiwanese regional general hospital. Minor psychiatric disorder, depressive disorder and quality of life were assessed for all staff, using self‐rating questionnaires including the Chinese Health Questionnaire 12‐item version, the Center for Epidemiologic Studies Depression Scale and World Health Organization Quality of Life Scale brief version. Nearly half of the staff had either a minor psychiatric disorder or depressive disorder. Nurses and pharmacists had the highest prevalence. The risk factors included single/divorced and being a nurse or pharmacist. Quality of life for hospital staff was poor, as compared with the Taiwanese norms, and was even worse for the nurses and pharmacists. In conclusion, the management teams of hospitals should pay more attention to the mental condition of all hospital staff, especially nurses and pharmacists. Adequate staffing, support, counselling or psychological intervention are required for further management, and may logically result in better mental health on the part of the staff and a better quality of care. Copyright © 2009 John Wiley &amp; Sons, Ltd.

Relationship between depressive mood and chronotype in healthy subjects

The endogenous circadian clock generates daily variations of physiological and behavior functions such as the endogenous interindividual component (morningness/eveningness preferences). Also, mood disorders are associated with a breakdown in the organization of ultradian rhythm. Therefore, the purpose of the present study was to assessed the association between chronotype and the level of depressive symptoms in a healthy sample population. Furthermore, the components of the depression scale that best discriminate the chronotypes were determined. This cross-sectional study involved 200 volunteers, aged 18-99 years, 118 women and 82 men. The instruments were the Montgomery-Asberg Depression Rating Scale (MADRS), the Morningness/Eveningness Questionnaire, the Self-Reporting Questionnaire-20, and the future self-perception questionnaire. Logistic regression showed that subjects with the eveningness chronotype had a higher chance of reporting more severe depressive symptoms compared to morning- and intermediate-chronotypes, with an odds ratio (OR) of 2.83 and 5.01, respectively. Other independent cofactors associated with a higher level of depressive symptoms were female gender (OR, 3.36), minor psychiatric disorders (OR, 3.70) and low future self-perception (OR, 3.11). Younger age, however, was associated with a lower level of depressive symptoms (OR, 0.97). The questions in the MADRS that presented higher discriminate coefficients among chronotypes were those related to sadness, inner tension, sleep reduction and pessimism. Identification of an association between evening typology and depressive symptoms in healthy samples may be useful in further investigation of circadian typology and the course of depressive disease.

Prevalência de hipertensão arterial entre motoristas de ônibus em Santa Maria, Rio Grande do Sul

OBJETIVOS: O objetivo deste estudo foi identificar a prevalência de hipertensão arterial sistêmica (HAS) em motoristas de ônibus urbanos de Santa Maria/RS e estudar fatores associados à mesma nesta categoria profissional. METODOLOGIA: Realizou-se um estudo epidemiológico do tipo transversal com 214 motoristas e igual número de vizinhos, selecionados por sexo e idade. Foi utilizado um questionário individual padronizado e realizadas medidas da pressão arterial, peso e altura no domicílio do entrevistado. RESULTADOS: A prevalência de HAS entre os motoristas foi de 22,4%, não apresentando diferença significativa entre os grupos, mesmo controlados os fatores de confusão. Entretanto, entre os motoristas, a obesidade (RP 2,30 IC95% 1,04-5,07) e os problemas psiquiátricos menores (RP 2,26 IC95% 1,15-4,43) estiveram associados à HAS. CONCLUSÕES: O FAto de Santa Maria ser uma cidade do interior, com um trânsito menos intenso e de menor complexidade pode ser uma explicação para que os motoristas não apresentem maior prevalência de HAS do que seus vizinhos. O perfil de classe parece ser mais importante do que as características específicas do trabalho de dirigir ônibus.