Prevalência e fatores associados aos transtornos mentais e ao acesso aos serviços de saúde mental
Introduction: mental disorders are a serious public health problem, with high prevalence in Brazil and worldwide. Common mental disorders involve depression and anxiety disorders, mainly affecting women. Timely access to mental health services brings early diagnosis and effective treatment, minimizi...
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| Formato: | doctoralThesis |
| Idioma: | pt_BR |
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Universidade Federal do Rio Grande do Norte
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| Endereço do item: | https://repositorio.ufrn.br/handle/123456789/46130 |
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| Resumo: | Introduction: mental disorders are a serious public health problem, with high prevalence in
Brazil and worldwide. Common mental disorders involve depression and anxiety disorders,
mainly affecting women. Timely access to mental health services brings early diagnosis and
effective treatment, minimizing complications and reducing the number of mental illnesses.
Objective: To identify factors associated with mental disorders and access to mental health
services in Brazil and worldwide. Method: This is a study of different methods. 1) systematic
review of cross-sectional studies on the prevalence and factors associated with common mental
disorders in women, with searches in PubMed, Web of Science, Science Direct, Scopus, Cinahl
databases; 2) systematic review of cross-sectional studies on the difference in the prevalence of
access to mental health services between women and men, with searches in the PubMed, Web
of Science, Science Direct, Scopus, Cinahl databases; 3) Cross-sectional study with data from
the 2013 National Health Survey of Brazil, aged 18 years or older, which analyzed the
prevalence of symptoms of mental distress in the Brazilian population and the association
between individual characteristics and social context, in an analysis multilevel; 4) Crosssectional study with data from the 2019 National Health Survey, including 15 years or more to
analyze factors associated with poor access to health services for the treatment of depression in
Brazil. Results: In the systematic review on the prevalence and factors associated with common
mental disorders in women, 19 studies were included, the main associated factors were
unemployment, debt, low economic income, being a housewife, smoking, lower educational
level, low self-assessment in health, being single, divorced or widowed. The risk of bias of the
studies was classified as low and moderate. In the second systematic review, on access
differences between men and women, 11 studies were included. The prevalence of access to
mental health services among women ranged from 5.2% to 56.5%; among men it was 2.9% to
47%. Men had a higher prevalence of access only to services for the treatment of alcohol and
drug use. In the first cross-sectional study, depressive thoughts were associated with young and
middle-aged female adults, with a low level of education, without a partner, accident or extreatment, and without a private health insurance plan; belonging to classes D-E and living in
states with lower expectations of years of education if informed as a protective factor. Similar
results were found for the outcome of decreased vital energy and somatic symptoms. The
prevalence of poor access to health services for the treatment of depression was 14.9% (95%CI
13.6-16.2), and it was associated with individuals aged 15-29 years (PR = 1.52) and 30-59 years
old (PR = 1.22), without education (PR = 1.43), who assess their health as regular⁄poor⁄very bad (PR = 1.26), who have some limitation in their usual activities because of depression (PR =
2.71), who had the last visit from 6 months to less than 2 years (PR = 2.63) and for more than
2 years (PR = 2.25). Conclusion: it is necessary to strengthen and redirect public mental health
policies, not aiming to meet the individual needs of the most vulnerable people with risk factors,
offering timely access to health services and reducing mental suffering, as well as prevalence
of mental disorders in Brazil and worldwide. |
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