COVID-19 pandemic in São Paulo: a quantitative study on clinical practice and mental health among medical residency specialties

Background: Immigrants and refugees have specific mental health needs. Studies of immigrant/refugee psychiatric patients in Latin America are scarce. Aims: Present the profile of patients from an outpatient psychiatric service in Sao Paulo (Brazil) to better inform mental health service planning for immigrants and refugees in the Global South. Methods: Exploratory study to characterize the sociodemographic and mental health profile of refugees and immigrants attending outpatient psychiatric service from 2003 to 2018. Chi-square tests and logistic regressions were used to examine the association of demographic variables, exposure to violence, and immigrant status with psychiatric diagnosis. Cluster analysis was used to identify subgroups within the sample. Results: A total of 162 immigrants and refugees referred to the service obtained treatment. Of these patients, 57.4% were men, 59.8% were refugees/asylum seekers, 51.9% were Black, 48.8% were single, 64.2% had 10 years of education, and 57.4% were unemployed; the mean age of the sample was 35.9. Half of the sample (52.5%) was exposed to violence. The most common diagnosis was depression (54.2%), followed by PTSD (16.6%). Approximately 34% of the participants sought psychiatric care within 6 months of arrival. Logistic regressions showed that men had lower odds of presenting with depression (OR = 0.34). Patients with PTSD were more likely to be refugees (OR = 3.9) and not have a university degree (OR = 3.1). In the cluster analysis, a cluster of patients with PTSD included almost all Black refugee men exposed to violence. Most patients diagnosed with psychotic disorders were also Black refugee men. Conclusion: Immigrants and refugees represent a vulnerable group. The majority of the sample was Black, refugee men, who were also more likely to present with PTSD. Future studies are needed to better understand issues in treatment adherence in relation to socioeconomic characteristics.

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Factors Related With Direct Costs Of Residential Mental Health Services In São Paulo City, Brazil: Does Resident Profile Affect Costs?

Value in Health ◽

10.1016/j.jval.2014.03.802 ◽

2014 ◽

Vol 17 (3) ◽

pp. A138

Author(s):

D Razzouk ◽

A Sousa ◽

A Cardoso ◽

GG Oliveira ◽

JJ Mari

Keyword(s):

Mental Health ◽

Mental Health Services ◽

Health Services ◽

Direct Costs ◽

Sao Paulo ◽

São Paulo

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Individual and contextual effects on mental health status in São Paulo, Brazil

Brazilian Journal of Psychiatry ◽

10.1590/s1516-44462000000300004 ◽

2000 ◽

Vol 22 (3) ◽

pp. 116-123 ◽

Cited By ~ 7

Author(s):

Ilona Blue

Keyword(s):

Mental Health ◽

Health Status ◽

Psychiatric Morbidity ◽

Sao Paulo ◽

Mental Health Status ◽

Independent Effect ◽

São Paulo ◽

Cross Sectional Survey ◽

Multicentric Study ◽

Socioeconomic Variables

Objectives: There is evidence that mental health status is partly determined by socioeconomic status. Recent research in the U.K. has highlighted the importance of place or context as a health determinant. This study aimed to analyze both individual socioeconomic variables and area of residence as potential risk factors for mental ill health. The objectives were to determine whether the effects of key explanatory variables on mental health status varies by area of residence and whether area of residence has an independent effect on mental health status once other key variables have been controlled for. Methods: The study used data collected as part of the Brazilian Multicentric Study of Psychiatric Morbidity. Data from a cross-sectional survey carried out in three socioeconomically contrasting sub-districts in São Paulo, Brazil, was used. The main outcome measure was mental health status as measured by the Questionário de Morbidade Psiquiátrica de Adultos (QMPA). Results: The results demonstrate that, even after key individual socioeconomic variables were controlled for, area of residence had a statistically significant effect on mental health status. Discussion: A possible explanation for the effect of area of residence relates to the social and physical features of places and their subsequent impact on health. Conclusions: It is important for mental health research to acknowledge the potential importance of the effect of area of residence on health, particularly in relation to developing new mental health promotion initiatives.

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Estimativa do custo do tratamento do câncer de pele tipo não-melanoma no Estado de São Paulo - Brasil

Anais Brasileiros de Dermatologia ◽

10.1590/s0365-05962011000400005 ◽

2011 ◽

Vol 86 (4) ◽

pp. 657-662 ◽

Cited By ~ 13

Author(s):

Reynaldo José Sant'Anna Pereira de Souza ◽

Adriana P Mattedi ◽

Marcelo P Corrêa ◽

Marcelo L Rezende ◽

Ana Cláudia Andrade Ferreira

Keyword(s):

Clinical Practice ◽

National Comprehensive Cancer Network ◽

Clinical Practice Guidelines ◽

Practice Guidelines ◽

Sao Paulo ◽

São Paulo ◽

Cancer Network ◽

Impacto Económico

FUNDAMENTOS: O câncer de maior incidência no Brasil é o de pele não-melanoma, que afeta aproximadamente 0,06% da população. Não existem políticas públicas para sua prevenção e o impacto econômico do seu diagnóstico não tem sido avaliado. OBJETIVOS: Estimar os custos do diagnóstico e tratamento do câncer de pele não-melanoma no Estado de São Paulo entre 2000 a 2007 e compará-los com os do melanoma cutâneo no mesmo período. MÉTODOS: Foi utilizado como modelo de procedimento o projeto diretriz Clinical Practice Guidelines in Oncology, (National Comprehensive Cancer Network), adequado aos procedimentos da Fundação SOBECCan - Hospital do Câncer de Ribeirão Preto - SP. Os custos estimados baseiam-se nos valores do tratamento médico pagos pelos setores público e privado em 2007. RESULTADOS: Os valores médios de custo individual do tratamento anual do câncer de pele não-melanoma são muito mais baixos do que os estimados para o tratamento do melanoma cutâneo. Entretanto, observados os gastos totais no tratamento do câncer de pele não-melanoma, percebe-se que os 42.184 casos deste câncer em São Paulo, no período estudado, fazem com que o custo total do seu tratamento seja 14% superior ao dos 2.740 casos de melanoma cutâneo registrados no mesmo período para o SUS. Porém, para o sistema privado, o gasto total é, aproximadamente, 34% menor para o tratamento do câncer de pele não-melanoma. CONCLUSÃO: O elevado número de casos de câncer de pele não-melanoma no Brasil - com 114 mil novos casos previstos para 2010, sendo 95% diagnosticados em estágios precoces - representa um impacto financeiro ao sistema público e aos sistemas privados de saúde de cerca de R$ 37 milhões e R$ 26 milhões ao ano, respectivamente

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Theoretical/practical teaching in nursing graduation for mental health / Ensino teórico/prático na graduação em enfermagem para atuação em saúde mental

Revista de Pesquisa Cuidado é Fundamental Online ◽

10.9789/2175-5361.rpcfo.v13.9534 ◽

2021 ◽

Vol 13 ◽

pp. 1256-1264

Author(s):

Maria do Perpétuo S.S. Nóbrega ◽

Wanderson Carneiro Moreira ◽

Suellen Cristina da Silva Chaves ◽

Carolina Marques Freitas

Keyword(s):

Mental Health ◽

Sao Paulo ◽

São Paulo ◽

Practical Teaching

Objetivo: analisar o ensino teórico/prático em Saúde Mental e Psiquiatria recebido durante a graduação em enfermagem. Método: estudo quantitativo, desenvolvido com 44 enfermeiros de uma Rede de Atenção Psicossocial do Município de São Paulo por meio de questionário validado. Resultados: 72,7% dos enfermeiros se sentem despreparados para lidar com Saúde Mental pela primeira vez, 68,2% consideram que o conteúdo foi pouco explorado e 84,1% tem interesse em fazer cursos na área. Conclusão: há dualidade no ensino teórico/prático ofertado pelas instituições de ensino superior, configurando a necessidade de que a formação seja revista para que enfermeiros generalistas consigam atender as demandas de Saúde Mental nos diversos campos de atuação profissional de acordo com o paradigma da Reforma Psiquiátrica e dos pressupostos da Reabilitação Psicossocial.

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Clinical and demographic profile of users of a mental health system for medical residents and other health professionals undergoing training at the Universidade Federal de São Paulo

Sao Paulo Medical Journal ◽

10.1590/s1516-31802004000400004 ◽

2004 ◽

Vol 122 (4) ◽

pp. 152-157 ◽

Cited By ~ 15

Author(s):

Rafael Fagnani Neto ◽

Cristina Sueko Obara ◽

Paula Costa Mosca Macedo ◽

Vanessa Albuquerque Cítero ◽

Luiz Antonio Nogueira-Martins

Keyword(s):

Mental Health ◽

Sao Paulo ◽

Medical Residents ◽

First Year ◽

São Paulo ◽

Depression And Anxiety ◽

Postgraduate Students ◽

Demographic Profile ◽

Leave Of Absence ◽

Seeking Help

CONTEXT: A postgraduate and resident trainee mental health assistance center was created in September 1996 within our university. OBJECTIVE: To describe the clinical and demographic profile of its users. TYPE OF STUDY: Retrospective. SETTING: Universidade Federal de São Paulo - Escola Paulista de Medicina (Unifesp-EPM). METHODS: The study was carried between September 1996 and November 2002, when 233 semi-structured registration forms were filled out either by the psychologist or the psychiatrist during their first contact with the trainees, who were medical and nursing residents, and postgraduate students at specialization, master or doctoral levels. The registration forms included demographic, occupational and clinical data. RESULTS: The trainees were predominantly young (mean of 27 years old), single (82.0% of cases), women (79.4%), seeking help especially during the first year of training (63.1%). In 70.8% of the cases, they came to the service spontaneously. Such individuals showed greater adherence to the treatment than those who were referred by supervisors (p < 0.05). In 30% of the cases, the trainee sought psychological guidance or support at the service due to specific situational conflicts. Depression and anxiety disorders were the most frequent diagnoses; 22.3% of the trainees followed up mentioned a tendency towards suicidal thoughts. In comparison with other trainees, there was a higher prevalence of males among the medical residents (p < 0.01), with more cases of sleep disorders (p < 0.05), a smaller number of individuals refraining from the use of alcohol (p < 0.05) and a higher number of trainees requiring leave of absence (p < 0.001). DISCUSSION: The first year of training in health sciences is the most stressful, especially for women. Depression and anxiety symptoms are common, reflecting transitory self-limited deadaptation. However, the severity of the cases can also be evaluated in view of the large number of trainees who mentioned suicidal tendencies. CONCLUSIONS: This study emphasizes the need and importance of providing formal, structured and confidential mental health services for medical residents and postgraduate students from other health professions, in the training programs of academic institutions.

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Barriers to care and psychopathology among Bolivian migrants living in São Paulo, Brazil

Transcultural Psychiatry ◽

10.1177/1363461519853639 ◽

2019 ◽

Vol 57 (1) ◽

pp. 71-80

Author(s):

Lineth Hiordana Ugarte Bustamante ◽

Raphael Oliveira Cerqueira ◽

Fernanda De Marzio ◽

Keila Pereira Leite ◽

Thatiane Dal Picolo Cadurin ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Family Income ◽

Barriers To Care ◽

Psychiatric Symptoms ◽

Linear Regression Analysis ◽

Sao Paulo ◽

São Paulo ◽

Self Reporting Questionnaire

The objective of this study was to investigate barriers to appropriate mental health care in a sample of Bolivian migrants living in São Paulo and to examine the association between barriers of care and the presence of symptoms of non-psychotic psychiatric disorders in this population. Considering that treatment usually reduces symptoms, it could be hypothesized that individuals reporting more barriers to care also will report more symptoms. The sample comprised 104 individuals born in Bolivia, with Bolivian nationality and living in São Paulo for at least 30 days prior to enrolling in the study, between 18 and 80 years of age and able to read and write in Spanish or Portuguese. The symptoms of mental disorders were assessed using the Self-Reporting Questionnaire (SRQ-20) and barriers to appropriate mental health care were evaluated using the Barriers to Assessing Care Evaluation (BACE). A multiple linear regression analysis was performed to determine the predictive effect of the BACE total score (independent variable) in the SRQ-20 score (dependent variable), including in the model, and the variables that were significantly correlated with the BACE total score or SRQ-20. Our results indicate that more than a half of the sample of Bolivian migrants living in Sao Paulo, Brazil, especially females, presented significant non-psychotic psychopathology. Individuals reporting more barriers to care, especially instrumental and attitudinal barriers, also have a higher risk of psychiatric symptoms, independently of sex, age and family income. Our results suggest that actions to increase availability of mental health services, especially culturally sensitive services, could reduce barriers to care and improve mental health among migrants.

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