Child and Adolescent Psychosocial Care Center service use profile in Brazil: 2008 to 2012

Objective: To describe the service use profile of Child and Adolescent Psychosocial Care Centers (Centro de Atenção Psicossocial Infanto-Juvenil [CAPSi]) in Brazil regarding diagnostic categories, sociodemographic aspects, and care modalities between 2008 and 2012. Methods: A descriptive, ecological study was performed using data from the Unified Health System regarding high-complexity procedure authorizations (Autorização de Procedimentos de Alta Complexidade [APAC]) for the period from 2008-2012. The variables sex, age, diagnosis (F00-F99 of ICD-10), and type of care provided were examined. The data were processed using TabWin and STATA version 12. Results: A total of 837,068 records were examined, each representing one visit to CAPSi. Most visits were by male users (68.8%). The most common diagnoses were hyperkinetic disorders (13%), pervasive developmental disorders (12.4%), and conduct disorders (8.4%). Conclusions: Behavioral and emotional disorders that usually appear during childhood or adolescence and psychological development disorders were frequent, with more than 50% of the latter comprising autism spectrum disorders. Regional differences were observed, with a higher presence of this diagnosis in the Southeast, while the North and Northeast had a high percentage of visits due to mental retardation.

Screening for common mental disorders using the SRQ-20 in Brazil: what are the alternative strategies for analysis?

Objective: To analyze the prevalence of common mental disorders (CMD) assessed with the Self Reporting Questionnaire (SRQ-20), using the established cutoff point, and comparing it with the results of a joint correspondence factor analysis (CFA) and cluster analysis and of a latent class analysis (LCA). Methods: A cross-sectional study was carried out in an urban sample of 1,095 women aged 19 to 55 years. Joint CFA-cluster analysis and LCA were used. Results: We found a high prevalence of CMD, regardless of classification method (37.6% when using the cutoff point; 44.4% and 52% for LCA and joint CFA-cluster, respectively). The alternative analysis strategies describe the cases more efficiently when compared to the traditional cutoff method, especially regarding more severe symptoms. Both alternative strategies also provide a description of the SRQ-20 dimensions in their particularities, which may be useful for the planning and implementation of specific actions in a given population. Conclusion: The SRQ-20 cutoff point seems to underestimate the magnitude of CMD among women. The alternative methods of analysis presented herein highlight the different possibilities of using this important instrument of screening for mental health.

Prevalence of behavior problems and associated factors in preschool children from the city of Salvador, state of Bahia, Brazil

Objective: To identify the prevalence of internalizing and externalizing behavior problems among preschoolers from the city of Salvador, state of Bahia, Brazil, and their associations with maternal mental health and family characteristics. Methods: This was a cross-sectional study of 349 children aged 49 to 72 months, randomly selected from 20,000 households representing the range of socioeconomic and environmental conditions in Salvador. In 1999, we assessed sociodemographic variables and family environment characteristics. In 2001, we used the Child Behavior Checklist to measure and describe the frequencies of behavior problems. We conducted bivariate and multivariate analysis to estimate associations between family and maternal factors and prevalence of behavior problems. Results: The overall prevalence of behavior problems was 23.5%. The prevalence of internalizing problems was 9.7%, and that of externalizing problems, 25.2%. Behavior problems were associated with several maternal mental health variables, namely: presence of at least one psychiatric diagnosis (odds radio [OR] 3.01, 95%CI 1.75-5.18), anxiety disorder (OR 2.06, 95%CI 1.20-3.46), affective disorder (OR 2.10, 95%CI 1.21-3.65), and mental health disorders due to use of psychoactive substances (OR 2.31, 95%CI 1.18-4.55). Conclusion: The observed prevalence of child behavior problems fell within the range reported in previous studies. Maternal mental health is an important risk factor for behavior problems in preschool-aged children.

The development of a scale to measure concepts of schizophrenia: experience among Brazilian psychiatrists

Foi desenvolvida uma escala para medir aderência ao conceito Bleuleriano Schneideriano de esquizofrenia entre psiquiatras trabalhando em Säo Paulo, analisando relaçöes entre variáveis sociodemográficas e de formaçäo sobre o escore obtido. Questionário contendo escala visual analógica com dezessete enunciados sobre conceitos Schneideriano e Bleuleriano de esquizofrenia, foi distribuído para 150 psiquiatras. As sub-escalas Bleuleriana e Schneideriana foram avaliadas por métodos psicométricos de consistência interna, estrutura das subescalas e confiabilidade test-reteste. Completaram o questionário 117 psiquiatras. A sub-escala Schneideriana demonstrou melhor consistência interna e melhores coeficientes de correlaçäo intraclasse. Näo houve associaçäo negativa entre os escores das sub-escalas. Discordância com o conceito Bleuleriano predominou entre profissionais treinados na USP. A baixa confiabilidade da sub-escla Bleuleriana limita a confiabilidade do instrumento como um todo, embora contribua para a discussäo dos modelos em questäo. Argumenta-se que o modelo Bleuleriano, por exigir maior inferência, torna-se propenso a baixa confiabilidade