ABSTRACT
BACKGROUND: Bipolar disorder (BD) is a severe psychiatric disease and part of its burden is related to the high rates of lifetime psychiatric comorbidity (PC), with diagnostic, therapeutic, and prognostic implications. METHODS: Registered in PROSPERO (CRD42021282356). Meta-analyses were performed, searching for relevant papers published from 1993 to 2022 in Medline/PubMed (including E-Pub Ahead of Print), Embase, Cochrane Library (Central), PsycINFO, Scopus, Web of Science and via hand-searching, without language restrictions. 12.698 studies were initially identified, 114 of which were ultimately chosen based on the eligibility criteria. We performed two meta-analyses (prevalence and risk ratio) of mental health conditions among subjects with BD and then conducted a comprehensive examination of moderator effects using multivariable meta-regression models for moderators identified as significant in the univariable analysis. FINDINGS: Overall PC prevalence of at least one disorder was 38.91 % (95 % CI 35.24-42.70) and the most frequent disorders were: anxiety (40.4 % [34.97-46.06]), SUD (30.7 % [23.73-38.73]), ADHD (18.6 % [10.66-30.33]) and Disruptive, impulse-control and conduct disorder (15 % [6.21-31.84). The moderators with higher association with individual prevalences were UN's Human Development Index (HDI), female gender, age, suicide attempt, and age at onset (AAO). INTERPRETATION: It becomes evident that the prevalence of PC among individuals with BD is notably high, surpassing rates observed in the general population. This heightened prevalence persists despite significant heterogeneity across studies. Consequently, it is imperative to redirect clinical focus towards comprehensive mental health assessments, emphasizing personalized and routine screening. Additionally, there is a pressing need for the enhancement of public policies to create a supportive environment for individuals with BD, ensuring better therapeutic conditions and sustained assistance. By addressing these aspects, we can collectively strive towards fostering improved mental health outcomes for individuals with BD.
Subject(s)
Bipolar Disorder , Comorbidity , Humans , Bipolar Disorder/epidemiology , Prevalence , Mental Disorders/epidemiology , Anxiety Disorders/epidemiologyABSTRACT
This was a cross-sectional study of women of reproductive age with systemic lupus erythematosus (SLE) being treated at Bahiana School Rheumatology Service in Brazil. The study aimed to assess the prevalence of contraceptive counselling and use. An interview was performed, and the results were analysed before and after the SLE diagnosis. Eighty-five women were included; the mean age of the group was 32.98 ± 8.39 years. Before SLE diagnosis, most of the patients had used some contraceptive method; mainly oral contraceptives (54%) or hormone injections (21%). After SLE diagnosis, 53% of patients did not use any contraceptive method. Among the remaining patients who continued using contraceptives, 22% used condoms, 11% used combined oral contraceptives and 7% used hormone injections. Although 62% of the patients regularly visited the gynaecologist, 56% were unaware of which contraceptive method could be used safely. Thus, a better contraceptive counselling of women of a reproductive age should be performed after SLE diagnosis. Impact Statement What is already known on this subject? Women diagnosed with SLE have inadequate counselling about family planning. What the results of this study add? Brazilian women with SLE have a low prevalence of contraceptive use after their diagnosis and are exposed to having high-risk pregnancies. What the implications are of these findings for clinical practice and/or further research? The results we found highlight the importance of continued medical educational programmes and establish questions for further studies in order to investigate the interventions used to improve the contraceptive use for women diagnosed with SLE.
Subject(s)
Contraception Behavior/statistics & numerical data , Contraception/statistics & numerical data , Counseling/statistics & numerical data , Lupus Erythematosus, Systemic/complications , Adult , Brazil , Cross-Sectional Studies , Family Planning Services/standards , Female , Humans , Pregnancy , Young AdultABSTRACT
O Diabetes Mellitus (DM) é uma doença decorrente de múltiplos fatores, tanto genéticos, quanto clínicos e, atualmente, é considerado um problema de saúde pública. O bom controle metabólico previne o surgimento ou retarda a progressão de suas complicações crônicas e o processo de educação em saúde está relacionado à maior autonomia e entendimento da doença pelo paciente, o que promove maior adesão ao tratamento farmacológico e não farmacológico. Este projeto visa instituir um grupo de estudos em Diabetes Mellitus em uma USF em Salvador-BA. Para alcançar esse objetivo, as reuniões semanais das equipes serão utilizadas para discutir estratégias de implantação do grupo e, posteriormente, ocorrerão reuniões com a participação de profissionais e pacientes. Ao final, espera-se que a equipe encontre-se capacitada para atender integralmente o paciente com DM e que a população apresente maior adesão ao tratamento farmacológico e não farmacológico do Diabetes Mellitus, além de melhor controle metabólico desta patologia.
