Major depressive episode in hospital workers during the Covid-19 pandemic in Brazil.

OBJECTIVES: To estimate prevalence and factors associated with major depressive episode (MDE), emphasizing occupational aspects, in workers of a public teaching hospital that is a reference for Covid-19 treatment. METHODS: A cross-sectional study was carried out between October and December 2020, after the first peak of the pandemic, interviewing 1,155 workers. The prevalence of MDE was estimated using the Patient Health Questionnaire (PHQ-9) algorithm. Multivariate hierarchical analysis was conducted using Poisson regression to assess associated factors. RESULTS: MDE prevalence was 15.3% (95%CI: 13.3-17.5) and was higher among young, white and female workers, those with a family history of depression, resident professionals, nursing professionals, workers who were exposed to three or more situations of moral dilemma, and those who had to put off a physiological need until later. Having a risk factor for Covid-19, being a smoker and being physically inactive were also positively associated with MDE. CONCLUSIONS: The study points to the considerable prevalence of MDE among tertiary health care workers; reviewing work processes is essential to reduce occupational stress and minimize the effects of the pandemic on mental health, preventing those problems from becoming chronic.

Major depressive episode in hospital workers during the Covid-19 pandemic in Brazil

ABSTRACT OBJECTIVES To estimate prevalence and factors associated with major depressive episode (MDE), emphasizing occupational aspects, in workers of a public teaching hospital that is a reference for Covid-19 treatment. METHODS A cross-sectional study was carried out between October and December 2020, after the first peak of the pandemic, interviewing 1,155 workers. The prevalence of MDE was estimated using the Patient Health Questionnaire (PHQ-9) algorithm. Multivariate hierarchical analysis was conducted using Poisson regression to assess associated factors. RESULTS MDE prevalence was 15.3% (95%CI: 13.3-17.5) and was higher among young, white and female workers, those with a family history of depression, resident professionals, nursing professionals, workers who were exposed to three or more situations of moral dilemma, and those who had to put off a physiological need until later. Having a risk factor for Covid-19, being a smoker and being physically inactive were also positively associated with MDE. CONCLUSIONS The study points to the considerable prevalence of MDE among tertiary health care workers; reviewing work processes is essential to reduce occupational stress and minimize the effects of the pandemic on mental health, preventing those problems from becoming chronic.

Suicidality among South Brazilian tobacco growers.

OBJECTIVE: To assess prevalence of suicidal ideation and suicide attempt among South Brazilian tobacco growers and to analyze the associated factors related to the suicidal ideation. METHODS: A cross-sectional study was conducted in 2011 with a random sample of 2469 tobacco growers in São Lourenço do Sul/RS. Suicidal ideation was characterized by the question "Has the thought of ending your life been on your mind?". Suicide attempt was assessed by the question "Have you ever tried to kill yourself?". Investigation of factors associated with suicidal ideation was done by means of Poisson regression. RESULTS: Prevalence of suicidal ideation and suicide attempt was 2.5 % and 1.2 % respectively. In the adjusted analysis, suicidal ideation was associated with being female, older age, moderate participation in religious activities and difficulty in paying debts. Those who worked in activities that required inadequate postures (hunched over or other forced positions), as well as farmers who performed 6-9 pesticide-related tasks demonstrated greater risk of suicidal ideation. Regarding health conditions, medical diagnosis of asthma, chronic low back pain, number of lifetime green tobacco sickness episodes and lifetime pesticide poisoning were positively associated with suicidal ideation. CONCLUSION: Suicidal thoughts and attempts are relevant mental health problems among tobacco growers. Reducing pesticide use, as well as exposure to nicotine and improving socio-economic conditions, can reduce suicidal ideation and improve the mental health of exposed workers.

Major depressive episode externalizing symptoms among university students.

INTRODUCTION: Depression affects 32% of university students and Major Depressive Episode (MDE) externalizing symptoms indicate the severity of the case. This study assessed MDE externalizing symptom prevalence and associated factors among university students, with emphasis on aspects related to the academic environment, including interpersonal relationships and study area chosen by students. METHODS: A census was performed on new students in the first semester of 2017 at a university in Southern Brazil. Depressive symptom prevalence was assessed by the Patient Health Questionnaire-9. The multivariate analysis of the associated factors followed a hierarchical model, using Poisson regression with backward selection. RESULTS: MDE externalizing symptoms were present in 20% of the university students and were more frequent among females, those with brown, black or other skin color in comparison to those with white skin color. Individuals with a family history of depression, minority sexual orientation, negative self-reported academic performance, students taking courses in the area of Linguistics, Modern Languages and Arts and students who reported strong conflicts with university teachers or colleagues also had higher prevalence of externalizing symptoms. CONCLUSION: It is important for education institutions to train teachers to identify and deal adequately with students who have externalizing symptoms of MDE. In addition, education institutions need to pay attention to conflicts, both between students and also between students and teachers in order to take preventive measures in these circumstances.

Illicit drug use among students of a university in Southern Brazil.

OBJECTIVE To describe drug consumption and the co-occurrence use of more than one illegal drug as well as associated factors in freshmen at a public university in Southern Brazil. METHODS Cross-sectional study with census of students entering undergraduate courses in 2017. A total of 1,788 university students answered questions about illicit drug use. For analysis, ordinal logistic regression was used. RESULTS Marijuana was the most consumed drug (lifetime: 42.1%; 30-day use: 22.7%), followed by hallucinogens (lifetime: 13.1%, 30-day use: 2.8%). Rates for lifetime use of 0, 1 and 2 or more drugs were 56.2%, 23.3% and 20.4%, respectively, and were associated with men (OR = 2.2; 95%CI:1.4-3.5), being at least 23 years old (OR = 2.7; 95%CI: 1.4-5.1), under 18 years old first experimentation with drugs (OR = 2.3; 95%CI: 1.3-3.9) and living with friends (OR = 2.0; 95%CI: 1.2-3.4). Rates for 30-day use of 0, 1 and 2 or more drugs were 76.8%; 18.1% and 5.1%, respectively, and were associated with being single, separated or widowed (OR = 3.2; 95%CI: 1.4-7.0), lower socioeconomic classes (OR = 0.3; 95%CI: 0.1-1.1; p = 0.001), under 18 years old first experimentation with drugs (OR = 1.8; 95%CI: 1.1-2.9) and living with friends (OR = 1.8 95%CI: 1.2-2.8). CONCLUSION Results indicate that students are at greater risk of illicit drug-related health problems. Thus, a better understanding of this consumption should be pursued, as well as the development of a prevention plan.

Major depressive episode among university students in Southern Brazil.

INTRODUCTION: Depression is the leading cause of disability around the world, and it has been increasingly affecting young people. This study evaluates the prevalence and factors associated with major depression in university students, with emphasis on the influence of the academic field, chosen study area and the environment they are inserted. METHODS: A census of students who entered the university in the first semester of 2017 was held at a university in Southern Brazil. The outcome of major depressive episode was evaluated using the Patient Health Questionnaire-9, considered when the individual had five or more depressive symptoms for at least one week. Its prevalence was estimated, and the associated factors were examined by the hierarchical multivariable analysis using the Poisson regression model. RESULTS: A total of 32% (95% confidence interval 29.9-34.2) of university students presented a major depressive episode, and the problem was more frequent among women (prevalence ratio [PR] = 1.59); people aged 21 to 23 years (PR = 1.24); those with a family history of depression (PR = 1.27); minorities' sexual orientation (homosexuals, PR = 1.64, and bisexuals, PR = 1.69); who lived with friends or colleagues (PR = 1.36); students in the area of applied social and human sciences (PR = 1.28), and linguistics, language and literature, and art (PR = 1.25). The worst academic performance (PR = 2.61), alcohol abuse (PR = 1.25), and illicit drug use (PR = 1.30) were also positively associated with major depressive episode. CONCLUSION: In addition to individual, family, and behavioral aspects, already described as risk factors for major depressive episodes in the general population, academic aspects also influence the occurrence of depression among university students. Considering the high prevalence of major depressive episode and its negative impact on health, public and institutional policies are necessary to focus on students' mental health promotion and care.

Major depressive episode among university students in Southern Brazil / Episódio depressivo maior entre universitários do sul do Brasil

ABSTRACT INTRODUCTION Depression is the leading cause of disability around the world, and it has been increasingly affecting young people. This study evaluates the prevalence and factors associated with major depression in university students, with emphasis on the influence of the academic field, chosen study area and the environment they are inserted. METHODS A census of students who entered the university in the first semester of 2017 was held at a university in Southern Brazil. The outcome of major depressive episode was evaluated using the Patient Health Questionnaire-9, considered when the individual had five or more depressive symptoms for at least one week. Its prevalence was estimated, and the associated factors were examined by the hierarchical multivariable analysis using the Poisson regression model. RESULTS A total of 32% (95% confidence interval 29.9-34.2) of university students presented a major depressive episode, and the problem was more frequent among women (prevalence ratio [PR] = 1.59); people aged 21 to 23 years (PR = 1.24); those with a family history of depression (PR = 1.27); minorities' sexual orientation (homosexuals, PR = 1.64, and bisexuals, PR = 1.69); who lived with friends or colleagues (PR = 1.36); students in the area of applied social and human sciences (PR = 1.28), and linguistics, language and literature, and art (PR = 1.25). The worst academic performance (PR = 2.61), alcohol abuse (PR = 1.25), and illicit drug use (PR = 1.30) were also positively associated with major depressive episode. CONCLUSION In addition to individual, family, and behavioral aspects, already described as risk factors for major depressive episodes in the general population, academic aspects also influence the occurrence of depression among university students. Considering the high prevalence of major depressive episode and its negative impact on health, public and institutional policies are necessary to focus on students' mental health promotion and care.

RESUMO INTRODUÇÃO A depressão é a principal causa de incapacidade em todo o mundo, atingindo cada vez mais os jovens. Este estudo avalia a prevalência e fatores associados ao episódio depressivo maior em universitários, com ênfase na influência do meio acadêmico, área de estudo escolhida pelo universitário e ambiente onde ele está inserido. METODOLOGIA Realizou-se um censo dos universitários ingressantes do primeiro semestre de 2017 em uma universidade do sul do Brasil. O desfecho episódio depressivo maior foi avaliado a partir do questionário Patient Health Questionnaire-9, considerado quando o indivíduo apresentava cinco ou mais sintomas depressivos por pelo menos uma semana. Sua prevalência foi estimada e os fatores associados foram examinados pela análise multivariável hierarquizada utilizando a regressão de Poisson com seleção para trás. RESULTADOS Um total de 32% (intervalo de confiança de 95% 29,9-34,2) dos universitários apresentou episódio depressivo maior, e o problema foi mais frequente entre indivíduos do sexo feminino (razão de prevalências [RP] = 1,59), de 21 a 23 anos de idade (RP = 1,24), com histórico familiar de depressão (RP = 1,27), com orientação sexual de minorias (homossexuais, RP = 1,64, e bissexuais, RP = 1,69), que moravam com amigos ou colegas (RP = 1,36), estudantes da área das ciências sociais aplicadas e humanas (RP = 1,28) e de linguística, letras e artes (RP = 1,25). O pior desempenho acadêmico (RP = 2,61), o uso abusivo de álcool (RP = 1,25) e o consumo de drogas ilícitas (RP = 1,30) também estiveram positivamente associados ao episódio depressivo maior. CONCLUSÃO Além dos aspectos individuais, familiares e comportamentais, semelhantes aos já descritos como fatores de risco para episódio depressivo maior na população em geral, aspectos acadêmicos também influenciam a ocorrência de depressão entre universitários. Considerando a alta prevalência de episódio depressivo maior e seu impacto negativo na saúde, são necessárias políticas públicas e institucionais que enfoquem a promoção da saúde e atenção à demanda de saúde mental dos estudantes.