Postnatal depression in Southern Brazil: prevalence and its demographic and socioeconomic determinants.

BACKGROUND: Studies investigating the prevalence of postnatal depression (PND) show rates ranging from 5% to 36.7%. The investigation of age, race, educational levels, religion and income as risk factors for PND has yielded conflicting results. The aim of this study is to investigate the prevalence of PND in women residing in Southern Brazil and the associated risk factors. METHODS: This is population-based cross-sectional study of women residing in Porto Alegre who delivered in June 2001. A sample of 271 participants were selected from the Record of Living Newborn Infants of the State Health Department (the official Brazilian database and stores the name and address of all women who give birth to living newborn infants) using a process based on pseudo-random numbers which choose a random sample from 2.000 records. Once the addresses were identified, the women were visited at their place of residence (home, hotel, boarding house and prison), with the interviews taking place between the 6th and the 8th week after delivery. The association between the risk factors and PND was investigated through bivariate analysis using Pearson's chi-square test. Student's t-test was used to analyze the continuous variables. To identify independent risk factors, multivariate analysis was performed using hierarchical levels with a predefined model that took into account the time relationship between PND and the risk factors. Cox's regression was used to calculate the prevalence ratios. RESULTS: The PND prevalence rate found was 20.7% (CI 95% 15.7 - 25.7). After adjusting for confounding variables, per capita income was found to have a significant association with PND. CONCLUSION: The prevalence of PND is higher than the figures found in most developed countries and similar to the figures found in developing countries. Differences in PND by regions or countries can be partially explained by the effect of income on the mediation of risk factors. In low income populations, women should be routinely evaluated for postnatal depression, and those with no partner or spouse are likely to require further care from health services and should be given the benefit of mental health prevention programs.

Confiabilidade diagnóstica dos transtornos mentais da versäo para cuidados primários da Classificaçäo Internacional das Doenças / Diagnostic reliability of mental disorders of the International Classification of Diseases - primary care

Objetivo: Avaliar a confiabilidade da versäo para teste do capítulo V - "Transtornos Mentais e do Comportamento", da décima revisäo da Classificaçäo Internacional das Doenças, Versäo para Cuidados Primários (CID-10 CP), preparado pela Divisäo de Saúde Mental da Organizaçäo Mundial da Saúde (OMS). Métodos: Durante os meses de setembro e outubro de 1994 foram treinados médicos gerais comunitários (MGC) da Secretaria da Saúde e do Meio Ambiente do Estado do Rio Grande do Sul, no uso da citada versäo, preparada para teste de campo, conforme o delineamento proposto pela OMS. Resultados: Os resultados referem-se ao estudo sobre concordância dos diagnósticos atribuídos por 9 duplas de MGC a 440 pacientes de primeira consulta. O Kappa de Cohen para Transtorno de Saúde Mental, presente ou ausente, foi de 0,79 (IC 95 por cento: 0,69-0,88). Conclusäo: O uso da CID-10 CP dará maior especificidade às informaçöes e permitirá maior comunicaçäo entre as equipes de saúde em nível de cuidados primários