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

<p>Abstract</p> <p>Background</p> <p>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.</p> <p>Methods</p> <p>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 6^thand the 8^thweek after delivery.</p> <p>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.</p> <p>Results</p> <p>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.</p> <p>Conclusion</p> <p>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.</p

Deese-roediger-McDermott paradigm: Effect of previous recall and type of memory task

Pretendeu-se averiguar se a activação dos itens críticos no paradigma de Deese-Roediger-McDermott também ocorreria numa tarefa de completamento. Para analisar a contaminação explícita explorámos a existência de resultados dissociados em função da manipulação do nível de processamento. Na tarefa de completamento, a primação semântica foi estatisticamente superior à primação directa. A ausência do efeito do nível de processamento demonstra que o teste foi de memória implícita. Também avaliámos o impacto de uma tarefa de evocação numa tarefa de memória posterior. Verificámos que a evocação prévia anulou o efeito do nível de processamento na tarefa de reconhecimento. Na tarefa de completamento de inícios de palavras, o incremento de inícios de palavras completados com associados só foi expressivo quando as palavras foram codificadas superficialmente.This study aimed to verifj whether lhe activation ofcritical items in the Deese-Roediger-McDermott paradigm ofproducing false memories could also occur in the word stem completion task. The finding that lhe levei ofprocessing did not seem to have any effect on the word stem completion task supported lhe conclusion that the stem completion task was in fact an irnplicit memory test. The impact of a previous recali in a followng memory task was also evaluated. The results indicated that lhe previous recall inhibited the effect ofthe processing levei in lhe recognition task. In the word stem completion task lhe increase ofstems completed with associates was only relevam when words were encoded superficialiy.(undefined

The relevance of continuity of care: a solution for the chaos in the emergency services.

BACKGROUND: In Brazil, there continues to be an excessive use of emergency services by patients with elective medical problems. Those patients who report having a primary care physician are less likely to utilize the emergency department for non-urgent consultations. OBJECTIVE: The objective of this study was to compare patients who have a primary care physician with those who do not in relation to severity of their chief complaint at presentation in the emergency department. METHODS: The study was carried out as a cross-sectional interview-based survey at the Conceição Hospital Emergency Service in Porto Alegre (Brazil). The sample was 553 patients selected through a systematic random sampling, and the response rate was 88%. The data entry and analysis were performed using the software Epi-info, EGRET and SPSS. The analysis included simple statistics to determine the prevalence of the conditions being investigated and the effect of independent variables (regular doctor) in relation to the dependent variable (severity of disease) through logistic regression. RESULTS: The chief complaints were divided up as follows: 15% emergency cases, 46% urgent cases and 39% elective. The chief complaint was defined as urgent or emergency if it exhibited a significantly statistical association with the following independent variables, after being analysed by a logistic regression model: patients who reported having a primary care physician [odds ratio (OR) = 2.98, 95% confidence interval (CI) = 1.84-4.80] and patients who usually go to the emergency room by car (OR = 2.67, 95% CI = 1.75-4.05). CONCLUSION: One strategy to reduce the number of non-urgent consultations at emergency rooms is to establish a close out-patient relationship between patients and physician. There is a need to optimize the health care of patients who have non-urgent problems but still seek the emergency department through strategies at the primary health care level-especially when continuous care is available-and where a comprehensive approach with an emphasis on prevention would stimulate better quality of care at a lower cost

Brazilian multicentric study of psychiatric morbidity - Methodological features and prevalence estimates

Background Psychiatric morbidity studies in developing countries have used diagnostic procedures of tow reliability, without a clinical definition of caseness, producing descriptive data with limited application for mental health planning.Method A two-stage cross-sectional design (with a sample size of 6476) was conducted to estimate the prevalence of DSM-III psychiatric diagnoses in three metropolitan areas of Brazil (Brasilia, São Paulo and Porto Alegre), All subjects were screened for the presence of psychopathology with a 44-item instrument (the QMPA) and a subsample was selected for a psychiatric interview.Results Age-adjusted prevalence of cases potentially in need of care ranged from 19% (São Paulo) to 34% (Brasilia and Porto Alegre). Anxiety disorders comprised the highest prevalences (up to 18%). Alcoholism yielded the most consistent prevalence levels, around 8% in all sites. Depression showed great variation between areas: from less than 3% (São Paulo and Brasilia) to 10% (Porto Alegre).Conclusions Overall prevalences were high in comparison with previous studies conducted in Brazil. A female excess of non-psychotic disorders (anxiety, phobias, somatisation and depression) and a male excess for alcoholism were consistently found.Univ Fed Bahia, Inst Saude Coletiva, BR-40210270 Salvador, BA, BrazilUniversidade Federal de São Paulo, Sch Med, Dept Psychiat & Med Psychol, São Paulo, BrazilUniv Brasilia, Dept Clin Med, BR-70910900 Brasilia, DF, BrazilUniv Fed Rio Grande Sul, Dept Neurol, BR-90046900 Porto Alegre, RS, BrazilUniv Fed Rio Grande Sul, Fac Med, Dept Psychiat, Porto Alegre, RS, BrazilUniversidade Federal de São Paulo, Sch Med, Dept Psychiat & Med Psychol, São Paulo, BrazilWeb of Scienc