Prevalence and clinical profile of chronic pain and its association with mental disorders

OBJECTIVE: To identify the prevalence of 12-month self-reported pain and chronic pain in a general population and to describe their clinical profile to assess if chronic pain is associated with 12-month mental disorders. METHODS: The data used comes from the São Paulo Megacity Mental Health Survey, a population-based study assessing adult (≥ 18 years) residents of the São Paulo metropolitan area, Brazil. We have assessed the respondents (n = 5,037) using the Composite International Diagnostic Interview (CIDI 3.0), with a global response rate of 81.3%. Descriptive analyses have been performed, and crude and adjusted odds ratios (OR) have been calculated with logistic and multinomial regression and presented with respective 95% confidence intervals (95%CI). RESULTS: The prevalence of pain and chronic pain in the past 12 months were 52.6% (95%CI 50.3–54.8) and 31.0% (95%CI 29.2–32.7), respectively. Joints (16.5%, 95%CI 15.4–17.5) and back or neck (15.5%, 95%CI 14.2–16.9) were the most frequently reported anatomical sites of chronic pain. On a 10-point analogue scale, the mean intensity of the worst pain was 7.7 (95%CI 7.4–7.8), and the mean average pain was 5.5 (95%CI 5.2–5.6); the mean treatment response was 6.3 (95%CI 6.0–6.6). Mean pain duration was 16.1 (95%CI 15.6–17.0) days a month and 132 (95%CI 126–144) minutes a day. Chronic pain was associated with 12-month DSM-IV mental disorders (OR = 2.7, 95%CI 2.3–3.3), anxiety disorders (OR = 2.1, 95%CI 1.9–3.0), and mood disorders (OR = 3.3, 95%CI 2.4–4.1). CONCLUSIONS: A high prevalence of chronic pain in multiple sites is observed among the general adult population, and associations between chronic pain and mental disorders are frequent

Prevalence and clinical profile of chronic pain and its association with mental disorders

ABSTRACT OBJECTIVE To identify the prevalence of 12-month self-reported pain and chronic pain in a general population and to describe their clinical profile to assess if chronic pain is associated with 12-month mental disorders. METHODS The data used comes from the São Paulo Megacity Mental Health Survey, a population-based study assessing adult (≥ 18 years) residents of the São Paulo metropolitan area, Brazil. We have assessed the respondents (n = 5,037) using the Composite International Diagnostic Interview (CIDI 3.0), with a global response rate of 81.3%. Descriptive analyses have been performed, and crude and adjusted odds ratios (OR) have been calculated with logistic and multinomial regression and presented with respective 95% confidence intervals (95%CI). RESULTS The prevalence of pain and chronic pain in the past 12 months were 52.6% (95%CI 50.3–54.8) and 31.0% (95%CI 29.2–32.7), respectively. Joints (16.5%, 95%CI 15.4–17.5) and back or neck (15.5%, 95%CI 14.2–16.9) were the most frequently reported anatomical sites of chronic pain. On a 10-point analogue scale, the mean intensity of the worst pain was 7.7 (95%CI 7.4–7.8), and the mean average pain was 5.5 (95%CI 5.2–5.6); the mean treatment response was 6.3 (95%CI 6.0–6.6). Mean pain duration was 16.1 (95%CI 15.6–17.0) days a month and 132 (95%CI 126–144) minutes a day. Chronic pain was associated with 12-month DSM-IV mental disorders (OR = 2.7, 95%CI 2.3–3.3), anxiety disorders (OR = 2.1, 95%CI 1.9–3.0), and mood disorders (OR = 3.3, 95%CI 2.4–4.1). CONCLUSIONS A high prevalence of chronic pain in multiple sites is observed among the general adult population, and associations between chronic pain and mental disorders are frequent

O Impacto dos transtornos mentais no trabalho : resultados do estudo epidemiológico de transtornos mentais São Paulo Megacity

O objetivo deste estudo é estimar a prevalência de transtornos mentais de acordo com a situação de emprego por sexo, analisar associações entre os transtornos mentais e situação de emprego, bem como entre a busca de tratamento e situação de emprego dentre os respondentes com transtornos mentais nos últimos 12 meses. Além disso, pretende-se analisar a perda de dias de trabalho devido ao absenteísmo e ao presenteísmo associando-os com os transtornos mentais, dentre os trabalhadores. Os dados foram analisados a partir do Estudo São Paulo Megacity, um estudo de base populacional que avaliou os transtornos mentais em uma amostra probabilística de 5.037 adultos residentes na Região Metropolitana de São Paulo, utilizando a versão do Composite International Diagnostic Interview da Organização Mundial de Saúde. A amostra foi dividida em grupos de acordo com a situação de trabalho – trabalhadores, economicamente inativos e desempregados. A prevalência dos transtornos mentais foi estimada estratificada por sexo, bem como, as associações com as situações de emprego, características sócio-demográficas e procura por tratamento. O número médio de dias perdidos por absenteísmo e presenteísmo na população de trabalhadores foi estimado baseado na Escala de Avaliação de Incapacidade Organização Mundial de Saúde. Os efeitos a nível populacional e os custos financeiros também foram estimados. As associações foram medidas pelo Odds Ratio e calculada através do modelo de regressão logística multinomial. Do total da amostra (n= 5.035), 63% eram trabalhadores, 25% economicamente inativos e 12% desempregados. Os trabalhadores foram associados ao sexo masculino, menor idade, maior número de anos estudados e maior renda. As mulheres apresentaram maior prevalência de transtornos de humor e ansiedade. Os homens foram associados a qualquer transtorno mental, transtorno de humor e transtorno de ansiedade, as mulheres foram associadas a situação de emprego economicamente inactivas e desempregadas. Os homens cuja situação de emprego era trabalhador mostrou maiores prevalências nos transtornos de impulso-controle e nos transtornos por uso de substâncias psicoativas. As mulheres cuja situação de emprego era trabalhador e os homens cuja situação de emprego era economicamente inativos, tiveram maiores prevalências de transtornos mentais. Dentre respondentes com algum transtorno mental, os respondentes economicamente inativos apresentaram associação com a procura de tratamento de saúde geral e de saúde mental. A presença de algum transtorno mental foi associado com 26,8 dias/ano devido ao absenteísmo, 92,2 dias/ano devido ao presenteísmo e 125,9 dias/ano de perda total de trabalho. Os custos anuais da perda de trabalho foram estimados em R$2,6 bilhões por ano, correspondentes a R$ 690 milhões por ano devido ao absenteísmo, e R$1,9 bilhões por ano devido ao presenteísmo. Nossos resultados fornecem importantes informações epidemiológicas sobre os transtornos mentais e o impacto no trabalho que devem ser levadas em consideração na definição de prioridades para os cuidados em saúde e alocação de recursos.The aims of this study is to estimate the prevalence of mental disorders according to employment status by gender, analyse associations of mental disorders and employment status, and identify the association between treatment seek and employment status among respondents with mental disorders. Moreover, we will estimate the work loss days due to absenteeism and presenteeism, and your association with mental disorders, in the working respondents. Data was analyzed from the São Paulo Megacity Mental Health Survey, a population-based study assessing mental disorders on a probabilistic sample of 5,037 adult residents in the São Paulo Metropolitan Area, using the World Mental Health Survey version of the Composite International Diagnostic Interview. The sample was divided into groups according to employment status, working, economically inactive, and unemployed. The prevalence of mental disorders estimatives were stratified by sex as well, associations with employment status, socio-demographics characteristics, and treatment seek. The mean number of absenteeism and presenteeism in working population was estimate based on the World Health Organization Disability Assessment Schedule. Population-level effects and financial burden were analised. The associations were measured by Odds Ratio using multinomial logistic regression model. The sample was composed by 63men, younger, higher education and income. Most men were working (75women were working and 40mood and anxiety disorders. Men presented magnitude of association between any mental, mood and anxiety disorders, and economically inactive or unemployed. Working men shows higher prevalences of impulse-control and substance use disorders. Working women and inactive men had higher mental disorders prevalence. Among respondents with mental disorders, economically inactive respondents were associated to seek general and mental treatment. Any mental disorder was associated with 26.8 loss days due to absenteeism, 92.2 due to presenteeism, and 125.9 total work loss days. The total work loss per year were costs estimated at R$ 2,6 billion per year, corresponding R$690 million per year due to absenteeism and R$ 1,9 billion per year due to presenteeism. Our findings provide news epidemiological information about mental disorders and these impacts on work should be considered in establishing priorities for the allocation of health care and resources

Prevalence and clinical profile of chronic pain and its association with mental disorders

ABSTRACT OBJECTIVE To identify the prevalence of 12-month self-reported pain and chronic pain in a general population and to describe their clinical profile to assess if chronic pain is associated with 12-month mental disorders. METHODS The data used comes from the São Paulo Megacity Mental Health Survey, a population-based study assessing adult (≥ 18 years) residents of the São Paulo metropolitan area, Brazil. We have assessed the respondents (n = 5,037) using the Composite International Diagnostic Interview (CIDI 3.0), with a global response rate of 81.3%. Descriptive analyses have been performed, and crude and adjusted odds ratios (OR) have been calculated with logistic and multinomial regression and presented with respective 95% confidence intervals (95%CI). RESULTS The prevalence of pain and chronic pain in the past 12 months were 52.6% (95%CI 50.3–54.8) and 31.0% (95%CI 29.2–32.7), respectively. Joints (16.5%, 95%CI 15.4–17.5) and back or neck (15.5%, 95%CI 14.2–16.9) were the most frequently reported anatomical sites of chronic pain. On a 10-point analogue scale, the mean intensity of the worst pain was 7.7 (95%CI 7.4–7.8), and the mean average pain was 5.5 (95%CI 5.2–5.6); the mean treatment response was 6.3 (95%CI 6.0–6.6). Mean pain duration was 16.1 (95%CI 15.6–17.0) days a month and 132 (95%CI 126–144) minutes a day. Chronic pain was associated with 12-month DSM-IV mental disorders (OR = 2.7, 95%CI 2.3–3.3), anxiety disorders (OR = 2.1, 95%CI 1.9–3.0), and mood disorders (OR = 3.3, 95%CI 2.4–4.1). CONCLUSIONS A high prevalence of chronic pain in multiple sites is observed among the general adult population, and associations between chronic pain and mental disorders are frequent

Mental disorders and employment status in the São Paulo Metropolitan Area, Brazil: gender differences and use of health services

Abstract: Mental disorders are associated with employment status as significant predictors and as consequences of unemployment and early retirement. This study describes the estimates and associations of 12-month DSM-IV prevalence rates of mental disorders and use of health services with employment status by gender in the São Paulo Metropolitan Area, Brazil. Data from the São Paulo Megacity Mental Health Survey was analyzed (n = 5,037). This is a population-based study assessing the prevalence and determinants of mental disorders among adults, using the Composite International Diagnostic Interview. The associations were estimated by odds ratios obtained through binomial and multinomial logistic regression. This study demonstrates that having mental disorders, especially mood disorders, is associated with being inactive or unemployed among men and inactive among women, but only having a substance use disorder is associated with being unemployed among women. Among those with mental disorders, seeking health care services is less frequent within unemployed

Brazilian Flora 2020: Leveraging the power of a collaborative scientific network

International audienceThe shortage of reliable primary taxonomic data limits the description of biological taxa and the understanding of biodiversity patterns and processes, complicating biogeographical, ecological, and evolutionary studies. This deficit creates a significant taxonomic impediment to biodiversity research and conservation planning. The taxonomic impediment and the biodiversity crisis are widely recognized, highlighting the urgent need for reliable taxonomic data. Over the past decade, numerous countries worldwide have devoted considerable effort to Target 1 of the Global Strategy for Plant Conservation (GSPC), which called for the preparation of a working list of all known plant species by 2010 and an online world Flora by 2020. Brazil is a megadiverse country, home to more of the world's known plant species than any other country. Despite that, Flora Brasiliensis, concluded in 1906, was the last comprehensive treatment of the Brazilian flora. The lack of accurate estimates of the number of species of algae, fungi, and plants occurring in Brazil contributes to the prevailing taxonomic impediment and delays progress towards the GSPC targets. Over the past 12 years, a legion of taxonomists motivated to meet Target 1 of the GSPC, worked together to gather and integrate knowledge on the algal, plant, and fungal diversity of Brazil. Overall, a team of about 980 taxonomists joined efforts in a highly collaborative project that used cybertaxonomy to prepare an updated Flora of Brazil, showing the power of scientific collaboration to reach ambitious goals. This paper presents an overview of the Brazilian Flora 2020 and provides taxonomic and spatial updates on the algae, fungi, and plants found in one of the world's most biodiverse countries. We further identify collection gaps and summarize future goals that extend beyond 2020. Our results show that Brazil is home to 46,975 native species of algae, fungi, and plants, of which 19,669 are endemic to the country. The data compiled to date suggests that the Atlantic Rainforest might be the most diverse Brazilian domain for all plant groups except gymnosperms, which are most diverse in the Amazon. However, scientific knowledge of Brazilian diversity is still unequally distributed, with the Atlantic Rainforest and the Cerrado being the most intensively sampled and studied biomes in the country. In times of “scientific reductionism”, with botanical and mycological sciences suffering pervasive depreciation in recent decades, the first online Flora of Brazil 2020 significantly enhanced the quality and quantity of taxonomic data available for algae, fungi, and plants from Brazil. This project also made all the information freely available online, providing a firm foundation for future research and for the management, conservation, and sustainable use of the Brazilian funga and flora