Epidemiology of childhood conduct problems in Brazil: systematic review and meta-analysis

This study aimed to review evidence on the prevalence of and risk factors for conduct problems in Brazil.We searched electronic databases and contacted Brazilian researchers up to 05/2012. Studies were included in the review if they reported the prevalence of or risk factors for conduct problems, conduct disorder, or oppositional defiant disorder for 100 + Brazilian children aged a parts per thousand currency sign18 years, systematically sampled in schools or the community. Prevalence rates and sex differences were meta-analysed. Risk factor studies were reviewed one by one.The average prevalence of conduct problems in screening questionnaires was 20.8 %, and the average prevalence of conduct disorder/oppositional defiant disorder was 4.1 %. There was systematic variation in the results of screening studies according to methodology: recruitment location, informants, instruments, impairment criterion for case definition, and response rates. Risk factors previously identified in high-income countries were mainly replicated in Brazil, including comorbid mental health problems, educational failure, low religiosity, harsh physical punishment and abuse, parental mental health problems, single parent family, and low socioeconomic status. However, boys did not always have higher risk for conduct problems than girls.Studies using screening questionnaires suggest that Brazilian children have higher rates of conduct problems than children in other countries, but diagnostic studies do not show this difference. Risk factors in Brazil were similar to those in high-income countries, apart from child sex. Future research should investigate developmental patterns of antisocial behaviour, employ a variety of research designs to identify causal risk mechanisms, and examine a broader range of risk factors.Wellcome TrustUniv Cambridge, Dept Psychiat, Cambridge CB2 8AH, EnglandUniv Fed Pelotas, Postgrad Program Epidemiol, Pelotas, BrazilUniv São Paulo, Dept Psychiat, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Psychiat, Pelotas, BrazilUniversidade Federal de São Paulo, Dept Psychiat, Pelotas, BrazilWellcome Trust: 089963/Z/09/ZWeb of Scienc

Childhood behaviour problems predict crime and violence in late adolescence: Brazilian and British birth cohort studies.

PURPOSE: Most children live in low- and middle-income countries (LMICs), many of which have high levels of violence. Research in high-income countries (HICs) shows that childhood behaviour problems are important precursors of crime and violence. Evidence is lacking on whether this is also true in LMICs. This study examines prevalence rates and associations between conduct problems and hyperactivity and crime and violence in Brazil and Britain. METHODS: A comparison was made of birth cohorts in Brazil and Britain, including measures of behaviour problems based on parental report at age 11, and self-reports of crime at age 18 (N = 3,618 Brazil; N = 4,103 Britain). Confounders were measured in the perinatal period and at age 11 in questionnaires completed by the mother and, in Brazil, searches of police records regarding parental crime. RESULTS: Conduct problems, hyperactivity and violent crime were more prevalent in Brazil than in Britain, but nonviolent crime was more prevalent in Britain. Sex differences in prevalence rates were larger where behaviours were less common: larger for conduct problems, hyperactivity, and violent crime in Britain, and larger for nonviolent crime in Brazil. Conduct problems and hyperactivity predicted nonviolent and violent crime similarly in both countries; the effects were partly explained by perinatal health factors and childhood family environments. CONCLUSIONS: Conduct problems and hyperactivity are similar precursors of crime and violence across different social settings. Early crime and violence prevention programmes could target these behavioural difficulties and associated risks in LMICs as well as in HICs.This is the final published version, published by Springer in Social Psychiatry and Psychiatric Epidemiology (http://link.springer.com/article/10.1007%2Fs00127-014-0976-z)

Victimization and maltreatment in childhood and adolescence and mental health problems at age 18: 1993 birth cohort study

Violence against children and adolescents, whatever its form, is an important concern for world organizations and one of the main global issues to be resolved, due to the impact it has on the number of victims and the magnitude of the organic and emotional consequences it produces. throughout an individual's life. Exposure to violence in childhood has been associated with the development of mental health problems in adolescence and adulthood. However, there is little evidence available from prospective studies in low- or middle-income countries, and the differences by sex in the association between maltreatment in childhood and adolescence with the subsequent development of depression or anxiety are not well understood. The objectives of this thesis were: 1) to study the various factors associated with exposure to violence in childhood and adolescence among members of the 1993 birth cohort study in the city of Pelotas-RS, Brazil, 2) to study the relationship between treatment in childhood and adolescence with the subsequent development of a major depressive episode at the age of 18-19, in this same cohort study, and 3) summarize the evidence in the literature on differences by sex in the association between childhood maltreatment and depression or anxiety in childhood. adulthood. The main findings are described below for each article:Article 1. Through official records, it was observed that victimization events in childhood and adolescence are present in 22% of cohort members up to the age of 18. The highest incidences were found among females, and among members whose mothers were teenagers, poorer, less educated and without a partner at the time of the child's birth. The most frequent violent victimization was for crimes of bodily harm, robbery and crimes against individual freedom. The rate of violence in the community registered in official bodies is much higher than violence within the family. Article 2. Women in the cohort who reported exposure to emotional abuse (OR = 2.7; 95% CI = 1.9 - 3.8) and domestic violence (OR = 1.9; 95% CI = 1.2 - 2.9) in childhood, were at increased risk for depression, even after adjusting for confounders and other types of maltreatment. Women exposed to two or more forms of maltreatment had a higher risk of depression (OR = 4.1; 95% CI = 2.8 - 6.1) compared to unexposed girls. In the adjusted analysis, maltreatment was not associated with depression among men. Review article. A significant association (p0.05). Violence against children and adolescents is an important risk factor for the development of major depressive episodes and /or anxiety. Early interventions to prevent all forms of violence in childhood are necessary in order to reduce the consequences on adult mental health, especially among girls exposed to poly-maltreatment. Studies like the present one would make it possible to identify risk and protective factors throughout an individual's life, highlighting the importance of implementing surveillance and violence control measures.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPESOutrosA violência contra crianças e adolescentes, qualquer que seja sua forma, é uma importante preocupação das organizações mundiais e um dos principais temas globais a ser resolvido, devido ao impacto que tem sobre o número de vítimas e a magnitude das sequelas orgânicas e emocionais que produz ao longo da vida de um individuo. Exposição à violência na infância tem sido associada com o desenvolvimento de problemas de saúde mental na adolescência e na vida adulta. No entanto, tem se pouca evidência disponível de estudos prospectivos em países de baixa ou média renda, assim mesmo, não são bem esclarecidas as diferenças por sexo na associação entre maus-tratos na infância e adolescência com o posterior desenvolvimento de depressão ou ansiedade. Os objetivos da presente tese foram: 1) estudar os diversos fatores associados com a exposição à violência na infância e adolescência dos membros do estudo de coorte de nascimentos de 1993 da cidade de Pelotas-RS, Brasil, 2) estudar a relação entre maus-tratos na infância e adolescência com o subsequente desenvolvimento de episódio depressivo maior aos 18-19 anos, neste mesmo estudo de coorte, e 3) sumarizar as evidências na literatura das diferenças por sexo na associação entre maus-tratos na infância com depressão ou ansiedade na idade adulta. Os principais achados são descritos na continuação para cada artigo:Artigo 1. Através de registros oficiais foi observado que eventos de vitimização na infância e adolescência encontram-se presentes em 22% dos membros da coorte até a idade de 18 anos. As maiores incidências foram constatadas para o sexo feminino, e entre membros cujas mães eram adolescentes, mais pobres, menos escolarizadas e sem companheiro ao momento do nascimento da criança. A vitimização violenta mais incidente foi por crimes de lesões corporais, roubo e crimes contra a liberdade individual. A taxa de violência na comunidade registrada nos órgãos oficiais é muito mais alta que violência no âmbito familiar. Artigo 2. Mulheres da coorte que relataram exposição a abuso emocional (OR = 2,7; IC95% = 1,9 - 3.8) e violência doméstica (OR = 1,9; IC95% = 1,2 - 2,9) na infância, estavam em risco aumentado para depressão, mesmo após o ajuste para fatores de confusão e outros tipos de maus-tratos. Mulheres expostas a duas ou mais formas de maus-tratos apresentaram maior risco para a depressão (OR = 4,1; IC95% = 2,8 - 6,1) em comparação com as meninas não expostas. Na análise ajustada, maus-tratos não foram associados com a depressão entre homens. Artigo de Revisão. Observou-se associação significativa (p0,05).A violência contra crianças e adolescentes é um importante fator de risco para o desenvolvimento de episódio depressivo maior e/ou ansiedade. Intervenções precoces para prevenir todas as formas de violência na infância são necessárias com o intuito de diminuir as consequências sobre a saúde mental do adulto, especialmente entre as meninas expostas a poli-maus-tratos. Estudos como o presente, permitiriam identificar fatores de risco e protetores ao longo da vida do indivíduo, salientando a importância da implementação de medidas de vigilância e controle da violência

Fetal growth, birth size and mental health problems at 11 years of age: the 1993 Pelotas (Brazil) births cohort study

The aim of this study was to evaluate the association between fetal growth and size at birth with mental health problems at 11 years of age in the 1993 Pelotas (Brazil) Birth Cohort Study. Newborns were weighed and measured and calculated anthropometric indexes. At age 11, were assessed mental health problems with the strengths and difficulties questionnaire (SDQ). The prevalence of mental health problems was 32%. After adjustment for potential confounders, we found that newborns with the z score of weight for age and body mass index (BMI) for age +2 SD were respectively 34% (95% CI: 6 to 71) and 19% (95% : 1 to 40) greater risk of developing the disease than babies with normal scores. The results suggest that factors occurring during pregnancy that are reflected in measures of size at birth can cause mental health problems in late stages.O objetivo deste estudo foi avaliar a associação entre crescimento fetal e tamanho ao nascer com problemas de saúde mental aos 11 anos na Coorte de Nascimentos de 1993 de Pelotas, RS. Recém-nascidos foram pesados e medidos, e calculados índices antropométricos. Aos 11 anos, foram avaliados problemas de saúde mental com o questionário de capacidades e dificuldades (SDQ). A prevalência de problemas de saúde mental foi 32%. Após ajuste para fatores de confusão, recém-nascidos com escore z de peso/idade e índice de massa corporal (IMC)/idade +2 DP apresentaram respectivamente 34% (IC95%: 6 a 71) e 19% (IC95%: 1 a 40) maior risco de desenvolver estes problemas que nascidos com escore normal. Os resultados sugerem que fatores ocorridos na gestação e refletidos nas medidas de tamanho ao nascer podem ocasionar problemas de saúde mental em etapas tardias

Propiedades psicométricas de la Escala de Fragilidad en ancianos ecuatorianos y análisis de correlación con el estado nutricional y maltrato global

The general objective was to analyze the psychometric properties of the feasibility scale in the Ecuadorian elderly and to determine whether frailty is associated with nutritional status and global mistreatment of the elderly, with the purpose of generating public policies that contribute to the reduction of mistreatment of the elderly. A study of the psychometric properties was carried out by means of an exploratory and confirmatory factor analysis, in addition, a non-experimental, quantitative, descriptive-correlational, cross-sectional, and prospective research was conducted with a sample of 195 older adults ≥ 60 years old belonging to the city of Cuenca through a non-probabilistic sampling. As results, women predominated in 61%, rural and urban residence in 50%, married marital status in 53.5%, academic level secondary level in 47.1%, medium socioeconomic level in 62.3%, with a total global mistreatment of 19.7%, where the female sex evidenced significant differences in physical mistreatment (p=0. 01), finally, it was evidenced that nutritional status was positively correlated with frailty in both urban and rural residence (r = 0.67, rural r = 0.68), rural r = 0.68); rural r = 0.68), but there is no relationship between frailty and nutritional status and maltreatment. In conclusion, this study will contribute to future research, and it is recommended that more research be conducted on this problem, especially on the factors that trigger mistreatment to contribute to the generation of public policies that benefit older adults and help them to better manage their old age.El objetivo general fue analizar las propiedades psicométricas de la escala de factibilidad en el anciano ecuatoriano y determinar si la fragilidad se asocia con el estado nutricional y el maltrato global del adulto mayor, con el propósito de generar políticas públicas que contribuyan a la reducción del maltrato del adulto mayor. Se realizó un estudio de las propiedades psicométricas mediante un análisis factorial exploratorio y confirmatorio, además se efectuó una investigación no experimental, cuantitativo, descriptivo-correlacional, transversal y prospectivo con una muestra de 195 adultos mayores ≥ 60 años pertenecientes a la ciudad de Cuenca a través de un muestreo no probabilístico. Como resultados, predominaron las mujeres en un 61%, residencia rural y urbana en un 50%, estado civil casado en un 53,5%, nivel académico nivel secundario en un 47,1%, nivel socioeconómico medio en un 62,3%, con un maltrato global total de 19,7%, donde el sexo femenino evidenció diferencias significativas en el maltrato físico (p=0. 01), finalmente se evidenció que el estado nutricional se correlacionó positivamente con la fragilidad tanto en la residencia urbana como en la rural (r = 0,67, rural r = 0,68), en la rural r = 0,68); rural r = 0,68), pero no hay relación entre fragilidad y estado nutricional y maltrato. En conclusión, este estudio contribuirá a futuras investigaciones y se recomienda realizar más investigaciones sobre esta problemática, especialmente sobre los factores que desencadenan el maltrato para contribuir a la generación de políticas públicas que beneficien a los adultos mayores y los ayuden a manejar mejor su vejez

Factores asociados al maltrato al adulto mayor: Revisión Sistemática

Elder abuse is defined as the intentional harm inflicted on an older adult or the failure to protect an older adult from harm or deprivation of the satisfaction of his or her basic needs. The main objective was to examine in the scientific literature the factors associated with elder mistreatment and, in the face of these findings, to seek help through preventive programs to reduce elder mistreatment. A systematic review of the literature was carried out using the recommendations of the PRISMA statement, in the Scopus, PubMed, and Web of Science databases. The risk factors associated with elder abuse were young age (60 to 74 years), female sex, married marital status, African American ethnicity, and low economic status. In addition, the protective factors were good physical and mental health. In conclusion, it would be of vital importance to generalize public policies to reduce elder abuse. El maltrato a los adultos mayores es definido como el daño intencionado infligido a una persona adulta mayor o la falta de protección de una persona adulta mayor contra el daño o la privación de la satisfacción de sus necesidades básicas. El objetivo principal fue examinar en la literatura científica los factores asociados al maltrato al adulto mayor y, frente a estos, resultados buscar ayuda mediante programas preventivos para disminuir el maltrato a los adultos mayores. Se llevó a cabo una revisión sistemática de la literatura mediante las recomendaciones de la declaración PRISMA, en las bases de datos de Scopus, PubMed y Web of Science. Los factores de riesgo asociados al maltrato al adulto mayor fueron la edades tempranas (60 a 74 años), el sexo femenino, el estado civil casado, la etnia afroamericana, la situación económica baja. Además, los factores protectores fueron el tener buena salud fisica y mental. En conclusión, sería de vital importancia generar políticas públicas para disminuir el maltrato en los adultos mayores. &nbsp

La antifragilidad: Una mirada positiva del envejecimiento

Demographic change in the world, with evidence of the increase in older people, requires professionals linked to their care to implement intervention models in accordance with their needs, related to their functional capacity and promotion of a culture of antifragility. The theoretical construction of what it means to be an older and anti-fragile adult, in a society that assimilates aging with frailty, illness and disability, is an opportunity to present a positive view of health in old age, based on the adaptations to stress in different dimensions that influence the life of this population group, in which physical, psychological and social capital are integrated and influenced, in a process that is related to antifragility and aging as a continuum of life, with gains and losses, whose study will allow having adequate inclusive policies in each stage of life.Este artículo pretende explorar el concepto de antifragilidad en el adulto mayor, dado el cambio demográficoen el mundo, con evidencia del aumento de personas mayores, que exige a los profesionales vinculados a su atenciónimplementar modelos de intervención acordes con sus necesidades, relacionadas con su capacidad funcional y promociónde una cultura de antifragilidad. La construcción teórica de lo que significa ser adulto mayor antifrágil, en unasociedad que asimila el envejecimiento con fragilidad, enfermedad y discapacidad, es una oportunidad para presentaruna mirada positiva de la salud en la vejez, a partir de las adaptaciones al estrés en diferentes dimensiones que influencianla vida de este grupo poblacional, en el que el capital físico, psicológico y social se integran e influencian, en unproceso que se relaciona con la antifragilidad y el envejecer como un continuo de la vida, con ganancias y pérdidas; elestudio de esta relación permitirá contar con políticas inclusivas adecuadas en cada etapa de la vida. Palabras clave: adulto mayor, adultos mayores fragilizados, envejecimiento, atención primaria de salud, atenciónambulatoria

Tamanho ao nascer e problemas de saúde mental aos 11 aons em uma coorte brasileria de nascimentos

The aim of this study was to evaluate the association between size at birth and mental health problems at 11 years of age in the 1993 Pelotas (Brazil) Birth Cohort Study. Newborns were weighed and measured, and anthropometric indices were calculated. At 11 years of age, mental health problems were assessed using the Strengths and Difficulties Questionnaire (SDQ). Prevalence of mental health problems was 32% (95%CI: 31-33). After adjusting for potential confounders, newborns with weight and body mass index (BMI) for age z-scores < -2 SD were at 27% 95%CI: 7-49) and 29% (95%CI: 10-51) greater risk, respectively, of developing mental health problems at age 11 years than those born with normal scores. Newborns with BMI and head circumference for age z-scores > +2 SD were at 34% (95%CI: 6-71) and 19% (95%CI: 1-40) greater risk, respectively, of developing mental health problems than those with normal scores. The results suggest that early factors that are reflected as size measurements at birth can cause mental health problems later in life.O objetivo foi avaliar a associação entre tamanho ao nascer e problemas de saúde mental aos 11 anos na Coorte de Nascimentos de Pelotas, Rio Grande do Sul, Brasil, de 1993. Foram pesados e medidos ao nascer 4.358 recém-nascidos. Avaliou-se problemas de saúde mental com o questionário de capacidades e dificuldades(Strengths and Difficulties Questionnaire– SDQ). A prevalência de problemas de saúde mental foi de 32% (IC95%: 31-33). Na análise ajustada, os 291 (6,7%) recém-nascidos com escore-z de peso/idade e os 268 (6,2%) com índice de massa corporal (IMC)/idade < -2 DP tiveram, respectivamente, 27% (IC95%: 7-49) e 29% (IC95%: 10-51) maior risco de apresentar problemas de saúde mental aos 11 anos quando comparados com aqueles com escore normal. Os 102 (2,43%) recém-nascidos com escore-z de IMC e os 279 (6,4%)com perímetro cefálico/idade > +2 DP tiveram, respectivamente, 34% (IC95%: 6-71) e 19% (IC95%: 1-40) maior risco de apresentar esses problemas se comparados com aqueles com escore normal. Os resultados sugerem que fatores ocorridos na gestação e refletidos nas medidas de tamanho ao nascer podem ocasionar problemas de saúde mental em etapas tardias