Debatendo a saúde digital no Brasil

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Depression, anxiety, and lifestyle among essential workers : a web survey from Brazil and Spain during the covid-19 pandemic

Background: Essential workers have been shown to present a higher prevalence of positive screenings for anxiety and depression during the COVID-19 pandemic. Individuals from countries with socioeconomic inequalities may be at increased risk for mental health disorders. Objective: We aimed to assess the prevalence and predictors of depression, anxiety, and their comorbidity among essential workers in Brazil and Spain during the COVID-19 pandemic. Methods: A web survey was conducted between April and May 2020 in both countries. The main outcome was a positive screening for depression only, anxiety only, or both. Lifestyle was measured using a lifestyle multidimensional scale adapted for the COVID-19 pandemic (Short Multidimensional Inventory Lifestyle Evaluation–Confinement). A multinomial logistic regression model was performed to evaluate the factors associated with depression, anxiety, and the presence of both conditions. Results: From the 22,786 individuals included in the web survey, 3745 self-reported to be essential workers. Overall, 8.3% (n=311), 11.6% (n=434), and 27.4% (n=1027) presented positive screenings for depression, anxiety, and both, respectively. After adjusting for confounding factors, the multinomial model showed that an unhealthy lifestyle increased the likelihood of depression (adjusted odds ratio [AOR] 4.00, 95% CI 2.72-5.87), anxiety (AOR 2.39, 95% CI 1.80-3.20), and both anxiety and depression (AOR 8.30, 95% CI 5.90-11.7). Living in Brazil was associated with increased odds of depression (AOR 2.89, 95% CI 2.07-4.06), anxiety (AOR 2.81, 95%CI 2.11-3.74), and both conditions (AOR 5.99, 95% CI 4.53-7.91). Conclusions: Interventions addressing lifestyle may be useful in dealing with symptoms of common mental disorders during the strain imposed among essential workers by the COVID-19 pandemic. Essential workers who live in middle-income countries with higher rates of inequality may face additional challenges. Ensuring equitable treatment and support may be an important challenge ahead, considering the possible syndemic effect of the social determinants of health

Lifestyle in undergraduate students and demographically matched controls during the covid-19 pandemic in Spain

Few studies have used a multidimensional approach to describe lifestyle changes among undergraduate students during the COVID-19 pandemic or have included controls. This study aimed to evaluate lifestyle behaviors and mental health of undergraduate students and compare them with an age and sex-matched control group. A cross-sectional web survey using snowball sampling was conducted several months after the beginning of COVID-19 pandemic in Spain. A sample of 221 students was recruited. The main outcome was the total SMILE-C score. Students showed a better SMILE-C score than controls (79.8 +- 8.1 vs. 77.2 +- 8.3; p < 0.001), although these differences disappeared after controlling for covariates. While groups did not differ in the screenings of depression and alcohol abuse, students reported lower rates of anxiety (28.5% vs. 37.1%; p = 0.042). A lower number of cohabitants, poorer self-perceived health and positive screening for depression and anxiety, or for depression only were independently associated (p < 0.05) with unhealthier lifestyles in both groups. History of mental illness and financial difficulties were predictors of unhealthier lifestyles for students, whereas totally/moderate changes in substance abuse and stress management (p < 0.05) were predictors for the members of the control group. Several months after the pandemic, undergraduate students and other young adults had similar lifestyles

Idade e gênero como fatores de risco para a transmissão do HIV em uma amostra de usuários de drogas, Porto Alegre, Brasil

Objetivo: Verificar se idade e gênero estão relacionados à soropositividade para HIV em usuários de drogas que procuram centros de atendimento em saúde de Porto Alegre. Método: Estudo transversal com amostragem por conveniência de 695 homens e mulheres acima de 15 anos, com uso recente de drogas e comportamento de risco para exposição ao HIV. Para obtenção de comportamentos de risco, utilizou-se questionário padrão denominado CRA, adquirindo-se testagem anti-HIV dos casos. Resultados: A maioria dos voluntários era masculina (75,8%) com idade média de 29,4 anos, com menos de sete anos de estudo (42,4%) e com renda familiar igual ou superior a quatro salários mínimos (46%). Não houve associação significativa entre gênero e soropositividade. Na análise multivariada, observou-se que indivíduos acima de 30 anos tinham três vezes mais chance de soropositividade do que os menores de 20 anos. Usuários injetáveis tinham sua chance aumentada em cinco vezes, quando em uso desde 1980, e, em quatro vezes, quando em uso no último mês. Discussão: Indivíduos maiores de 30 anos apresentam chance maior de soropositividade do que os mais jovens, possivelmente por utilizar mais cocaína injetável e repetir mais comportamentos de risco ao longo da vida. Não houve diferença na soropositividade entre gêneros. Isto destoa da realidade atual, considerando o aumento do número de mulheres soropositivas na população nos últimos anos e o provável “risco duplo” que apresentam usuárias de drogas. É obrigatória a realização de novos estudos que avaliem idade e gênero como fatores de risco para soropositividade, visando confirmar ou refutar esses achados e planejar estratégias específicas para grupos de maior risco.Objective: To verify the association between age and gender regarding HIV seropositivity in drug users who seek public health centers in Porto Alegre, Brazil. Methods: The authors designed a cross-sectional study with a convenience sampling of 695 men and women aged above 15, who reported recent drug use and risk behaviors to HIV exposure. We used a standard questionnaire (CRA, Brazilian version of the RAB, Risk Assessment Battery) to assess risk behaviors and we collected blood for HIV testing. Results: Most individuals were males (75,8%), with a mean age of 29.4 years, less than seven years of schooling (42,4%), and family income equal or superior to four minimum wages (46%). There was no significant association between gender and seropositivity. Multivariate analyses showed that individuals aged above 30 had a threefold increased odds of being seropositive over subjects aged 20 or less. Intravenous drug users who had been using drugs since 1980 had five-fold odds of seropositivity and those who had been using them in the month prior to the interview had four-fold odds. Discussion: Subjects aged more than 30 showed higher odds of seropositivity than the younger group. This is possibly due to a higher use of intravenous cocaine and to having more risk behaviors along their lifetime. There was no difference in seropositivity between genders, what differs from current data of other studies, if we take into consideration that rates of populational seropositivity among women have increased, mostly among drug users, who are, therefore, at ‘double risk’. The development of further studies is mandatory in order to assess gender and age as risk factors for seropositivity, whether to confirm or to deny these findings, and to plan specific strategies for high-risk groups