Use of mental health services by children with mental disorders in two major cities in Brazil

Objective: The study examined lifetime use of mental health services among children diagnosed as having mental disorders in two major cities in Brazil and identified characteristics associated with unmet need. Methods: The data were collected as part of the High Risk Cohort Study, a community study conducted in Sao Paulo and Porto Alegre, Brazil. During the period from 2010 to 2011, a total of 2,511 children ages 6 to 12 were assessed, and 652 were given a diagnosis of at least one mental disorder. The current study analyzed data for a subsample of 651 children with complete information on use of mental health services. Results: Eighty-one percent of the children with mental disorders had not received mental health treatment in the past. The majority who received treatment were treated with psychotherapy or a combination of psychotherapy and medication. Mixed-race children were significantly more likely to have unmet need for treatment, compared with white children. Conclusions: The high rate of unmet need among children with mental disorders should be addressed with strategies to improve access to health care

Childhood mental health problems in primary care

The present population study aimed at identifying the prevalence of mental health problems (MHP) and describing health services use in a sample of children attending Primary Healthcare Units (PHU) in the city of Sao Paulo. Caregivers of 825 6-11 years old children were assessed. MHP were assessed with the Strength and Difficulties Questionnaire and health services use with an adapted version of the Client Receipt Inventory Children`s version. Prevalence of internalizing and externalizing MHP was 30.7% and 18.3%, respectively. Pediatricians were the most consulted health professional (56.7%) and psychologists the most consulted mental health professional (7.9%). Only 3 children were under medication treatment for MHP. The high prevalence of MHP among children in the primary care setting and the low rate of treatment constitute a public health problem. Training programs for health professionals are relevant to help identify and refer MHP cases.O presente estudo populacional de corte transversal teve como objetivo verificar a prevalência de problemas de saúde mental (PSM) e descrever o uso de serviços de saúde numa amostra de crianças atendidas em unidades de saúde (UBS) do município de São Paulo. Responsáveis de 825 crianças de 6-11 anos de idade foram entrevistados. PSM das crianças foram avaliados pelo “Strength and Difficulties Questionnaire” e uso de serviços por uma versão adaptada do “Client Service Receipt Inventory Children’s version”. A prevalência de PSM internalizantes e externalizantes foi de 30,7% e 18,3%, respectivamente. O pediatra foi o profissional de saúde mais consultado (56,7%), o psicólogo foi o profissional da saúde mental mais consultado (7,9%). Apenas 3 crianças estavam em tratamento medicamentoso para PSM. A alta prevalência de PSM em crianças atendidas na AP e o baixo número de atendimentos em serviços configuram um importante problema de saúde pública. Programas de capacitação para profissionais são importantes para aprimorar a identificação e o encaminhamento de casos de PSM

lnfluence of early separation on the interaction between mother and newborn infant

O presente estudo tem como objetivo avaliar a interação mãe-bebê a partir de diferentes tempos de contato no período pós-parto imediato. A idéia inicial do estudo era a comparação de dois grupos: um que seguiria a rotina do Centro Obstétrico do Hospital de Clínicas de Porto Alegre e outro ao qual se ofereceria um tempo extra de contato. Devido à ocorrência de efeito Hawthorne, perdeu-se o grupo-controle (não houve diferença no tempo de contato das duplas em cada um dos grupos durante o período sensível). Assim, as 29 duplas que efetivamente entraram na pesquisa foram acompanhadas, sendo avaliadas as interações, como um único grupo, já que o tempo extra de contato e o apoio às mães no período de pósparto imediato foram os mesmos, o que pode ter contribuído para os bons resultados das interações. Após o primeiro, o sexto e o 12º meses de vida do bebê, as duplas apresentaram, respectivamente, taxa de 95%, 100% e 92,8% de boas e muito boas interações. Investigações futuras nesta área, com amostras maiores, devem ser realizadas, fornecendo outras contribuições aos profissionais da saúde, gerando conhecimento capaz de auxi liar na prevenção de doenças mentais, abandono e abuso, a baixo custo.The aim of the study was to assess mother-infant interaction regarding different amounts of contact during the immediate post partum period. The original idea was to compare two groups: one lha! would follow normal routine of the Obstelrical Center of Hospital de Clínicas de Porto Alegre, and the other that would receive additional time together. Due to the loss ofthe control group (Hawthorne effect), the 29 dyads that consisted the sample were followed as a whole group. After the first, sixth and twelveth months, lhe dyads presented a rate of95%, 100% and 92.85%, respectively, of good and very good relationships. Once matched the groups, there is evidence that the interventian (extra time together and support to mothers during the immediate post partum period) might have contributed to the good results on the interaction. Future research on this area, with larger samples, will be needed in order to allert health professionals of developing countries to this possibility of low cost prevention of mental disorders

Schedule for affective disorders and schizophrenia for school-age children - present and lifetime version (K-SADS-PL), DSM-5 update : translation into Brazilian Portuguese

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