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da Rocha HA, Reis IA, Cherchiglia ML. Early and Frequent Psychiatric Readmissions in a Brazilian Cohort of Hospitalized Patients Between 2001 and 2013. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2024; 51:147-161. [PMID: 37971543 DOI: 10.1007/s10488-023-01322-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVE To characterize the profile of patients who were readmitted for mental and behavioral disorders, in the Brazilian Unified Health System, from 2001 to 2014, and the factors associated with early and frequent readmission. METHOD A retrospective, non-concurrent cohort study of patients admitted with a primary diagnosis of mental or behavioral disorders, from 2001 to 2014. This study selected demographic variables and clinical variables, as well as variables related to the characteristics of the hospitals. Poisson Regression methods with a robust variance estimator were used to estimate the incidence rate ratio (IRR) for each of the outcomes. RESULTS Early readmission occurred for 6.8% of the patients and frequent readmission for 8.3%. Characteristics such as being male, younger, with a diagnosis of a bipolar disorder, and admitted to a specialized hospital show a higher IRR for early readmission. The occurrence of early readmission was the most heavily associated characteristic with an increased rate of early readmission, and the magnitude of this increase depends on the patient's age. CONCLUSION Early and frequent readmissions are linked to patients' demographics, clinical information and health system's organization. Early readmission should be a priority in treatment planning to prevent frequent readmissions due to its strong association.
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Affiliation(s)
- Hugo André da Rocha
- Faculdade de Medicina. Programa de Pós- Graduação em Saúde Pública. Belo Horizonte, Universidade Federal de Minas Gerais, Minas Gerais, Brasil.
| | - Ilka Afonso Reis
- Instituto de Ciências Exatas. Departamento de Estatística. Belo Horizonte, Universidade Federal de Minas Gerais, Minas Gerais, Brasil
| | - Mariangela Leal Cherchiglia
- Faculdade de Medicina. Departamento de Medicina Preventiva e Social, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
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Fridh M, Rosvall M, Lindström M. Mental distress in relation to police reporting among adolescent victims of robbery. A population-based study in southern Sweden. SSM Popul Health 2023; 23:101483. [PMID: 37588765 PMCID: PMC10425401 DOI: 10.1016/j.ssmph.2023.101483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 07/15/2023] [Accepted: 08/03/2023] [Indexed: 08/18/2023] Open
Abstract
•Robberies as well as mental distress have increased among adolescents in Sweden.•This study on school students in southern Sweden was population-based with a high response rate.•Half of the robbed adolescents abstained from police reporting.•Non-reporters had poorer mental health than victims who reported the robbery.•Non-reporters were also an overall more disadvantaged group.
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Affiliation(s)
- Maria Fridh
- Social Medicine and Health Policy, Department of Clinical Sciences in Malmö, Lund University, CRC, Jan Waldenströmsgata 35, Skåne University Hospital Malmö, SE-205 02, Malmö, Sweden
| | - Maria Rosvall
- Social Medicine and Health Policy, Department of Clinical Sciences in Malmö, Lund University, CRC, Jan Waldenströmsgata 35, Skåne University Hospital Malmö, SE-205 02, Malmö, Sweden
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden
- Socialmedicinskt centrum, Regionhälsan, Västra Götalandsregionen, Sweden
| | - Martin Lindström
- Social Medicine and Health Policy, Department of Clinical Sciences in Malmö, Lund University, CRC, Jan Waldenströmsgata 35, Skåne University Hospital Malmö, SE-205 02, Malmö, Sweden
- Center for Primary Health Care Research, Region Skåne and Lund University, S-205 02, Malmö, Sweden
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Orellana JDY, Murray J, Lima NP, Pinheiro RT, Horta BL. Robbery Victimization in Early Adulthood, and Depression and Anxiety at Age 30 Years: Results From the 1982 Pelotas (Brazil) Birth Cohort Study. Front Public Health 2022; 10:821881. [PMID: 35757622 PMCID: PMC9218107 DOI: 10.3389/fpubh.2022.821881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 05/17/2022] [Indexed: 11/13/2022] Open
Abstract
Robbery is one of the most common urban crimes, but little is known about its relationship with mental disorders in young adults. This study aimed to assess the relationship between robbery victimization and Major Depressive Disorder (MDD), Generalized Anxiety Disorder (GAD) and comorbidity between MDD and GAD at 30 years of age. A birth cohort study has followed all children born in the city of Pelotas, southern Brazil, since 1982. At ages 23 and 30 years, participants were interviewed and asked about lifetime and recent experiences of robbery. Covariates were measured in interviews between birth and age 30 years. MDD and GAD were measured using the MINI-International Neuropsychiatric Interview. Adjusted prevalence ratio (aPR) and corresponding 95% confidence interval (CI) for associations between robbery and mental disorders were calculated using Poisson regression with robust standard error. Of 3,701 cohort members interviewed at age 30 years, 42% reported robbery victimization during their lifetime. Victimization across three periods (lifetime, past 10 years, past 12 months) was associated with increased occurrence of MDD, GAD, as well as the MDD and GAD comorbidity. The strongest associations were found to robbery occurring in the previous 12 months with the MDD and GAD comorbidity, both for burglary at home (aPR 2.52; 95% CI 1.52-4.22) or community family victimization (aPR 2.10; 95% CI 1.34-3.27). These findings highlight the importance of community violence for mental health in young adulthood, and the need for public policies to prevent violence as well as support services for victims to mitigate its adverse health consequences.
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Affiliation(s)
| | - Joseph Murray
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- Human Development and Violence Research Centre, Federal University of Pelotas, Pelotas, Brazil
| | - Natália Peixoto Lima
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil
| | | | - Bernardo Lessa Horta
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
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Crossley NA, Alliende LM, Ossandon T, Castañeda CP, González-Valderrama A, Undurraga J, Castro M, Guinjoan S, Díaz-Zuluaga AM, Pineda-Zapata JA, López-Jaramillo C, Reyes-Madrigal F, León-Ortíz P, de la Fuente-Sandoval C, Czepielewski LS, Gama CS, Zugman A, Gadelha A, Jackowski A, Bressan R. Imaging Social and Environmental Factors as Modulators of Brain Dysfunction: Time to Focus on Developing Non-Western Societies. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2018; 4:8-15. [PMID: 30396768 DOI: 10.1016/j.bpsc.2018.09.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 09/13/2018] [Accepted: 09/14/2018] [Indexed: 12/18/2022]
Abstract
Social and environmental factors are known risk factors and modulators of mental health disorders. We here conducted a nonsystematic review of the neuroimaging literature studying the effects of poverty, urbanicity, and community violence, highlighting the opportunities of studying non-Western developing societies such as those in Latin America. Social and environmental factors in these communities are widespread and have a large magnitude, as well as an unequal distribution, providing a good opportunity for their characterization. Studying the effect of poverty in these settings could help to explore the brain effect of economic improvements, disentangle the effect of absolute and relative poverty, and characterize the modulating impact of poverty on the underlying biology of mental health disorders. Exploring urbanicity effects in highly unequal cities could help identify the specific factors that modulate this effect as well as examine a possible dose-response effect by studying megacities. Studying brain changes in those living among violence, which is particularly high in places such as Latin America, could help to characterize the interplay between brain predisposition and exposure to violence. Furthermore, exploring the brain in an adverse environment should shed light on the mechanisms underlying resilience. We finally provide examples of two methodological approaches that could contribute to this field, namely a big cohort study in the developing world and a consortium-based meta-analytic approach, and argue about the potential translational value of this research on the development of effective social policies and successful personalized medicine in disadvantaged societies.
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Affiliation(s)
- Nicolas A Crossley
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; Biomedical Imaging Center and Center for Integrative Neuroscience, Pontificia Universidad Católica de Chile, Santiago, Chile; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neurosciences, King's College London, United Kingdom.
| | - Luz Maria Alliende
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Tomas Ossandon
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - Alfonso González-Valderrama
- Early Intervention Program, José Horwitz Psychiatric Institute, Santiago, Chile; School of Medicine, Universidad Finis Terrae, Santiago, Chile
| | - Juan Undurraga
- Early Intervention Program, José Horwitz Psychiatric Institute, Santiago, Chile; Department of Neurology and Psychiatry, Faculty of Medicine, Clínica Alemana Universidad del Desarrollo, Santiago, Chile
| | - Mariana Castro
- FLENI Foundation, Buenos Aires, Argentina; Department of Psychiatry and Mental Health, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina
| | - Salvador Guinjoan
- FLENI Foundation, Buenos Aires, Argentina; Department of Psychiatry and Mental Health, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina
| | - Ana M Díaz-Zuluaga
- Research Group in Psychiatry, Department of Psychiatry, Faculty of Medicine, Universidad de Antioquia, Medellín, Colombia
| | | | - Carlos López-Jaramillo
- Research Group in Psychiatry, Department of Psychiatry, Faculty of Medicine, Universidad de Antioquia, Medellín, Colombia; Mood Disorders Program, Hospital Universitario San Vicente Fundación, Medellín, Colombia
| | - Francisco Reyes-Madrigal
- Laboratory of Experimental Psychiatry, Neuropsychiatry Department, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
| | - Pablo León-Ortíz
- Laboratory of Experimental Psychiatry, Neuropsychiatry Department, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
| | - Camilo de la Fuente-Sandoval
- Laboratory of Experimental Psychiatry, Neuropsychiatry Department, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
| | - Leticia Sanguinetti Czepielewski
- Molecular Psychiatry Laboratory, Hospital de Clinicas de Porto Alegre, Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Clarissa S Gama
- Molecular Psychiatry Laboratory, Hospital de Clinicas de Porto Alegre, Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Andre Zugman
- Laboratory of Interdisciplinary Clinical Neuroscience, Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Ary Gadelha
- Laboratory of Interdisciplinary Clinical Neuroscience, Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Andrea Jackowski
- Laboratory of Interdisciplinary Clinical Neuroscience, Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Rodrigo Bressan
- Laboratory of Interdisciplinary Clinical Neuroscience, Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
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