Detecção de transtornos mentais comuns por médicos da estratégia Saúde da Família em Petrópolis, RJ

• Ano de defesa: 2009
• Autor(a) principal: Gonçalves, Daniel Almeida [UNIFESP]
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: Detecção; Sofrimento emocional; Atenção primária a saúde; Estratégia Saúde da Família; Transtornos mentais comuns; Detection; Emotional suffering; Primary health care; Family Health Program; Common mental disorders
• Link de acesso: http://repositorio.unifesp.br/handle/11600/9324

BACKGROUND: Since the 80 s, several studies conducted in Brazil have demonstrated a prevalence of Common Mental Disorders (CMD) around 50% among patients attending primary care units. It has also been demonstrated that many of these disorders remain unrecognized by general practitioners, with the detection rates varying from 30 to 60%. Since 1994, a new comprehensive and patient-oriented Primary Health policy was extensively introduced in Brazil the Family Health Program (FHP) but there isn t any study aimed to evaluate the detection of CMD by GPs in this program. METHODS: A cross sectional study was conducted with consecutive patients seen in 5 FHP units, from August to December 2002, in the city of Petrópolis, Rio de Janeiro. The overall prevalence of psychiatric morbidity was measured by means of the General Health Questionnaire (GHQ 12), and the doctor s detection of CMD was evaluated by a questionnaire completed by the general practitioners (GPs) after the medical appointment. RESULTS: 714 subjects participated of the study, and 400 (56%) subjects were screened positive using GHQ-12 cut-off point of 2/3. GPs diagnosed 379 people with CMD (53.1%). Two hundred and sixty (36%) subjects were detected by both GHQ and the GPs with an OR of 3,043 (95% CI 2,23-4,13). The accuracy of detection of CMD by GPs was 65%. There was a strong association between the detection of CMD and the presence of medically unexplained physical symptoms (MUS). Being female, married and a frequent service user were also related to higher detection rates by GPs. CONCLUSION: The rate of detection of common mental disorders in the Family Health Program in Brazil is similar to those reported worldwide, but contrary to other studies, the presence of MUS increased the detection rate. The high frequency of CMD in PHC highlights the need for improving training for GPs and health workers to recognize accurately and treat psychological distress with evidence based and culturally adapted interventions.