| Texto completo | |
| Autor(es): |
Franca, Mariane Henriques
;
Bharat, Chrianna
;
Novello, Ercole
;
Hwang, Irving
;
Medina-Mora, Maria Elena
;
Benjet, Corina
;
Andrade, Laura Helena
;
Vigo, Daniel V.
;
Viana, Maria Carmen
Número total de Autores: 9
|
| Tipo de documento: | Artigo Científico |
| Fonte: | INTERNATIONAL JOURNAL OF MENTAL HEALTH SYSTEMS; v. 17, n. 1, p. 12-pg., 2023-06-16. |
| Resumo | |
BackgroundMajor depressive disorder (MDD) contributes to a significant proportion of disease burden, disability, economic losses, and impact on need of treatment and health care in Brazil, but systematic information about its treatment coverage is scarce. This paper aims to estimate the gap in treatment coverage for MDD and identify key bottlenecks in obtaining adequate treatment among adult residents in the Sao Paulo Metropolitan area, Brazil.MethodsA representative face-to-face household survey was conducted among 2942 respondents aged 18+ years to assess 12-month MDD, characteristics of 12-month treatment received, and bottlenecks to deliver care through the World Mental Health Composite International Diagnostic Interview.ResultsAmong those with MDD (n = 491), 164 (33.3% [SE, 1.9]) were seen in health services, with an overall 66.7% treatment gap, and only 25.2% [SE, 4.2] received effective treatment coverage, which represents 8.5% of those in need, with a 91.5% gap in adequate care (66.4% due to lack of utilization and 25.1% due to inadequate quality and adherence). Critical service bottlenecks identified were: use of psychotropic medication (12.2 percentage points drop), use of antidepressants (6.5), adequate medication control (6.8), receiving psychotherapy (19.8).ConclusionsThis is the first study demonstrating the huge treatment gaps for MDD in Brazil, considering not only overall coverage, but also identifying specific quality- and user-adjusted bottlenecks in delivering pharmacological and psychotherapeutic care. These results call for urgent combined actions focused in reducing effective treatment gaps within services utilization, as well as in reducing gaps in availability and accessibility of services, and acceptability of care for those in need. (AU) | |
| Processo FAPESP: | 08/53818-2 - Estudo epidemiológico dos transtornos psiquiátricos na Região Metropolitana de São Paulo: prevalência, fatores de risco e sobrecarga social e econômica |
| Beneficiário: | Maria Carmen Viana Caputi |
| Modalidade de apoio: | Bolsas no Brasil - Pós-Doutorado |
| Processo FAPESP: | 03/00204-3 - Estudo epidemiológico dos transtornos psiquiátricos na região metropolitana de São Paulo: prevalências, fatores de risco e sobrecarga social e econômica |
| Beneficiário: | Laura Helena Silveira Guerra de Andrade |
| Modalidade de apoio: | Auxílio à Pesquisa - Temático |