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1 in which the authors highlighted that early-onset social anxiety disorder (SAD) patients presented more commonly with the generalized subtype, were more frequently inactive and had higher prevalence of psychiatric comorbidities. They could not find differences between groups regarding severity of the symptoms and therapeutic responses. The authors concluded that there is a subgroup of SAD patients with early-onset of social anxiety symptoms with different clinical characteristics.In the framework of a prevalence study of SAD with undergraduate students, we evaluated 2,319 subjects taking several different courses at the University of São Paulo (USP) campus Ribeirão Preto and from the Universidade de Franca (UNIFRAN). The Social Phobia Inventory (SPIN) 2 was collectively administered to all subjects who agreed to participate. After this first phase of the study, individuals with Os gastos federais absolutos em saúde mental (e saúde em geral) vêm crescendo consistentemente ao longo dos últimos dez anos, e a proporção GSM/GTS vem se mantendo praticamente estável (em torno de 2% e 2,5%). Todos estamos de acordo que é necessária uma melhora significativa desta proporção (a OMS recomenda uma taxa de 5%, desempenho este que só se observa em alguns dos países europeus 3 ), mas não existem dados para indicar que ela sofreu redução. Se o Brasil ostentasse de fato 5,8% do orçamento da saúde destinados à saúde mental, estaríamos melhor, em 1995, que a maioria dos países europeus herdeiros da época de ouro do Welfare State! 4 O que houve foi um aumento regular em termos absolutos e um redirecionamento dos recursos para o sistema extra-hospitalar (em 1995, mais de 90% dos recursos SUS em saúde mental financiavam o sistema hospitalar). Ocorreu, sim, redução proporcional dos gastos hospitalares que, pela primeira vez, em 2006, ficaram menores que os extra-hospitalares (48,7% contra 51,3%), 5 caracterizando a desejável mudança do modelo assistencial psiquiátrico públi-co do Brasil. Esta nos parece a questão real do debate sobre o financiamento da saúde mental no SUS: como sustentar a mudança de modelo, que exigirá sempre novos investimentos. O futuro, não o passado.

Introduction: Joint hypermobility (JH) is an inherited clinical condition with increased joint elasticity in passive movements. In the general population, its frequency, which can be estimated through specific methods, such as the nine-point Beighton hypermobility score (Beighton score) and the self-reported five-part questionnaire for identifying hypermobility (five-part questionnaire), ranges from 10% to 20%. Objectives: To validate the Portuguese version of the five-part questionnaire and to determine its sensitivity and specificity when compared with the Beighton score for diagnosing JH. Methods: The five-part questionnaire for identifying hypermobility was translated into Portuguese and applied to 2,523 Brazilian university students. Then, a sample with 394 randomly selected students was evaluated by use of the Beighton score, aiming at establishing the JH diagnosis. Finally, the two methods were statistically compared. Results: The JH frequency was 37.01% when using the five-part questionnaire, and 34% when using the Beighton score. Considering sex, the JH frequencies according to the five-part questionnaire and Beighton score were 43.54% and 44.26% in females, and 28.44% and 16% in males, respectively. The sensitivity of the self-reported questionnaire was 70.9% and its specificity was 77.4%, with an area under the receiver operating characteristic (ROC) curve of 0.786. Conclusions: JH is frequent in Brazilian university students, and more common in women. The self-reported five-part questionnaire for JH identification, translated into Portuguese and validated, was an effective method when compared with the Beighton score for identifying JH.