The social adjustment of patients with schizophrenia: implications to the mental health policy in Brazil

Menezes, Paulo Rossi; Mann, Anthony

doi:10.1590/s0034-89101993000500004

Cited by 16 publications

(15 citation statements)

References 23 publications

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“…17 As in their study, social withdrawal and participation in household activities were the items in which patients presented higher levels of disability, but, differently from that, in the present study, the item where most patients showed any degree of dysfunction was underactivity. The item where fewer subjects were reported to have any level of disability was social contacts, a finding similar to that of Menezes and Mann.…”

Section: Interpretation Of Resultscontrasting

confidence: 70%

The social adjustment of people with severe mental illness in São Paulo, Brazil

Gulinelli

Ratto

Menezes

2005

Rev. Bras. Psiquiatr.

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The social adjustment of people with severe mental illness in São Paulo, Brazil O ajustamento social de pessoas com transtornos mentais graves em São Paulo, Brasil A b s t r a c t Objective: To investigate the social adjustment of individuals with severe mental illness living in the community in a large urban center of a developing country, and the characteristics associated with poor social functioning. Method: A cross-sectional study was performed in the city of Sao Paulo. Eligible subjects were residents of a defined geographic area, aged between 18 and 65, with a diagnosis of functional psychosis who had had contact with any public psychiatric service during a defined period. Structured assessments were used to obtain information on social-demographic characteristics, diagnosis (ICD-10), psychiatric symptoms (PANSS), and social adjustment (DAS). Results: One hundred and eighty-eight subjects were included, of whom, 120 (63.8%) had some degree of impairment in social functioning. The most frequently affected areas of social functioning were work performance and sexual role. Twenty-four patients (12.8%) showed poor or very poor social adjustment in the month prior to the interview. Negative symptoms, number of previous admissions and general symptoms showed statistically significant associations with global social adjustment scores. Conclusions: The proportion of patients showing any degree of impairment in social adjustment was as high as in more developed societies. In order to successfully implement the new mental health policy in Brazil, better provision of community-based mental health services for those with severe mental illnesses is needed.Keywords: Mental disorders; Social adjustment; Cross-sectional studies; Interview, psychological; Mental health services; Brazil Resumo Objetivo: Investigar o ajustamento social em indivíduos com transtornos mentais graves vivendo na comunidade de um grande centro urbano de um país em desenvolvimento e as características associadas a um ajustamento social pobre. Método: Um estudo de corte transversal foi conduzido em São Paulo. Indivíduos elegíveis deviam residir em áreas definidas da cidade de São Paulo, ter tido contato com os serviços psiquiátricos do setor público em período de três meses, idade entre 18 e 65 anos e diagnóstico de psicose funcional. Entrevistas estruturadas foram utilizadas para obter dados sociodemográficos, diagnóstico (CID-10), sintomas psiquiátricos (PANSS) e ajustamento social (DAS). Resultados: Cento e oitenta e oito indivíduos foram incluídos e 120 (63,8%) apresentaram algum grau de desajustamento social. As áreas mais afetadas foram performance no trabalho e sexual. Vinte e quatro indivíduos (12,8%) apresentaram ajustamento social pobre ou muito pobre no mês anterior à entrevista. Número de internações anteriores, sintomas gerais e negativos de esquizofrenia mostraram-se associados ao ajustamento social global. Conclusões: A proporção de indivíduos apresentando qualquer grau de desajustamento social é comparável à encontrada em países mai...

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Section: Interpretation Of Resultscontrasting

confidence: 70%

The social adjustment of people with severe mental illness in São Paulo, Brazil

Gulinelli

Ratto

Menezes

2005

Rev. Bras. Psiquiatr.

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“…14 In many societies in low and middle income countries, most individuals with severe mental illnesses live with and rely upon their families to survive. 13,19 This may decrease their exposure and 19 reinforcing this assumption. In Brazil, smoking is allowed in most psychiatric hospitals, and it is common the use of cigarettes to maintain patients calm and under control, given as a reward for "good behavior" in the ward.…”

Section: Discussionmentioning

confidence: 80%

“…The authors argued that lack of fi nancial independence might explain such fi nding, through restrictions imposed by the families of those with severe mental illnesses. In Brazil, high fi nancial dependence is also common among people with severe mental illnesses, 13 and the prevalence of substance misuse among them is much lower than that observed in developed countries. 14 Therefore, the prevalence of cigarette smoking people with severe mental illnesses may not follow the pattern seen in developed countries.…”

Section: Descritores: Pessoas Mentalmente Doentes Diagnóstico Duplo mentioning

confidence: 98%

Prevalence of tobacco use in individuals with severe mental illnesses, São Paulo, Brazil

2007

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OBJECTIVE: To analyze the prevalence of cigarette smoking in individuals with severe mental illnesses in a large urban centre of a middle income country. METHODS: Cross-sectional study carried out in São Paulo. The sample (N=192) comprised individuals diagnosed with severe mental illnesses who had contact with public psychiatric care services from September to November 1997 and were aged between 18 and 65 years. Prevalence of daily tobacco smoking in the 12 months previous to the interview and characteristics associated were studied. RESULTS: Out of 192 subjects with severe mental illnesses interviewed, 115 (59.9%; 95% CI: 52.6%; 66.9%) reported smoking cigarettes on a daily basis. Male gender, marital status separated or widowed, irregular use of neuroleptic drugs and history of ten or more psychiatric admissions were independently associated with cigarette smoking. CONCLUSIONS: The prevalence of cigarette smoking in the present sample was higher than that found in the general Brazilian population. Mental care services should implement non-smoking policies and mental health providers need to help patients with severe mental illness who want to quit smoking.

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“…Estes encontraram 0,6% de demanda potencial de tratamento para o paciente psicótico na população geral 8 , que 30,0% desses são graves e demandam hospitalizações repetidas 9 . Dentre os hospitalizados, 50,0% são internados novamente caso não sejam tratados adequadamente na comunidade 10 . Baseado neste cenário, estimamos que 416 pacientes necessitariam de hospitalização na Cidade de Santos, caso não estivessem encontrando tratamento adequado na comunidade.…”

Section: Discussionunclassified

Utilização dos Centros de Atenção Psicossocial (CAPS) na cidade de Santos, São Paulo, Brasil

et al. 2004

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A fim de descrever a clientela atendida nos Centros de Atenção Psicossocial (CAPS) da Cidade de Santos foi realizado um censo de pacientes atendidos nos CAPS no período 1º de junho de 2001 a 30 de junho de 2001. O primeiro contato do paciente com o serviço foi registrado e seus dados foram preenchidos em ficha padronizada utilizando o prontuário médico como fonte de informação. Foram atendidos 1.673 usuários, com idade média de 46 anos, mulheres (59,0%), morando com a família (78,0%) e tempo médio de três anos em tratamento no serviço. Atenderam 38,0% de esquizofrênicos, esquizotípicos e delirantes, 31,0% com transtorno de humor e 17,0% de neuróticos, nas modalidades de ambulatório médico-psiquiátrico (81,0%), individual (23,0%), grupal (13,0%) e reabilitação psicossocial (4,3%). Os CAPS de Santos atendem todas as categorias de transtornos mentais, sendo os mais freqüentes aqueles considerados mais graves, o que é esperado para este tipo de serviço. O modelo de tratamento oferecido tem características ambulatorial e médico-psiquiátrica.

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The social adjustment of patients with schizophrenia: implications to the mental health policy in Brazil

Cited by 16 publications

References 23 publications

The social adjustment of people with severe mental illness in São Paulo, Brazil

The social adjustment of people with severe mental illness in São Paulo, Brazil

Prevalence of tobacco use in individuals with severe mental illnesses, São Paulo, Brazil

Utilização dos Centros de Atenção Psicossocial (CAPS) na cidade de Santos, São Paulo, Brasil

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