Violence and post-traumatic stress disorder in Sao Paulo and Rio de Janeiro, Brazil: the protocol for an epidemiological and genetic survey

Abstract

Background: violence is a public health major concern, and it is associated with post-traumatic stress disorder and other psychiatric outcomes. Brazil is one of the most violent countries in the world, and has an extreme social inequality. Research on the association between violence and mental health may support public health policy and thus reduce the burden of disease attributable to violence. The main objectives of this project were: to study the association between violence and mental disorders in the Brazilian population; to estimate the prevalence rates of exposure to violence, post-traumatic stress disorder, common metal disorder, and alcohol hazardous use and dependence: and to identify contextual and individual factors, including genetic factors, associated with the outcomes.

Peritraumatic tonic immobility in a large representative sample of the general population: association with posttraumatic stress disorder and female gender

“…Given an expected refusal rate of 20%, the estimated sample size was determined to be 1500 interviews in Rio de Janeiro and 3000 in São Paulo. We oversampled the most violent strata in São Paulo to identify more current PTSD cases to be referred to a case-control study and a clinical trial [19,21].…”

“…The population of this study came from a cross-sectional study survey carried out in a representative sample of residents in the two largest cities in Brazil, São Paulo and Rio de Janeiro (N = 2536 and 1208 respectively), aged 15 to 75 years [19].…”

Trauma and stressor-related disorders

“…3,4,5 Deste modo, diversos estudos têm sido realizados mundialmente e no Brasil para detectar a taxa de vitimização da população. 6 O estudo de Andreoli et al 7 evidenciou que no Brasil mais da metade dos habitantes das cidades do Rio de Janeiro e São Paulo relataram ter vivenciado um evento traumático ao longo de suas vidas. Outra pesquisa com amostra brasileira verificou que 36% das mortes ocasionadas por eventos externos são decorrentes de homicídio.…”

The joint structure of major depression, anxiety disorders, and trait negative affect

“…The study was conducted to assess the impact of urban violence on the prevalence of alcohol dependence, unipolar mood and anxiety disorders, and other mental health-related problems. A detailed description of the protocol of this study is provided elsewhere by Andreoli et al 31 All participants were assessed in their households by trained non-clinicians using structured questionnaire and interview measures used widely in international research in psychology and psychiatry, including the 20-item Positive and Negative Affect Schedule (PANAS) 30 and the Composite International Diagnostic Interview (CIDI) 2.1. 32,33 All instruments were previously adapted and validated for use in Brazil or, in the case of some inventories including the PANAS, carefully translated to Brazilian Portuguese via standard procedures of translation/back-translation.…”