LAURA HELENA SILVEIRA GUERRA DE ANDRADE
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/23 - Laboratório de Psicopatologia e Terapêutica Psiquiátrica, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/23 - Laboratório de Psicopatologia e Terapêutica Psiquiátrica, Hospital das Clínicas, Faculdade de Medicina - Líder
6 resultados
Resultados de Busca
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- Twelve-month mental health service use in six countries of the Americas: A regional report from the World Mental Health Surveys(2020) BORGES, G.; AGUILAR-GAXIOLA, S.; ANDRADE, L.; BENJET, C.; CIA, A.; KESSLER, R. C.; OROZCO, R.; SAMPSON, N.; STAGNARO, J. C.; TORRES, Y.; VIANA, Maria Carmen; MEDINA-MORA, M. E.Aims. To provide cross-national data for selected countries of the Americas on service utilization for psychiatric and substance use disorders, the distribution of these services among treatment sectors, treatment adequacy and factors associated with mental health treatment and adequacy of treatment. Methods. Data come from data collected from 6710 adults with 12 month mental disorder surveys across seven surveys in six countries in North (USA), Central (Mexico) and South (Argentina, Brazil, Colombia, Peru) America who were interviewed 2001-2015 as part of the World Health Organization (WHO) World Mental Health (WMH) Surveys. DSM-IV diagnoses were made with the WHO Composite International Diagnostic Interview (CIDI). Interviews also assessed service utilization by the treatment sector, adequacy of treatment received and socio-demographic correlates of treatment. Results. Little over one in four of respondents with any 12 month DSM-IV/CIDI disorder received any treatment. Although the vast majority (87.1%) of this treatment was minimally adequate, only 35.3% of cases received treatment that met acceptable quality guidelines. Indicators of social-advantage (high education and income) were associated with higher rates of service use and adequacy, but a number of other correlates varied across survey sites. Conclusions. These results shed light on an enormous public health problem involving under-treatment of common mental disorders, although the problem is most extreme among people with social disadvantage. Promoting services that are more accessible, especially for those with few resources, is urgently needed.
- Pre-marital predictors of marital violence in the WHO World Mental Health (WMH) Surveys(2020) STOKES, Cara M.; ALONSO, Jordi; ANDRADE, Laura Helena; ATWOLI, Lukoye; CARDOSO, Graca; CHIU, Wai Tat; DINOLOVA, Rumyana V.; GUREJE, Oye; KARAM, Aimee N.; KARAM, Elie G.; KESSLER, Ronald C.; CHATTERJI, Somnath; KING, Andrew; LEE, Sing; MNEIMNEH, Zeina; OLADEJI, Bibilola D.; PETUKHOVA, Maria; RAPSEY, Charlene; SAMPSON, Nancy A.; SCOTT, Kate; STREET, Amy; VIANA, Maria Carmen; WILLIAMS, Michelle A.; BOSSARTE, Robert M.Purpose Intimate partner violence (IPV) is a pervasive public health problem. Existing research has focused on reports from victims and few studies have considered pre-marital factors. The main objective of this study was to identify pre-marital predictors of IPV in the current marriage using information obtained from husbands and wives. Methods Data from were obtained from married heterosexual couples in six countries. Potential predictors included demographic and relationship characteristics, adverse childhood experiences, dating violence, and psychiatric disorders. Reports of IPV and other characteristics from husbands and wives were considered independently and in relation to spousal reports. Results Overall, 14.4% of women were victims of IPV in the current marriage. Analyses identified ten significant variables including age at first marriage (husband), education, relative number of previous marriages (wife), history of one or more categories of childhood adversity (husband or wife), history of dating violence (husband or wife), early initiation of sexual intercourse (husband or wife), and four combinations of internalizing and externalizing disorders. The final model was moderately predictive of marital violence, with the 5% of women accounting for 18.6% of all cases of marital IPV. Conclusions Results from this study advance understanding of pre-marital predictors of IPV within current marriages, including the importance of considering differences in the experiences of partners prior to marriage and may provide a foundation for more targeted primary prevention efforts.
- The epidemiology of alcohol use disorders cross-nationally: Findings from the World Mental Health Surveys(2020) GLANTZ, Meyer D.; BHARAT, Chrianna; DEGENHARDT, Louisa; SAMPSON, Nancy A.; SCOTTS, Kate M.; LIM, Carmen C. W.; AL-HAMZAWI, Ali; ALONSO, Jordi; ANDRADE, Laura Helena; CARDOSO, Graca; GIROLAMO, Giovanni De; GUREJE, Oye; HE, Yanling; HINKOV, Hristo; KARAM, Elie G.; KARAM, Georges; KOVESS-MASFETY, Viviane; LASEBIKAN, Victor; LEE, Sing; LEVINSON, Daphna; MCGRATH, John; MEDINA-MORA, Maria-Elena; MIHAESCU-PINTIA, Constanta; MNEIMNEH, Zeina; MOSKALEWICZ, Jacek; NAVARRO-MATEU, Fernando; POSADA-VILLA, Jose; RAPSEY, Charlene; STAGNARO, Juan Carlos; TACHIMORI, Hisateru; HAVE, Margreet Ten; TINTLE, Nathan; TORRES, Yolanda; WILLIAMS, David R.; ZIV, Yuval; KESSLER, Ronald C.Background: Prevalences of Alcohol Use Disorders (AUDs) and Mental Health Disorders (MHDs) in many individual countries have been reported but there are few cross-national studies. The WHO World Mental Health (WMH) Survey Initiative standardizes methodological factors facilitating comparison of the prevalences and associated factors of AUDs in a large number of countries to identify differences and commonalities. Methods: Lifetime and 12-month prevalence estimates of DSM-IV AUDs, MHDs, and associations were assessed in the 29 WMH surveys using the WHO CIDI 3.0. Results: Prevalence estimates of alcohol use and AUD across countries and WHO regions varied widely. Mean lifetime prevalence of alcohol use in all countries combined was 80%, ranging from 3.8% to 97.1%. Combined average population lifetime and 12-month prevalence of AUDs were 8.6% and 2.2% respectively and 10.7% and 4.4% among non-abstainers. Of individuals with a lifetime AUD, 43.9% had at least one lifetime MHD and 17.9% of respondents with a lifetime MHD had a lifetime AUD. For most comorbidity combinations, the MHD preceded the onset of the AUD. AUD prevalence was much higher for men than women. 15% of all lifetime AUD cases developed before age 18. Higher household income and being older at time of interview, married, and more educated, were associated with a lower risk for lifetime AUD and AUD persistence. Conclusions: Prevalence of alcohol use and AUD is high overall, with large variation worldwide. The WMH surveys corroborate the wide geographic consistency of a number of well-documented clinical and epidemiological findings and patterns.
- The epidemiology of alcohol use disorders cross-nationally: Findings from the World Mental Health Surveys (vol 102, 106128, 2020)(2020) GLANTZ, Meyer D.; BHARAT, Chrianna; DEGENHARDT, Louisa; SAMPSON, Nancy A.; SCOTT, Kate M.; LIM, Carmen C. W.; AL-HAMZAWI, Ali; ALONSO, Jordi; ANDRADEH, Laura Helena; CARDOSO, Graca; GIROLAMO, Giovanni De; GUREJE, Oye; HE, Yanling; HINKOV, Hristo; KARAM, Elie G.; KARAM, Georges; KOVESS-MASFETY, Viviane; LASEBIKAN, Victor; LEE, Sing; LEVINSON, Daphna; MCGRATH, John; MEDINA-MORA, Maria-Elena; MIHAESCU-PINTIA, Constanta; MNEIMNEH, Zeina; MOSKALEWICZ, Jacek; NAVARRO-MATEU, Fernando; POSADA-VILLA, Jose; RAPSEY, Charlene; STAGNARO, Juan Carlos; TACHIMORI, Hisateru; HAVE, Margreet Ten; TINTLE, Nathan; TORRES, Yolanda; WILLIAMS, David R.; ZIV, Yuval; KESSLER, Ronald C.
- Benzodiazepine use in Sao Paulo, Brazil(2020) CAMPANHA, Angela Maria; RAVAGNANI, Beatriz; MILHORANCA, Igor Andre; BERNIK, Marcio Antonini; VIANA, Maria Carmen; WANG, Yuan-Pang; ANDRADE, Laura HelenaOBJECTIVES: To report the prevalence and factors associated with the use of benzodiazepines in the general population and those with a mental health condition in the metropolitan area of Sao Paulo, Brazil. METHODS: 5,037 individuals from the Sao Paulo Megacity Mental Health Survey data were interviewed using the Composite International Diagnostic Interview, designed to generate DSM-IV diagnoses. Additionally, participants were asked if they had taken any medication in the previous 12 months for the treatment of any mental health condition. RESULTS: The prevalence of benzodiazepine use ranged from 3.6% in the general population to 7.8% among subjects with a mental health condition. Benzodiazepine use was more prevalent in subjects that had been diagnosed with a mood disorder as opposed to an anxiety disorder (14.7% vs. 8.1%, respectively). Subjects that had been diagnosed with a panic disorder (33.7%) or bipolar I/II (23.3%) reported the highest use. Individuals aged >= 50 years (11.1%), those with two or more disorders (11.2%), those with moderate or severe disorders (10%), and those that used psychiatric services (29.8%) also reported higher use. CONCLUSION: These findings give an overview of the use of benzodiazepines in the general population, which will be useful in the public health domain. Benzodiazepine use was higher in those with a mental health condition, with people that had a mood disorder being the most vulnerable. Furthermore, females and the elderly had high benzodiazepine use, so careful management in these groups is required.
- Findings From World Mental Health Surveys of the Perceived Helpfulness of Treatment for Patients With Major Depressive Disorder(2020) HARRIS, Meredith G.; KAZDIN, Alan E.; CHIU, Wai Tat; SAMPSON, Nancy A.; AGUILAR-GAXIOLA, Sergio; AL-HAMZAWI, Ali; ALONSO, Jordi; ALTWAIJRI, Yasmin; ANDRADE, Laura Helena; CARDOSO, Graca; CIA, Alfredo; FLORESCU, Silvia; GUREJE, Oye; HU, Chiyi; KARAM, Elie G.; KARAM, Georges; MNEIMNEH, Zeina; NAVARRO-MATEU, Fernando; OLADEJI, Bibilola D.; O'NEILL, Siobhan; SCOTT, Kate; SLADE, Tim; TORRES, Yolanda; VIGO, Daniel; WOJTYNIAK, Bogdan; ZARKOV, Zahari; ZIV, Yuval; KESSLER, Ronald C.Key PointsQuestionWhat proportion of patients with depression perceive treatment as helpful? FindingsThis study of 80332 respondents surveyed in 16 countries found that 68.2% of adults with a lifetime history of DSM-IV major depressive disorder (n=2726) obtained treatment that they considered helpful; other patients stopped seeking treatment after early unhelpful treatment. Most patients (93.9%) were helped if they persisted through 10 treatment professionals, but only 21.5% of patients were that persistent. MeaningMany more patients with major depressive disorder might obtain helpful treatment if they persist after early unhelpful treatment. ImportanceThe perceived helpfulness of treatment is an important patient-centered measure that is a joint function of whether treatment professionals are perceived as helpful and whether patients persist in help-seeking after previous unhelpful treatments. ObjectiveTo examine the prevalence and factors associated with the 2 main components of perceived helpfulness of treatment in a representative sample of individuals with a lifetime history of DSM-IV major depressive disorder (MDD). Design, Setting, and ParticipantsThis study examined the results of a coordinated series of community epidemiologic surveys of noninstitutionalized adults using the World Health Organization World Mental Health surveys. Seventeen surveys were conducted in 16 countries (8 surveys in high-income countries and 9 in low- and middle-income countries). The dates of data collection ranged from 2002 to 2003 (Lebanon) to 2016 to 2017 (Bulgaria). Participants included those with a lifetime history of treated MDD. Data analyses were conducted from April 2019 to January 2020. Data on socioeconomic characteristics, lifetime comorbid conditions (eg, anxiety and substance use disorders), treatment type, treatment timing, and country income level were collected. Main Outcomes and MeasuresConditional probabilities of helpful treatment after seeing between 1 and 5 professionals; persistence in help-seeking after between 1 and 4 unhelpful treatments; and ever obtaining helpful treatment regardless of number of professionals seen. ResultsSurvey response rates ranged from 50.4% (Poland) to 97.2% (Medellin, Columbia), with a pooled response rate of 68.3% (n=117616) across surveys. Mean (SE) age at first depression treatment was 34.8 (0.3) years, and 69.4% were female. Of 2726 people with a lifetime history of treatment of MDD, the cumulative probability (SE) of all respondents pooled across countries of helpful treatment after seeing up to 10 professionals was 93.9% (1.2%), but only 21.5% (3.2%) of patients persisted that long (ie, beyond 9 unhelpful treatments), resulting in 68.2% (1.1%) of patients ever receiving treatment that they perceived as helpful. The probability of perceiving treatment as helpful increased in association with 4 factors: older age at initiating treatment (adjusted odds ratio [AOR], 1.02; 95% CI, 1.01-1.03), higher educational level (low: AOR, 0.48; 95% CI, 0.33-0.70; low-average: AOR, 0.62; 95% CI, 0.44-0.89; high average: AOR, 0.67; 95% CI, 0.49-0.91 vs high educational level), shorter delay in initiating treatment after first onset (AOR, 0.98; 95% CI, 0.97-0.99), and medication received from a mental health specialist (AOR, 2.91; 95% CI, 2.04-4.15). Decomposition analysis showed that the first 2 of these 4 factors were associated with only the conditional probability of an individual treatment professional being perceived as helpful (age at first depression treatment: AOR, 1.02; 95% CI, 1.01-1.02; educational level: low: AOR, 0.48; 95% CI, 0.33-0.70; low-average: AOR, 0.62; 95% CI, 0.44-0.89; high-average: AOR, 0.67; 95% CI, 0.49-0.91 vs high educational level), whereas the latter 2 factors were associated with only persistence (treatment delay: AOR, 0.98; 95% CI, 0.97-0.99; treatment type: AOR, 3.43; 95% CI, 2.51-4.70). Conclusions and RelevanceThe probability that patients with MDD obtain treatment that they consider helpful might increase, perhaps markedly, if they persisted in help-seeking after unhelpful treatments with up to 9 prior professionals. This study analyzes surveys conducted in 16 countries to evaluate the proportion of respondents with a lifetime history of major depressive disorder who perceive treatment professionals as helpful and who persist in help-seeking after previous unhelpful treatments.