Psychiatric evaluation of women who were assisted at a university referral center in Campinas, Brazil, following an experience of sexual violence.

OBJECTIVE: To present the sociodemographic characteristics and psychiatric symptoms of women who have been raped. METHODS: Between 2006 and 2010, a retrospective study was conducted of 468 women who underwent psychiatric evaluation at a university referral center in Brazil after an experience of sexual violence. RESULTS: The women had a mean age of 24.1 years; were predominantly white, unmarried, childless, and employed; had 9-11 years of education; and had a religion. Rape was the first sexual intercourse for 124 (26.8%) of 462 for whom data were available; 53 (13.6%) of 389 had a personal history of sexual violence and 29 (8.0%) of 361 had a family history. No psychiatric symptoms were reported in 146 (32.9%) of 444 women, mild/short-term symptoms were reported in 107 (24.1%), and a psychiatric diagnosis was made for 191 (43.0%). Psychiatric comorbidity was seen in 59 (12.6%) women, and 174 (38.0%) received pharmacologic treatment. All follow-up consultations were attended by 215 (45.9%) of 468 women; 166 (35.5%) attended some, and 87 (18.6%) attended only one during the 6-month follow-up period. CONCLUSION: The frequency and severity of psychiatric symptoms and mental disorders among women who have been raped highlights the importance of mental health monitoring.

Perception of intimate partner violence among women seeking care in the primary healthcare network in São Paulo state, Brazil.

OBJECTIVE: To evaluate the prevalence and perception of intimate partner violence (IPV) among women in the primary healthcare network in the state of São Paulo, Brazil. METHODS: In a cross-sectional descriptive study conducted between August 2008 and May 2009 in São Paulo state, Brazil, sociodemographic variables (age, education, ethnicity, paid employment, religion, marital status, economic stratum), experiences of IPV (physical, sexual, psychological), and women's perception of violence were compared among 2379 women attending primary healthcare units. Statistical analysis was performed via χ(2) test, Student t test, and multiple logistic regression (odds ratios with 95% confidence intervals) to determine interrelations between the type and perception of violence. RESULTS: The overall prevalence of IPV was 55.7%, whereas that of psychological, physical, and sexual violence was 53.8%, 32.2%, and 12.4%, respectively; however, only 48.7% of women who experienced IPV had perceived this violence. The perception of IPV was highest for sexual violence (76.3%), followed by physical (64.7%) and psychological (49.7%) violence. CONCLUSION: The results showed that, among women within the primary healthcare network in the state of São Paulo, a high percentage had experienced some form of IPV during their lifetime but the rate of self-perception of IPV was low.

A three-year longitudinal evaluation of the forearm bone density of users of etonogestrel- and levonorgestrel-releasing contraceptive implants.

BACKGROUND: The aim of this study was to evaluate bone mineral density (BMD) at baseline and at 18 and 36 months of use of etonogestrel (ENG)-and levonorgestrel (LNG)-releasing contraceptive implants. This is a continuation of a previous study in which BMD was evaluated at baseline and at 18 months of use. METHODS: A total of 111 women, 19-43 years of age, were randomly allocated to use one of the two implants. At 36 months of follow-up, only 36 and 39 women were still using the ENG- and LNG-releasing implants, respectively. BMD was evaluated at the distal and at the ultra-distal radius of the non-dominant forearm using dual-energy X-ray absorptiometry. RESULTS: There was no difference in the BMD of users of either implant at 18 and at 36 months. BMD was significantly lower at 18 and at 36 months at the distal radius in both groups of users compared to pre-insertion values; however, no difference was found at the ultra-distal radius. CONCLUSION: Women 19-43 years of age using either one of these two contraceptive implants for 36 months had lower BMD values at the distal radius compared to pre-insertion values; however, no difference was found at the ultra-distal radius.

Bone mineral density in users of two kinds of once-a-month combined injectable contraceptives.

OBJECTIVE: The objective of this descriptive study was to compare bone mineral density (BMD) between users of two kinds of once-a-month combined injectable contraceptives (CICs) and control subjects. SUBJECTS AND METHODS: This cross-sectional descriptive study included 97 women aged between 20 and 45 years using CICs containing either 25 mg of medroxyprogesterone acetate and 5 mg of estradiol cypionate for 12-82 months or 50 mg of norethindrone enanthate and 5 mg of estradiol valerate for 12-60 months, matched by age (+/-1 year) and body mass index (BMI; kg/m(2)) (+/-1) with users of the TCu 380A intrauterine device as control subjects. BMD was evaluated at the midshaft of the ulna and at the distal section of the radius of the nondominant forearm using double X-ray absorptiometry. RESULTS: There was no difference in BMD between users of either CIC and nonusers at either section of the forearm studied. There was also no difference in BMD between users of the two CICs at either section of the forearm. CONCLUSIONS: Women aged between 20 and 45 years, currently using one of these two kinds of CICs, presented BMDs similar to those of control subjects paired by age and BMI.

A prospective study of the forearm bone density of users of etonorgestrel- and levonorgestrel-releasing contraceptive implants.

BACKGROUND: The aim of the study was to compare bone mineral density (BMD) before insertion and at 18 months of use of etonorgestrel- and levonorgestrel-releasing contraceptive implants. METHODS: One hundred and eleven women, 19-43 years of age, were randomly allocated to two groups: 56 to etonorgestrel and 55 to levonorgestrel. BMD was evaluated at the midshaft of the ulna and at the distal radius of the non-dominant forearm using dual-energy X-ray absorptiometry before insertion and at 18 months of use. RESULTS: There was no difference in baseline demographic or anthropometric characteristics, or in BMD of users of either model of implant. BMD was significantly lower at 18 months of use at the midshaft of the ulna in both groups of users. However, no difference was found at the distal radius. Multiple linear regression analysis showed that the variables associated with BMD at 18 months of use in both implant groups were baseline BMD, body mass index (BMI) and difference in BMI (0 versus 18 months of use). CONCLUSIONS: Women of 19-43 years of age using either one of the implants showed lower BMD at 18 months of use at the midshaft of the ulna, however, without a difference at the distal radius.