RESUMO
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. METHODS/DESIGN: one phase cross-sectional survey carried out in Sao Paulo and Rio de Janeiro, Brazil. A multistage probability to size sampling scheme was performed in order to select the participants (3000 and 1500 respectively). The cities were stratified according to homicide rates, and in Sao Paulo the three most violent strata were oversampled. The measurements included exposure to traumatic events, psychiatric diagnoses (CIDI 2.1), contextual (homicide rates and social indicators), and individual factors, such as demographics, social capital, resilience, help seeking behaviours. The interviews were carried between June/2007 February/2008, by a team of lay interviewers. The statistical analyses will be weight-adjusted in order to take account of the design effects. Standardization will be used in order to compare the results between the two centres. Whole genome association analysis will be performed on the 1 million SNP (single nucleotide polymorphism) arrays, and additional association analysis will be performed on additional phenotypes. The Ethical Committee of the Federal University of Sao Paulo approved the study, and participants who matched diagnostic criteria have been offered a referral to outpatient clinics at the Federal University of Sao Paulo and Federal University of Rio de Janeiro.
Assuntos
Transtornos de Estresse Pós-Traumáticos/epidemiologia , Violência/estatística & dados numéricos , Adolescente , Adulto , Idoso , Transtornos Relacionados ao Uso de Álcool/epidemiologia , Brasil/epidemiologia , Distúrbios de Guerra/epidemiologia , Distúrbios de Guerra/genética , Estudos Transversais , Feminino , Estudo de Associação Genômica Ampla , Genótipo , Inquéritos Epidemiológicos , Homicídio/psicologia , Homicídio/estatística & dados numéricos , Humanos , Acontecimentos que Mudam a Vida , Masculino , Transtornos Mentais/epidemiologia , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único/genética , Prevalência , Transtornos de Estresse Pós-Traumáticos/genética , População Urbana/estatística & dados numéricos , Violência/psicologiaRESUMO
Our study evaluated the relationship between positive affect (PA) and negative affect (NA) traits on the development of posttraumatic stress symptoms (PTSS) among peacekeepers. A longitudinal study with 138 army personnel deployed to a peacekeeping mission in Haiti was conducted. An instrument for measuring PA and NA traits was used before deployment. PTSS, indexed by posttraumatic stress disorder Checklist--Military Version (PCL-M) and frequency of stressful situations were measured after return. Regression analysis showed that both NA and number of stressful situations contributed toward increasing PCL-M scores (Adjusted R = 0.25; p < 0.001). We also found that NA traits interact with intensively stressful situations enhancing the occurrence of PTSS (Adjusted R = 0.32; p < 0.001). These findings suggest that NA traits are an important predictor for PTSS among peacekeepers and also worsen the consequences of being exposed to stressful situations.
Assuntos
Sintomas Afetivos/diagnóstico , Distúrbios de Guerra/diagnóstico , Militares/psicologia , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Nações Unidas , Voluntários/psicologia , Adulto , Sintomas Afetivos/epidemiologia , Sintomas Afetivos/psicologia , Brasil , Caráter , Distúrbios de Guerra/epidemiologia , Distúrbios de Guerra/psicologia , Estudos Transversais , Haiti , Humanos , Estudos Longitudinais , Masculino , Inventário de Personalidade/estatística & dados numéricos , Estudos Prospectivos , Psicometria , Fatores de Risco , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Voluntários/estatística & dados numéricos , Adulto JovemRESUMO
Médicos alertam: conflitos no Terceiro Mundo devem ser tratados como uma doença
Assuntos
Conflitos Armados , Países em Desenvolvimento/classificação , Transtornos do Comportamento Infantil , Comportamento Infantil , Distúrbios de Guerra/epidemiologia , Guerra/históriaRESUMO
The initial weeks of Operation Uphold Democracy were marked by a high rate of major axis I disorders among soldiers presenting for treatment at the 528th Combat Stress Center. The mission to Haiti was also marked by three suicides during the first 30 days. The author explores psychodynamic sources of stress that may have contributed to the high level of psychiatric acuity observed during that first month. Then, distinctions are made between psychiatric conditions that present in combat and those that occur on peacekeeping missions.