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Book

Mental health at the crossroads: the promise of the psychosocial approach

Editors:
RAMON Shulamit, WILLIAMS Janet E., (eds.)
Publisher:
Ashgate
Publication year:
2005
Pagination:
235p.
Place of publication:
Aldershot

This book is a challenge to the enduring status and domination of bio-medical approaches in mental health services. Contributors from four continents argue that this domination, along with modernization and multidisciplinary work, will not improve people's lives unless social and psychological perspectives are appreciated and integrated. This implies new forms of relationships and social arrangements. The book presents an analysis of the psychosocial approach as it resonates across the discipline divide, considering the past and future development. It is written from the perspectives of service users and carers, managers, practitioners, educators, researchers and policy makers, illustrated with case studies from Australia, Brazil, Italy, UK and the USA. This book presents an alternative approach to conventional thinking in mental health, providing perspectives, grounded in theory with practice examples, in order to influence the current agenda and change practice.

Journal article

The quality of life of HIV-infected women is associated with psychiatric morbidity

Authors:
TOSTES M.A., CHALUB M., BOTEGA N.J.
Journal article citation:
AIDS Care, 16(2), February 2004, pp.177-186.
Publisher:
Taylor and Francis

Evaluates the effect of clinical, demographic and psychiatric factors on the health-related quality of life of 76 women with HIV infection seen in two HIV reference centres in Brazil. The generic questionnaire for evaluation of Health-Related Quality of Life (SF-36), the Hospital Anxiety and Depression Scale (HAD) and the Clinical Interview Schedule (CIS-R) were used. The statistical tests included the covariance analysis. The sub-group of the non-AIDS symptoms (clinical stage B) showed the worst quality of life. The variables which better explained the scoring variation on both the mental and physical components of the SF-36 were related to mental health. The more mental symptoms present, the worse the health-related quality of life. Concludes that care strategies should be rethought in the area of mental health which are directed toward HIV+ patients, by virtue of the levels of mental health symptoms found and the request for care which the research revealed.

Journal article

Impact evaluation of a cognitive behavioral group therapy model in Brazilian sexually abused girls

Authors:
HABIGZANG Luísa, DAMÁSIO Bruno Figueiredo, KOLLER Silvia Helena
Journal article citation:
Journal of Child Sexual Abuse, 22(2), 2013, pp.173-190.
Publisher:
Taylor and Francis
Place of publication:
Philadelphia, USA

This study evaluated the impact of a newly developed cognitive behavioural group therapy model for young female victims of sexual abuse. The effect of the waiting period before treatment and the enduring effectiveness of the treatment after 6 and 12 months were also evaluated. The cognitive behavioural group therapy consisted of 3 stages: psychoeducation and cognitive restructuring (Stage 1, 6 weeks of group therapy); stress inoculation training (Stage 2, 10 weeks of group therapy); and relapse prevention (Stage 3, 16 weeks of group therapy). The participants were 49 Brazilian girls from 9-16 years of age who had experienced at least one episode of sexual abuse. The participants completed instruments measuring depression, anxiety, stress, and post-traumatic stress disorder before, during, and after the group therapy. The findings showed that group therapy had a positive impact on the girls psychological functioning, significantly reducing symptoms of anxiety, stress, and post-traumatic stress disorder. They also showed that the model was of benefit regardless of the time between the sexual abuse and the beginning of group therapy. The therapeutic effects of the group therapy continued to be maintained 6-12 months after the treatment ended.

Journal article

Violence against women by their intimate partner and common mental disorders

Authors:
LUDERMIR Ana Bernarda, et al
Journal article citation:
Social Science and Medicine, 66(4), February 2008, pp.1008-1018.
Publisher:
Elsevier

The World Health Organization considers gender violence a cause of anxiety, depression and suicidal thoughts among women. This study investigated the association between violence committed against women by their intimate partners, defined by psychologically, physically and sexually abusive acts, and common mental disorders, assessed by using the Self Reporting Questionnaire (SRQ-20). A population-based household survey was carried out among women aged 15–49 years in two sites: São Paulo, the largest Brazilian city, and Zona da Mata of Pernambuco, a region with both urban and rural areas in the Northeast of the country. A large proportion of women reported violence (50.7%). The most frequent forms were psychological violence alone (18.8%) or accompanied by physical violence (16.0%). The prevalence of mental disorders was 49.0% among women who reported any type of violence and 19.6% among those who did not report violence (p < 0.0001). After adjustment for demographic and socioeconomic characteristics, the nature of the relationship, stressful life events and social support, all the forms of violence studied, with the exception of sexual violence alone or accompanied by either physical or psychological violence (p = 0.09), were significantly associated with mental disorders: physical violence alone, psychological violence alone, sexual violence alone or accompanied by either physical or psychological violence, both psychological and physical violence  and all three forms of violence. This is the first population-based study on the association between intimate partner violence and mental health in Brazil. It contributes to the existing body of research and confirms that violence, frequently experienced by women in the country, is associated with mental disorders. Policies and strategies aimed at reducing gender-based violence are necessary for preventing and reducing anxiety and depression among women.

Journal article

Co-occurrence of chronic physical pain and psychiatric morbidity in a community sample of older people

Authors:
BLAY Sergio Luis, et al
Journal article citation:
International Journal of Geriatric Psychiatry, 22(9), September 2007, pp.903-908.
Publisher:
Wiley-Blackwell

Knowledge about co-occurrence of the most frequent chronic pain symptoms with psychiatric morbidity in older people is very limited. The aim was to study the association of psychiatric morbidity and painful physical conditions in people aged 60 years and over. Population-based random sample of 7,040 household residents, aged 60 years and over, in Brazil. The overall prevalence of pain conditions is 76%. Age-sex specific prevalence of chronic pain conditions such as back pain, joint, abdominal, chest, headaches, reported by respondents ranged from 11.6% up to 51.1%. In logistic regression models, chest pain, head pain, back pain, joint pain and abdominal pain emerged as predictors of psychiatric morbidity. The odds of psychiatric morbidity are also affected by income, ethnicity, origin (urban/rural), and marital status. The association of chronic painful conditions and psychiatric morbidity in late life is statistically strong in this surveyed population.

Journal article

Targeted ethnography as a critical step to inform cultural adaptations of HIV prevention interventions for adults with severe mental illness

Authors:
WAINBERG Milton L., et al
Journal article citation:
Social Science and Medicine, 65(2), July 2007, pp.296-308.
Publisher:
Elsevier

As in other countries worldwide, adults with severe mental illness (SMI) in Brazil are disproportionately infected with HIV relative to the general population. Brazilian psychiatric facilities lack tested HIV prevention interventions. To adapt existing interventions, developed only in the US, the authors conducted targeted ethnography with adults with SMI and staff from two psychiatric institutions in Brazil. The authors sought to characterize individual, institutional, and interpersonal factors that may affect HIV risk behaviour in this population. The authors conducted 350 hours of ethnographic field observations in two mental health service settings in Rio de Janeiro, and 9 focus groups (n=72) and 16 key-informant interviews with patients and staff in these settings. Data comprised field notes and audiotapes of all exchanges, which were transcribed, coded, and systematically analyzed. The ethnography identified and/or characterized the institutional culture: (1) patients’ risk behaviours; (2) the institutional setting; (3) intervention content; and (4) intervention format and delivery strategies. Targeted ethnography also illuminated broader contextual issues for development and implementation of HIV prevention interventions for adults with SMI in Brazil, including an institutional culture that did not systematically address patients’ sexual behaviour, sexual health, or HIV sexual risk, yet strongly impacted the structure of patients’ sexual networks. Further, ethnography identified the Brazilian concept of “social responsibility” as important to prevention work with psychiatric patients. Targeted ethnography with adults with SMI and institutional staff provided information critical to the adaptation of tested US HIV prevention interventions for Brazilians with SMI.

Book

Mental health services in the global village

Editors:
APPLEBY Louis, ARAYA Ricardo
Publisher:
Gaskell
Publication year:
1991
Pagination:
231p.,tables,bibliogs.
Place of publication:
London

Comparative study of mental health services in 16 countries from both the developed and the developing world. Contains sections on countries from: Asia, Europe, Africa, the Middle East and South and Central America.

Journal article

Borderline personality disorder typical symptoms among Brazilian adolescents in a foster care institution

Authors:
SCHAFER Julia L., DORNELLES Vinícius G., HORTA Rogerio L.
Journal article citation:
Vulnerable Children and Youth Studies, 11(1), 2016, pp.13-23.
Publisher:
Taylor and Francis
Place of publication:
Philadelphia, USA

Borderline personality disorder (BPD) symptoms usually emerge during adolescence. Because it is a highly dysfunctional disorder, this study aimed to identify the presence of BPD typical symptoms in Brazilian adolescents in a foster care institution. This research was conducted with 44 adolescents ranging from 12 to 17 years old from a foster care institution in south of Brazil. The adolescents answered the instrument Borderline Symptoms List-23 to assess BPD symptomatology, and the psychologist of the institution answered a questionnaire about the adolescents regarding sex, age, education, the process of entering the institution and mental health history. The sample was divided in two groups: one composed of adolescents with problematic levels of symptoms, showing an intense presentation of BPD symptoms, and the other made of adolescents with non-problematic levels of symptoms, showing a slight presentation of BPD symptoms. Comparisons between sex and the instrument total scores showed that girls had significant higher means than boys (p < 0.05). Through regression analysis, the adolescents presenting problematic levels of symptoms were those who entered the foster care institution at 12 years old or older (p < 0.05), and were in high school (p < 0.05). The results of this study indicate the presence of different levels of BPD symptoms in Brazilian adolescents in the foster care institution suggesting the importance of the development of interventions aiming mental health promotion. (Publisher abstract)

Journal article

"The Lord is my Shepherd": examining spirituality as a protection against mental health problems in youth exposed to violence in Brazil

Authors:
HUCULAK Susan, McLENNAN John D.
Journal article citation:
Mental Health Religion and Culture, 13(5), July 2010, pp.467-484.
Publisher:
Taylor and Francis
Place of publication:
Philadelphia, USA

Data collected from 325 young male and female young offenders, aged between 12 and 17 years, from juvenile detention facilities in Sao Paulo, Brazil were analysed to examine the role that intrinsic or institutionally inspired spirituality or religious beliefs have as protective factors against the possible, negative effects of stress on their mental health. Questions about violence exposure and spirituality from two instruments of measure, the ‘social and health assessment’ and the ‘strengths and difficulties questionnaire’ were asked and the answers analysed (correlation, mediation and regression analyses) alongside socioeconomic and demographic data. Some evidence of buffering of the effects exposure to violence can have on mental health problems were observed if spirituality or religious beliefs were evident in participants lives. In addition, these authors claim that “intrinsic spirituality may mediate the relationship between institutional activities and mental well-being outcomes”. They conclude that the data support that spirituality in high-risk youth population is multi-dimensional, suggesting that “a small differential and interactive role” may be played by intrinsic or institutional spirituality in protecting against and preventing some mental health problems.

Journal article

Psychological distress in Brazilian caregivers of relatives with dementia

Authors:
BANDEIRA D. R., et al
Journal article citation:
Aging and Mental Health, 11(1), January 2007, pp.14-19.
Publisher:
Taylor and Francis

The authors evaluated stress, anxiety, depression, and feelings of hopelessness in caregivers of relatives with dementia. One hundred and twenty-nine caregivers and 145 non-caregivers who lived in metropolitan Porto Alegre, Brazil completed Lipp's Inventory of Stress Symptoms for Adults, (ISSL), and Beck's Anxiety (BAI), Depression (BDI), and Hopelessness (BHS) scales. Caregivers showed higher levels of anxiety, depression, hopelessness, resistance/pre-exhaustion stress than controls. This study indicates that constant caregiving may significantly increase the risk of physical and mental health problems for caregivers in Brazil.

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