Papers by Geilson Santana
Journal of Affective Disorders
Journal of Occupational & Environmental Medicine
International Review of Psychiatry, 2022
<p>Multivariate model for associations between child adversity and lifetime (LT) suicidalit... more <p>Multivariate model for associations between child adversity and lifetime (LT) suicidality during teen (13–19 y.o.), early adult (20–20 y.o.) and later adult years (30 or more y.o)<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0155639#t006fn002" target="_blank"><sup>1</sup></a>.</p
Journal of Psychiatric Research
<p>Association between personality disorders and 12-month treatment in the Sao Paulo Metrop... more <p>Association between personality disorders and 12-month treatment in the Sao Paulo Metropolitan Area.</p
<p>Sociodemographic predictors of personality disorders in the Sao Paulo Metropolitan Area.... more <p>Sociodemographic predictors of personality disorders in the Sao Paulo Metropolitan Area.</p
<p>Weighted prevalence and distribution of chronic childhood adversities in the total sampl... more <p>Weighted prevalence and distribution of chronic childhood adversities in the total sample and among individuals with suicidality (N = 5,037).</p
<p>Schematic representation of the sample—Number of cases with the outcome variable; N repr... more <p>Schematic representation of the sample—Number of cases with the outcome variable; N represents the number of person-years.</p
<p>Prevalence of 12-month treatment among those with personality disorders in the Sao Paulo... more <p>Prevalence of 12-month treatment among those with personality disorders in the Sao Paulo Metropolitan Area.</p
Brazilian Journal of Psychiatry, 2021
Objective: Most countries fail to treat individuals with psychopathologies. Investigating treatme... more Objective: Most countries fail to treat individuals with psychopathologies. Investigating treatment barriers and reasons for dropout are key elements to overcoming this scenario. Methods: A representative sample of 2,942 urban-dwelling adults was interviewed face-to-face within a cross-sectional, stratified, multistage probability survey of the general population. Psychiatric diagnosis, severity level, use of services, reasons for not seeking treatment, and treatment dropout were investigated. Results: Only 23% of individuals with a psychopathology of any severity level in the last 12 months received treatment. Low perceived need for treatment (56%) was the most common reason for not seeking treatment. The most visited settings were psychiatric, other mental health care, and general medical care. Among those with a perceived need for treatment (44%), psychological barriers were the most common reason for not seeking it. Treatment dropout was more prevalent among those who visited a general medical care setting. Among individuals still in treatment, human services and psychiatric care were the most common types. Female sex was associated with structural barriers (OR = 2.1). Disorder severity was negatively associated with need barriers (OR = 0.4), and positively associated with structural barriers (OR = 2.5) and psychological barriers (OR = 2.5). Conclusion: Despite the need for treatment and better services, psychological barriers were the major reason for not seeking treatment. Apart from providing more specialists, investing in awareness, de-stigmatization, and information is the ultimate strategy for improving psychiatric care.
Brazilian Journal of Psychiatry, 2022
International Review of Psychiatry, 2022
☯ These authors contributed equally to this work. ‡ These authors also contributed equally to thi... more ☯ These authors contributed equally to this work. ‡ These authors also contributed equally to this work.
PLoS ONE, 2021
Introduction Alcohol Use Disorders are frequently comorbid with personality disorders. However, t... more Introduction Alcohol Use Disorders are frequently comorbid with personality disorders. However, the heterogeneity of the prevalence estimates is high, and most data come from high income countries. Our aim is to estimate the prevalence and association between alcohol use outcomes and the three DSM-5 clusters of personality disorders in a representative sample of the São Paulo Metropolitan Area. Materials and methods A representative household sample of 2,942 adults was interviewed using the WHO Composite International Diagnostic Interview and the International Personality Disorder Examination Screening Questionnaire. Lifetime PD diagnoses were multiply imputed, and AUD diagnoses were obtained using DSM-5 criteria. We conducted cross-tabulations and logistic regression to estimate the associations between AUDs and PDs. Results and discussion Our study did not find significant associations of PDs with heavy drinking patterns or mild AUD. Cluster B PD respondents tended to show the hig...
Introduction: Most studies on the epidemiology of personality disorders (PDs) have been conducted... more Introduction: Most studies on the epidemiology of personality disorders (PDs) have been conducted in high-income countries and may not represent what happens in most part of the world. In the last decades, population growth has been concentrated in low-and middle-income countries, with rapid urbanization, increasing inequalities and escalation of violence. Our aim is to estimate the prevalence of PDs in the Sao Paulo Metropolitan Area, one of the largest megacities of the world. We examined sociodemographic correlates, the influence of urban stressors, the comorbidity with other mental disorders, functional impairment and service use. Methods: A representative household sample of 2,942 adults was interviewed using the WHO-Composite International Diagnostic Interview and the International Personality Disorder Examination-Screening Questionnaire. Diagnoses were multiply imputed, and analyses used multivariate regression and multilevel analysis. Results and discussion: Prevalence was 4.33% (Cluster A), 2.73% (Cluster B), 4.62% (Cluster C) and 6.77% (any PD). Cumulative exposure to violence was associated with PDs, although urbanicity, migration and neighbourhood social deprivation were not significant predictors. Comorbidity was the rule, and all clusters were associated with other mental disorders. Lack of treatment is a reality in Greater Sao Paulo, and this is especially true for PDs. With the exception of Cluster C, non-comorbid PDs remained largely untreated in spite of functional impairment independent of other mental disorders. Conclusion: Personality disorders are prevalent, clinically significant and undertreated, and public health strategies must address the unmet needs of these subjects. These results may reflect what happens in other developing world megacities, and future studies are expected in other low-and middle-income countries.
Scientific Reports, 2019
Chronic diseases are often comorbid and present a weighty burden for communities in the 21 st cen... more Chronic diseases are often comorbid and present a weighty burden for communities in the 21 st century. the present investigation depicted patterns of multimorbidity in the general population and examined its association with the individual-and area-level factors in an urban sample of non-elderly adults of Brazil. Data were from the cross-sectional são paulo Megacity Mental Health survey, a stratified multistage area probability sampling investigation. Trained interviewers assessed mental morbidities and asked about physical conditions for 1,571 community-dwelling women and 1,142 men, aged between 18 and 64 years. Principal component analysis depicted patterns of physicalmental multimorbidity, by sex. Following, the patterns of multimorbidity were subjected to multilevel regression analysis, taking into account individual-and area-level variables. three patterns of clustering were found for women: 'irritable mood and headache', 'chronic diseases and pain', and 'substance use disorders'. Among men, the patterns were: 'chronic pain and respiratory disease', 'psychiatric disorders', and 'chronic diseases'. Multilevel analyses showed associations between multimorbidity patterns and both individual-and area-level determinants. Our findings call for a reformulation of health-care systems worldwide, especially in low-resource countries. Replacing the single-disease framework by multi-disease patterns in health-care settings can improve the ability of general practitioners in the health-care of person-centred needs. Multimorbidity is a taxing concept to delimitate 1 , but it can be defined as a non-random association pattern between diseases 2. Generally, multimorbidity is conceptualized as the co-occurrence of multiple chronic or long-term medical conditions. Multimorbidity includes both physical and mental illnesses and is distinguished from comorbidity due to the absence of an index disease or condition as is the case of the second 3. The tendency of chronic conditions to cluster into distinct configurations represents the norm in older age people, resulting in higher disease persistence, functional disability, polypharmacy, health-care service use, and mortality 3-5. Although multimorbidity is a worldwide concern, most of beyond chance combination of medical and psychiatric conditions has been recognized in developed countries 6. However, this phenomenon is not restricted to the elderly living in high-income countries (HICs). Multimorbidity affects more young people in low-and middle-income countries (LMICs) than in HICs 7. Chronic non-communicable diseases represent a large share of disease burden in LMICs 8 , which start during peak economically active years of age. For example, the World Health Survey has estimated a mean prevalence of multimorbidity of 7.8% in 28 LMICs 9. Moreover, in WHO's Study on global AGEing and adult health (SAGE), over one-fifth of participants from six LMICs reported multiple
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Papers by Geilson Santana