Laura Helena Silveira Guerra Andrade

University of São Paulo | USP · Instituto / Departamento de Psiquiatria (FM) (São Paulo)

Objective: Our aim was to assess the prevalence and predictors of well-being among Brazilian industry workers on returning to the physical workplace during the COVID-19 pandemic. Methods: 2,241 participants completed an online survey between October and November 2021. Well-being was assessed with the WHO-5, and the questionnaire also addressed s...

Background Post-traumatic stress disorder (PTSD) is a debilitating condition, which generates an extensive burden. We aimed to investigate in a huge metropolitan area, the prevalence of traumatic experiences, the development of PTSD, and its predictors. Methods Traumatic experiences and PTSD were assessed in 5037 adult individuals of the general p...

During the COVID-19 pandemic, Brazilian urban peripheries have been severely affected both by the spread of the virus and by social, political, and economical dynamics, raising concerns about the psychological wellbeing and mental health of the population living in these areas. The pandemic broke out in a context of reduced public spending in socia...

Purpose Lesbian, gay, and bisexual (LGB) individuals, and LB women specifically, have an increased risk for psychiatric morbidity, theorized to result from stigma-based discrimination. To date, no study has investigated the mental health disparities between LGB and heterosexual AQ1individuals in a large cross-national population-based comparison. T...

Aim Exposure to traumatic events (TEs) is associated with substance use disorders (SUDs). However, most studies focus on a single TE, and are limited to single countries, rather than across countries with variation in economic, social and cultural characteristics. We used cross-national data to examine associations of diverse TEs with SUD onset, an...

Background Most individuals with major depressive disorder (MDD) receive either no care or inadequate care. The aims of this study is to investigate potential determinants of effective treatment coverage. Methods In order to examine obstacles to providing or receiving care, the type of care received, and the quality and use of that care in a repre...

Patient‐reported helpfulness of treatment is an important indicator of quality in patient‐centered care. We examined its pathways and predictors among respondents to household surveys who reported ever receiving treatment for major depression, generalized anxiety disorder, social phobia, specific phobia, post‐traumatic stress disorder, bipolar diso...

An under-studied crucial step in the health-related help-seeking process is making prompt contact with a treatment provider when a mental disorder strikes. This study aims to provide data on patterns and predictors of failure and delay in making initial treatment contact after the first onset of a mental disorder among adult residents in São Paulo,...

Background: Major Depressive Disorder (MDD) contributes to a significant proportion of disease burden, disability, economic losses, and impact on need of treatment and health care in Brazil, but systematic information about its treatment coverage is scarce. This paper aims to estimate the gap in treatment coverage for MDD and identify key bottlenec...

Purpose: To investigate the prevalence and predictors of perceived helpfulness of treatment in persons with a history of DSM-IV social anxiety disorder (SAD), using a worldwide population-based sample. Methods: The World Health Organization World Mental Health Surveys is a coordinated series of community epidemiological surveys of non-institutio...

Background Different land cover types in cities, including green areas, have impacts on mental health. Few studies, however, have been conducted in megacities in low-/middle-income countries, which have extremely complex urban arrangements. Objective We analyzed land cover using the population database of the São Paulo Megacity Mental Health Surve...

Urban mental health studies traditionally search for causal relationships between elements of the city and the prevalence of mental disorders. This paper discusses the importance of (re)thinking the 'lived urban experience' from the perspective of city residents about how the immediate environment affects their mental health and how people cope wit...

Objective: to estimate structural and attitudinal reasons for premature discontinuation of mental health treatment, socio-demographic and clinical correlates of treatment dropout due to these reasons, and to test country differences from the overall effect across the region of the Americas. Methods: World Health Organization-World Mental Health (WM...

Background Mental health treatment is scarce and little resources are invested in reducing the wide treatment gap that exists in the Americas. The regional barriers are unknown. We describe the barriers for not seeking treatment among those with mental and substance use disorders from six (four low- and middle-income and two high-income) countries...

Background Mental healthcare is delivered across service sectors that differ in level of specialization and intervention modalities typically offered. Little is known about the perceived helpfulness of the combinations of service sectors that patients use. Methods Respondents 18 + years with 12-month DSM-IV mental or substance use disorders who sa...

Aim We examined prevalence and factors associated with receiving perceived helpful alcohol use disorder (AUD) treatment, and persistence in help-seeking after earlier unhelpful treatment. Methods Data came from 27 community epidemiologic surveys of adults in 24 countries using the World Health Organization World Mental Health surveys (n = 93,843)....

Background The most common treatment for major depressive disorder (MDD) is antidepressant medication (ADM). Results are reported on frequency of ADM use, reasons for use, and perceived effectiveness of use in general population surveys across 20 countries. Methods Face-to-face interviews with community samples totaling n = 49 919 respondents in t...

Background: We report results of an internet-based field study evaluating the diagnostic guidelines for ICD-11 mood disorders. Accuracy of clinicians' diagnostic judgments applying draft ICD-11 as compared to the ICD-10 guidelines to standardized case vignettes was assessed as well as perceived clinical utility. Methods: 1357 clinician members o...

Background We estimate work loss and economic costs due to mental and substance use disorders in the economically active population of the São Paulo Metropolitan Area, Brazil. Methods The São Paulo Megacity Mental Health Survey assessed a population-based sample of 3,007 economically active residents using the Composite International Diagnostic In...

Background: Treatment guidelines for generalized anxiety disorder (GAD) are based on a relatively small number of randomized controlled trials and do not consider patient-centered perceptions of treatment helpfulness. We investigated the prevalence and predictors of patient-reported treatment helpfulness for DSM-5 GAD and its two main treatment pa...

Background Immigrants and refugees have specific mental health needs. Studies of immigrant/refugee psychiatric patients in Latin America are scarce. Aims Present the profile of patients from an outpatient psychiatric service in Sao Paulo (Brazil) to better inform mental health service planning for immigrants and refugees in the Global South. Meth...

Background: Cardiovascular risk factors can mediate the association between depression and cardiovascular diseases. Objective: To evaluate cardiovascular risk factors in adult individuals with and without histories of major depression in the metropolitan region of São Paulo, Brazil. Design and setting: Cross-sectional study in São Paulo (SP),...

PurposeMajor depressive disorder (MDD) and anxiety disorders (AD) are both highly prevalent among individuals with arrhythmia, ischemic heart disease, heart failure, hypertension, and dyslipidemia. There should be increased support for MDD and AD diagnosis and treatment in individuals with cardiac diseases, because treatment rates have been low. Ho...

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...

PurposeTo estimate the prevalence of intermittent explosive disorder (IED) in comorbidity with other psychiatric disorders and to describe the temporal sequencing of disorders in the São Paulo Metropolitan Area, Brazil.Methods Data from the São Paulo Megacity Mental Health Survey, a population-based study of 5037 adult individuals, were analyzed. T...

Background Although randomized trials show that social phobia treatments can be effective, it is unclear whether patients experience treatment as helpful in clinical practice. We investigated this issue by assessing perceived treatment helpfulness for specific phobia in a cross-national epidemiological survey. Methods Cross-sectional population-ba...

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 representa...

Background Childhood adversities (ECA) are deleterious experiences that can occur during individuals’ development, which has been associated with several negative health outcomes. Aim Analyze the effect of ECA on the onset of DSM-IV disorders throughout life. Method The Composite International Diagnostic Interview (CIDI) was used in a stratified,...

Background Depressive and anxiety disorders are highly comorbid, which has been theorized to be due to an underlying internalizing vulnerability. We aimed to identify groups of participants with differing vulnerabilities by examining the course of internalizing psychopathology up to age 45. Methods We used data from 24158 participants (aged 45+) i...

Objectives: 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 São Paulo, Brazil. Methods: 5,037 individuals from the Sao Paulo Megacity Mental Health Survey data were interviewed using the Composite International Diagnosti...

Importance The 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. Objective To examine the prevalence and factors associated with the 2 main components of pe...

Background There is a substantial proportion of patients who drop out of treatment before they receive minimally adequate care. They tend to have worse health outcomes than those who complete treatment. Our main goal is to describe the frequency and determinants of dropout from treatment for mental disorders in low-, middle-, and high-income countr...

Background Immigrants and refugees have specific mental health needs. Studies of immigrant/refugee psychiatric patients in Latin America are scarce. This article presents the profile of patients from an outpatient psychiatric service in Sao Paulo (Brazil) and aims to better inform mental health service planning for immigrants and refugees. Methods...

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 D...

Mangolini VI, Andrade LH, Wang YP. Epidemiologia dos transtornos de ansiedade em regiões do Brasil: uma revisão de literatura / Epidemiology of anxiety disorders in Brazilian regions: a literature review. Rev Med (São Paulo). 2019 nov.-dez.;98(6):415-22. RESUMO: Objetivo: Identificar a frequência, os fatores determinantes e o uso de serviços de saú...

The aim of this study was to review emerging evidence of novel treatments for anxiety disorders. We searched PubMed and EMBASE for evidence-based therapeutic alternatives for anxiety disorders in adults, covering the past five years. Eligible articles were systematic reviews (with or without meta-analysis), which evaluated treatment effectiveness o...

Rapidly urbanizing areas of Latin America experience elevated but unevenly distributed levels of violence. Extensive research suggests that individual exposure to violence is associated with higher odds of both internalizing (anxiety and mood) and externalizing (substance and intermittent explosive) mental disorders. Less research, however, has foc...

Background: Illicit drug use and associated disease burden are estimated to have increased over the past few decades, but large gaps remain in our knowledge of the extent of use of these drugs, and especially the extent of problem or dependent use, hampering confident cross-national comparisons. The World Mental Health (WMH) Surveys Initiative inv...

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 l...

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 a...

BACKGROUND: This study describes the effects of common health conditions associated with absenteeism and presenteeism in a population-based sample of workers in Brazil. METHODS: Data were analysed from the cross-sectional São Paulo Megacity Mental Health Survey on 1,737 employed residents aged >18 years old conducted from 2005 to 2007. RESULTS: P...

Importance Limited empirical research has examined the extent to which cohort-level prevalence of substance use is associated with the onset of drug use and transitioning into greater involvement with drug use. Objective To use cross-national data to examine time-space variation in cohort-level drug use to assess its associations with onset and tr...

Chronic diseases are often comorbid and present a weighty burden for communities in the 21st 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...

Purpose Our understanding of community-level predictors of individual mental disorders in large urban areas of lower income countries is limited. In particular, the proportion of migrant, unemployed, and poorly educated residents in neighborhoods of these urban areas may characterize group contexts and shape residents’ health. Methods Cross-sectio...

Background: Self-reported depressive complaints among college students might indicate different degrees of severity of depressive states. Through the framework of item response theory, we aim to describe the pattern of responses to items of the Beck Depression Inventory-II (BDI-II), in terms of endorsement probability and discrimination along the c...

Objective: The purpose of this study was to estimate the need for population-level services for alcohol and other drug abuse in support of local planning. Method: Data were drawn from a subsample of 2,942 interviewees from the São Paulo Megacity Study, which evaluated mental health in the general population (18 years and older) of residents in t...

Objectives Although clinical evidence suggests important differences between unipolar mania and bipolar‐I disorder (BP‐I), epidemiological data are limited. Combining data from 9 population‐based studies, we compared subjects with mania (M) or mania with mild depression (Md) to those with BP‐I with both manic and depressive episodes with respect to...

Background and aims The World Health Organization's (WHO's) proposed International Classification of Diseases, 11th Edition (ICD‐11) includes several major revisions to substance use disorder (SUD) diagnoses. It is essential to ensure the consistency of within‐subject diagnostic findings across countries, languages and cultures. To date, agreement...

The objective of present study is to investigate the relationship between different childhood adversities. The potential impact of early adversity on prevention programs is discussed. Data on twelve childhood adversities was collected from a representative sample of 5037 members of the general population living in a large metropolitan area. Data we...

Trauma and Posttraumatic Stress Disorder - edited by Evelyn Bromet August 2018

OBJECTIVE: Childhood adversities (CAs) comprise a group of negative experiences individuals may suffer in their lifetimes. The goal of the present study was to investigate the cluster discrimination of CAs through psychometric determination of the common attributes of such experiences for men and women. METHODS: Parental mental illness, substance m...

We investigated the dimensionality and possible measurement bias of ICD-11 Nicotine Dependence (ND) criteria in a sample of smokers from a middle-income country. Data are from the São Paulo Megacity Project (part of World Mental Health Surveys) collected between 2005 and 2007 (n = 5,037). The current analyses were restricted to the 1,388 participan...

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 v...

Dataset with variables used in this study. (XLS)

Steps involved in the multiple imputation of personality disorders diagnoses from IPDE screening questions. DS 1–10: datasets 1 to 10; PE 1–10: parameter estimates 1 to 10. (PDF)

Background Given the gender differences that permeate Tobacco Use Disorders (TUD), we aimed to identify phenotypes of TUD in female and male in a representative sample of smokers in a developing country. Methods Data came from lifetime weekly smokers ages 18 and older taking part in the São Paulo Megacity Mental Health Survey collected between 200...

Background: This study examines the response pattern of depressive symptoms in a nationwide student sample, through item analyses of a rating scale by both classical test theory (CTT) and item response theory (IRT). Methods: The 21-item Beck Depression Inventory-II (BDI-II) was administered to 12,711 college students. First, the psychometric pro...

We aimed to identify phenotypes of DSM–ICD nicotine dependence among a representative sample of lifetime weekly smokers in the largest metropolitan area in South America. Data came from 1,387 lifetime weekly smokers in the São Paulo Megacity Mental Health Survey. We used exploratory factor analysis (EFA) and latent class analysis (LCA) on ICD-11 ni...

Background: Anxiety disorders are a major cause of burden of disease. Treatment gaps have been described, but a worldwide evaluation is lacking. We estimated, among individuals with a 12-month DSM-IV (where DSM is Diagnostic Statistical Manual) anxiety disorder in 21 countries, the proportion who (i) perceived a need for treatment; (ii) received a...

Aims A substantial proportion of persons with mental disorders seek treatment from complementary and alternative medicine (CAM) professionals. However, data on how CAM contacts vary across countries, mental disorders and their severity, and health care settings is largely lacking. The aim was therefore to investigate the prevalence of contacts with...

Background and aims: Prior research has found bidirectional associations between psychotic experiences (PEs) and selected substance use disorders. We aimed to extend this research by examining the bidirectional association between PEs and various types of substance use (SU) and substance use disorders (SUDs), and the influence of antecedent mental...

Background The patterns of comorbidity among mental disorders have led researchers to model the underlying structure of psychopathology. While studies have suggested a structure including internalizing and externalizing disorders, less is known with regard to the cross-national stability of this model. Moreover, little data are available on the pla...

OBJECTIVE To identify the prevalence of 12-month self-reported pain and chronic pain in a general population and to describe their clinical profile to assess if chronic pain is associated with 12-month mental disorders. METHODS The data used comes from the São Paulo Megacity Mental Health Survey, a population-based study assessing adult (≥ 18 year...

Background Traumatic events are associated with increased risk of psychotic experiences, but it is unclear whether this association is explained by mental disorders prior to psychotic experience onset.AimsTo investigate the associations between traumatic events and subsequent psychotic experience onset after adjusting for post-traumatic stress diso...

Mental disorders are associated with employment status as significant predictors and as consequences of unemployment and early retirement. This study describes the estimates and associations of 12-month DSM-IV prevalence rates of mental disorders and use of health services with employment status by gender in the São Paulo Metropolitan Area, Brazil....

Substance use is a major cause of disability globally. This has been recognized in the recent United Nations Sustainable Development Goals (SDGs), in which treatment coverage for substance use disorders is identified as one of the indicators. There have been no estimates of this treatment coverage cross-nationally, making it difficult to know what...

Objective: While psychotic experiences (PEs) are known to be associated with a range of mental and general medical disorders, little is known about the association between PEs and measures of disability. We aimed to investigate this question using the World Mental Health surveys. Method: Lifetime occurrences of six types of PEs were assessed alo...

Mental disorders among college students in the World Health Organization World Mental Health Surveys – CORRIGENDUM - R. P. Auerbach, J. Alonso, W. G. Axinn, P. Cuijpers, D. D. Ebert, J. G. Green, I. Hwang, R. C. Kessler, H. Liu, P. Mortier, M. K. Nock, S. Pinder-Amaker, N. A. Sampson, S. Aguilar-Gaxiola, A. Al-Hamzawi, L. H. Andrade, C. Benjet, J....

Background We assessed comorbid associations of 12-month DSM-IV mood/any anxiety disorders with chronic physical conditions within the São Paulo (SP) Megacity Mental Health cross-sectional survey of 5,037 participants and explored whether strength of comorbid associations were modified when controlling for demographics. Methods Chi-square tests an...

Importance: Generalized anxiety disorder (GAD) is poorly understood compared with other anxiety disorders, and debates persist about the seriousness of this disorder. Few data exist on GAD outside a small number of affluent, industrialized nations. No population-based data exist on GAD as it is currently defined in DSM-5. Objective: To provide the...