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Characteristics of hospital-treated schizophrenia in São Paulo, Brazil

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Summary

This paper reports a study on the prevalence of hospital-treated schizophrenia in a large urban centre in Brazil. A sample of 124 individuals from a defined catchment area of São Paulo consecutively admitted to psychiatric hospitals due to acute episodes of non-affective psychoses were assessed by standardized instruments for mental state and social adjustment. The sample was predominantly white (72.6%), single (65.2%), Catholic (61.3%) and not born in that city (58.9%). Eighty-six subjects fulfilled DSM-III-R criteria for schizophrenia (69.3%), 15 were classified as schizophreniform psychosis (12.1%), and 7 as schizoaffective (5.6%). Almost twothirds showed Schneider's ‘first rank’ symptoms. Social adjustment before admission was poor or very poor in nearly half the sample. Mean age at onset was 3.2 years earlier in men than in women (P=0.007). No gender differences in mental state or social adjustment were observed. Individuals born outside São Paulo State had significantly more florid symptoms than those born in that state. These findings suggest that the features of schizophrenia in a large urban centre of Brazil are consistent with the patterns of schizophrenia described in Western developed countries.

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References

  • Almeida NF (1980) Urbanizacao e doenca mental. Rev Assoc Psiq Bahia 1: 61–77

    Google Scholar 

  • Almeida NF (1985) Cultura e psicopatologia. Revisao da literatura epidemiologica latino-americana. J Bras Psiq 34: 357–364

    Google Scholar 

  • Almeida NF (1987) Social epidemiology of mental disorders. Acta Psychiatr Scand 75: 1–10

    Google Scholar 

  • Almeida NF, Mari JJ, Coutinho ESF, Franca JF, Fernandes JG, Andreoli SB, Busnello E (1992) Estudo multicentrico de morbidade psiquiatrica em areas urbanas brasileiras (Brasilia, São Paulo, Porto Alegre). Rev ABP-APAL 14: 93–104

    Google Scholar 

  • Alves DSN, Seidl EMF, Schechtman A, Silva RC (1992) Elementos para uma analise da assistencia em saude mental no Brasil. J Bras Psiq 41: 423–426

    Google Scholar 

  • American Psychiatric Association (1987) Diagnostic and statistic manual of mental disorders, 3rd edn, revised (DSM-III-R). APA, Washington

    Google Scholar 

  • Araujo D (1955) Atividades da Secao de Cooperacao do SNDM: Dados estatisticos. Arq Serv Nac Doenca Mental 4: 247–251

    Google Scholar 

  • Bartko JJ (1991) Measurement and reliability: statistical thinking considerations. Schizophren Bull 17: 483–489

    Google Scholar 

  • Caetano R, Gentil V (1983) Glossario das definicoes dos sintomas incluidos na 9a. edicao do PSE mimeo, São Paulo

    Google Scholar 

  • Campbell PG, Taylor J, Pantelis C, et al (1990) Studies of schizophrenia in a large mental hospital proposed for closure, and in two halves of an inner London borough served by the hospital. In: Weller M (ed) International perspectives in schizophrenia: Biological, epidemiological and social findings. Libbey, London Paris, pp 185–202

    Google Scholar 

  • Carpenter WT Jr, Strauss JS (1974) Cross-cultural evaluation of Schneider's first-rank symptoms of schizophrenia: A report from the International Pilot Study of Schizophrenia. Am J Psychiatry 131: 682–687

    Google Scholar 

  • Chaves AC, Sarin LM, Mari JJ (1990) Escala de avaliacao de incapacitacao psiquiatrica (DAS). Escola Paulista de Medicina (mimeo). São Paulo

    Google Scholar 

  • De Jong A, Giel R, Slooff CJ, Wiersma D (1985) Social disability and outcome in schizophrenic patients. Br J Psychiatry 147: 631–636

    Google Scholar 

  • Dean AG, Dean JA, Burton AH, et al (1990) Epi Info, Version 5.01: A word processing, database and statistics program for epidemiology on microcomputers. USD, Georgia

  • Forattini OP (1991) Qualidade de vida e meio urbano. A cidade de São Paulo, Brasil. Rev Saude Publica 25: 75–86

    Google Scholar 

  • Gmur M (1991) The 12-year clinical course of schizophrenia. Soc Psychiatry Psychiatr Epidemiol 26: 202–211

    Google Scholar 

  • Hafner H, Maurer K, Loffler W, Riecher-Rossler A (1993) The influence of age and sex on the onset and early course of schizophrenia. Br J Psychiatry 162: 80–86

    Google Scholar 

  • Haines A (1993) Health care in Brazil. BMJ 306: 503–506

    Google Scholar 

  • Hambrecht M, Maurer K, Hafner H (1992) Gender differences in schizophrenia in three cultures. Results of the WHO Collaborative Study on Psychiatric Disability. Soc Psychiatry Psychiatr Epidemiol 27: 117–121

    Google Scholar 

  • Harvey R (1987) Clumsy giant. A survey of Brazil. Economist, special supplement 26 April

  • Iacoponi E (1989) The detection of emotional disorders by primary care physicians. A study in São Paulo. Brazil. PhD thesis, University of London

  • IBGE—Fundacao Instituto Brasileiro de Geografia e Estatistica (1992) Censo demografico 1991. IBGE, São Paulo

    Google Scholar 

  • Isele R, Angst J (1985) Social disability in schizophrenia: the controlled prospective Burgholzili study. I. Case-finding, research design, and characteristics of the sample. Eur Arch Psychiatry Neurol Sci 234: 341–347

    Google Scholar 

  • Jablensky A, Sartorius N, Ernberg G, Anker M, Korten A, Cooper JE, Day R, Bertelsen A (1992) Schizophrenia: manifestations, incidence and course in different cultures. A World Health Organization ten-country study. Psychol Med Monogr Suppl 20 [whole issue]

  • Kramer M (1980) The rising pandemic of mental disorders and associated chronic diseases and disabilities. In: Stromgren E, Dupont A, Nielsen JA (eds) Epidemiological research as basis for the organization of extra-mural psychiatry. Acta Psychiatr Scand Suppl 62: 382–397

  • Levav I, Lima BR, Lennon MS, Kramer M, Gonzalez R (1989) Salud Mental para todos en America Latina y el Caribe. Bases epidemiologicas para la accion. Bol Of Sanit Panam 107: 196–219

    Google Scholar 

  • Mari JJ (1983) Psychiatric care in Brazil. In: Brown S (ed) Psychiatry in developing countries. Gaskell, London, pp 7–9

    Google Scholar 

  • Mari JJ, Andreoli SB (1990) Estudo multicentrico de transtornos mentais: relatorio preliminar—setor São Paulo. Escola Paulista de Medicina, São Paulo

    Google Scholar 

  • McCreadie RG (1982) The Nithsdale Schizophrenia Survey. I. Psychiatric and social handicaps. Br J Psychiatry 140: 582–586

    Google Scholar 

  • McGlashan TH (1984) The Chestnut Lodge Follow-up Study. I. Follow-up methodology and study sample. Arch Gen Psychiatry 41: 573–585

    Google Scholar 

  • Mignolli G, Fanccincani C, Platt S (1991) Psychopathology and social performance in a cohort of patients with schizophrenic psychoses. A seven-year follow-up study. Psychol Med Monogr Suppl 19: 17–54

    Google Scholar 

  • Ndetei DM (1988) Psychiatric phenomenology across countries: constitutional, cultural, or environmental? Acta Psychiatr Scand Suppl 344: 33–44

    Google Scholar 

  • Roemer MI (1986) The changeability of health care systems—Latin American experience. Med Care 24: 24–29

    Google Scholar 

  • Santana VS, Almeida N, Fo., Mari JJ (1988) Revisao dos estudos epidemiologicos em saude mental no Brasil, part 1. J Bras Psiq 37: 227–231

    Google Scholar 

  • Shirakawa I (1989) O ajustamento social na esquizofrenia. PhD thesis, Escola Paulista de Medicina, São Paulo

    Google Scholar 

  • Sougey EB, Carvalho TFR, Bandin JM, Albuquerque JOM (1987) Frequencia de sintomas de primeira ordem de Kurt Schneider numa populacao de esquizofrenicos do Nordeste brasileiro. Rev ABP-APAL 9: 151–156

    Google Scholar 

  • Souza CM (1983) Epidemiologia em medicina clinica. Educ Med Salud 17: 83–87

    Google Scholar 

  • Tsuang MT, Fleming JA (1987) Long-term outcome of schizophrenia and other psychoses. In: Hafner H, Gattaz WF, Janzarik W (eds) Search for the causes of schizophrenia. Springer, Berlin Heidelberg New York, pp 88–97

    Google Scholar 

  • VEJA (1993) Uma piramide feita de desigualdade. VEJA 1281: 78–81

    Google Scholar 

  • Westermeyer JF, Harrow M (1988) Course and outcome in schizophrenia. In: Tsuang MT, Simpson JC (eds) Handbook of schizophrenia, vol 3: Nosology, epidemiology and genetics. Elsevier Science, Amsterdam, pp 205–244

    Google Scholar 

  • Wing JK, Cooper JE, Sartorius N (1974) Measurement and classification of psychiatric symptoms: an instruction manual for the PSE and Catego Program. Cambridge University Press, London

    Google Scholar 

  • World Health Organization (1973) The international pilot study of schizophrenia, vol 1. World Health Organization, Geneva

    Google Scholar 

  • World Health Organization (1975) International classification of diseases, 9th version. WHO, Geneva

    Google Scholar 

  • World Health Organization (1988) Psychiatric Disability Assessment Schedule (WHO/DAS). WHO, Geneva

    Google Scholar 

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Menezes, P.R., Mann, A.H. Characteristics of hospital-treated schizophrenia in São Paulo, Brazil. Soc Psychiatry Psychiatr Epidemiol 28, 267–274 (1993). https://doi.org/10.1007/BF00795906

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