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International Journal for Equity in Health
Published in: International Journal for Equity in Health 1/2016

Open Access 01-12-2016 | Research

Inequities in access to depression treatment: results of the Brazilian National Health Survey – PNS

Authors: Claudia Souza Lopes, Natália Hellwig, Gulnar de Azevedo e Silva, Paulo Rossi Menezes

Published in: International Journal for Equity in Health | Issue 1/2016

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Abstract

Background

Despite depression being one of the most prevalent mental disorders in the world, access to treatment is still insufficient, especially in low- and middle-income countries. The aim of this study is to investigate differences in access to treatment for depression according to socio-demographic characteristics, geographical area and multi-morbidity in a nationally representative sample of individuals with depression.

Methods

This study analyses data from the National Health Survey (Pesquisa Nacional de Saúde – PNS), a Brazilian household-based nationwide survey, which comprises 60,202 adults (aged 18 years or older). Depression was evaluated through the Patient Health Questionnaire-9 (PHQ-9). Prevalence Ratios and corresponding 95 % confidence intervals (95%CI) were calculated using Poisson regression.

Results

The general prevalence of depression was 7.9 % (95 % CI 7.5 to 8.3). Among those with depression, 78.8 % did not receive any treatment, and 14.1 % received only pharmacotherapy. Multivariable analyses showed that being female, white, aged between 30 and 69 years, living in regions other than the North, having higher education and having multi-morbidities were independently associated with higher likelihood of access to any treatment.

Conclusions

Most Brazilians with clinically relevant depressive symptoms are not receiving any treatment. Access to care is unequal, with the poor and those living in low resource areas having higher difficulties to access mental health care. Understanding these disparities is important for the provision of effective interventions aimed at reducing the prevalence of depression and inequities in access to mental health care.
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Metadata
Title
Inequities in access to depression treatment: results of the Brazilian National Health Survey – PNS
Authors
Claudia Souza Lopes
Natália Hellwig
Gulnar de Azevedo e Silva
Paulo Rossi Menezes
Publication date
01-12-2016
Publisher
BioMed Central
Published in
International Journal for Equity in Health / Issue 1/2016
Electronic ISSN: 1475-9276
DOI
https://doi.org/10.1186/s12939-016-0446-1

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