The Child Mental Health Treatment Gap in an Urban Low-Income Setting: Multisectoral Service Use and Correlates.

Objective: To efficiently target capacity-building efforts for child mental health services in low- and middle-income countries (LMICs), it is critical to define how care is structured across sectors and individual-level factors.

Methods: In a community-based sample of 1,408 children and adolescents (ages 6-15 years) from Itaboraí, Brazil, the authors assessed need and service use across four care systems (mental health specialty, health, welfare, and informal). Individual-level factors included child gender and age, maternal perception of child mental health need, paternal absence, maternal education, and maternal anxiety and depression.

Early vulnerabilities for psychiatric disorders in elementary schoolchildren from four Brazilian regions.

Purpose: The purpose of the study is to identify early vulnerabilities for psychiatric disorders among Brazilian elementary school children, controlling for familial and community adversities.

Methods: This is a cross-sectional study examining the association between child psychiatric disorders and potential early vulnerabilities (disability, low intellectual quotient, and negative dimensions of the temperament trait self-directedness (low resourcefulness, low purposefulness, low enlightened second nature), controlling for the potential confounders: familial and community adversities.

Sample: Four probabilistic samples of second-to-sixth grade students from public schools in four towns from different Brazilian regions (N = 1620).

The mental health care gap among children and adolescents: data from an epidemiological survey from four Brazilian regions.

Introduction: Worldwide, a minority of disordered children/adolescents receives mental health assistance. In order to improve service access, it is important to investigate factors that influence the process leading to receiving care. Data on frequency and barriers for mental health service use (MHSU) among Brazilian children/adolescents are extremely scarce and are needed to guide public policy.

How to improve the mental health care of children and adolescents in Brazil: actions needed in the public sector.

Introduction: Child/adolescent mental health (CAMH) problems are associated with high burden and high costs across the patient's lifetime. Addressing mental health needs early on can be cost effective and improve the future quality of life.

Objective/methods: Analyzing most relevant papers databases and policies, this paper discusses how to best address current gaps in CAMH services and presents strategies for improving access to quality care using existing resources.

Exposure to violence in incarcerated youth from the city of São Paulo.

Objective: This study aimed to determine the extent of exposure to community violence among delinquent Brazilian youth in the 12-month period prior to their incarceration and to identify factors associated with this exposure.

Method: With an oversampling of girls, a cross-section of youth under 18 years of age from juvenile detention units in the city of São Paulo, Brazil completed a structured interview. Key items related to exposure to violence (witnessed and experienced) were drawn from the Social and Health Assessment questionnaire to cover the 12-month period prior to incarceration.

Measuring child exposure to violence and mental health reactions in epidemiological studies: challenges and current issues.

This paper examines challenges and current issues involved in measuring exposure to different types of violence which are associated mental health problems in children and adolescents. Standardized measures suitable for epidemiological studies, selected based on their relevance in the current literature, are briefly described and commented. The assessment of child's exposure to violence may focus on a specific event (e.

Gender differences in aggressiveness in children and adolescents at risk for schizophrenia.

Objective: This study aimed to investigate whether differences in aggression-related behavioral problems occur between boys and girls at high risk for schizophrenia living in the city of São Paulo, Brazil.

Method: Using the Child Behavior Checklist, we compared the prevalence of behavioral problems between genders for the offspring (6-18 years) of mothers with diagnosis of schizophrenia and a comparison group of children born to women with no severe mental disorders recruited at the gynecology outpatient clinic of the same hospital. The Structured Clinical Interview for DSM-IV Axis I Disorders, Patient Edition was applied for the evaluation of diagnostic status of mothers.

[Mental health and violence among sixth grade students from a city in the state of São Paulo].

Objective: To analyze risk and protective factors for mental health problems among adolescents.

Methods: Cross-sectional study with a random sample (N=327; attrition rate=6.9%) of sixth grade students from all public and private schools in the city of Barretos, Southeastern Brazil, conducted in 2004.

Prevalence of mental health problems in children and adolescents from the outskirts of Sao Paulo City: treatment needs and service capacity evaluation.

Objective: To estimate the prevalence of mental health problems in children and adolescents, with or without considering global impairment, within a low-income urban community; to estimate the public service delivery capacity in terms of mental healthcare; and to determine the relationship between delivery capacity and treatment demand.

Method: Cross-sectional study. Probabilistic sample of clusters including all eligible households (low-income community - Embu, Southeastern Brazil).

Severe physical punishment and mental health problems in an economically disadvantaged population of children and adolescents.

Objective: To estimate the prevalence of severe physical punishment of children/adolescents in a low-income community, and to examine child mental health problems as a potential correlate.

Method: This study is a Brazilian cross-sectional pilot study of the World Studies of Abuse in Family Environments. A probabilistic sample of clusters including all eligible households (women aged 15-49 years, son/daughter < 18 years) was evaluated.

[Lifetime prevalence and help seeking behavior in physical marital violence].

Objective: To estimate the lifetime prevalence of physical marital violence among women from a low-income urban community and to investigate help-seeking behavior among victims.

Methods: This is the Brazilian pilot cross-sectional study for an international multicenter study conducted in 1999, and is based on a probabilistic cluster sample from the municipality of Embu, São Paulo State. We considered as eligible women aged 15 to 49 years, living with children under age 18 years, who had lived with a husband or partner in lifetime.

[Parental beliefs and child-rearing attitudes and mental health problems among schoolchildren].

Objective: To verify the prevalence and identify the risk factors related to mental health problems among schoolchildren and its possible association with the beliefs and educational attitudes of parents/caretakers.

Methods: Cross-sectional study with a stratified probabilistic sample (n=454) of first to third-graders from public and private schools in Southeastern Brazil. Standardized instruments were administered to parents/caretakers by trained interviewers, including screening questionnaires for mental health problems among children and parents/caretakers; a questionnaire on beliefs and attitudes; and a questionnaire for socio-economic status.

Physical intimate partner violence in Chile, Egypt, India and the Philippines.

Background: Violence against women is recognized by globally as a serious health and social problem that impedes development.

Objectives: To determine the magnitude of physical intimate partner violence against women in six selected communities from Chile, Egypt, India and the Philippines.

Design: Population-based household surveys.

Intimate partner violence and the role of socioeconomic indicators in WorldSAFE communities in Chile, Egypt, India and the Philippines.

Background: The literature documenting the influence of socioeconomic status (SES) on health and injury does not provide a clear consensus on how to account for socioeconomic indicators in population and health outcome studies across countries. The World Studies of Abuse in the Family Environment (WorldSAFE) consortium conducted a series of population-based, multi-stage probability sampling cross-sectional surveys in selected communities in five countries from 1997 to 2003 that allows for the examination of the relationship of SES with current physical and psychological intimate partner violence (IPV).

Methods: Women aged 15-49 years (n = 3975) from six urban low- and middle-income communities participating the the WorldSAFE consortium were interviewed.

The CBCL and the identification of children with autism and related conditions in Brazil: pilot findings.

Unlabelled: The Child Behavior Checklist (CBCL)/4-18 is one of the few standardized means available for assessing child mental health in Brazil. In this context, the identification of a specific pathology such as autism by the CBCL/4-18 is relevant. To examine the validity of the CBCL/4-18 for the identification of autism, the CBCL/4-18 was applied to 101 children: 36 with autism and related conditions, 31 with other psychiatric disorders, and 34 schoolchildren.

[Factors associated to hospitalization of children under five years of age, São Paulo, Brazil].

Objective: In developing countries acute respiratory infection (ARI) is the leading cause of hospitalization among children under five years of age. Their underprivileged life conditions and restricted access to health care services are important determining factors. The objective of the study was to assess hospital morbidity and to identify factors associated to hospitalization of children under five years of age.