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Este estudo teve o objetivo de examinar a relação entre gênero e utilização de substâncias psicoativas entre adolescentes (consumo de bebidas alcoólicas, fumo e uso de drogas ilícitas). Em 2002 foi realizado um estudo transversal na área urbana de Pelotas, extremo-sul do Brasil. Foi empregada amostragem em múltiplos estágios para se obter uma amostra de adolescentes entre 15 e 18 anos de idade. As entrevistas foram realizadas com questionário auto-aplicado. Tabagismo foi mais prevalente entre as meninas, enquanto o consumo de bebida alcoólica no mês anterior às entrevistas foi maior entre os meninos. Por outro lado, a proporção de adolescentes que relataram uso de drogas ilícitas no mês que antecedeu as entrevistas não esteve relacionada ao gênero. O maior consumo de tabaco entre meninas que entre meninos pode indicar risco de expansão do consumo desta substância por mulheres de outras faixas etárias em gerações futuras, o que justifica preocupação e esforços específicos.

CONTEXT AND OBJECTIVE: Diabetes is a public health problem and good glycemic control is able to prevent or contain its complications. Self-efficacy is a key factor in successfully achieving behavior goals. The aim of this study was to analyze the psychometric properties of the insulin management diabetes self-efficacy scale (IMDSES) on type 1 diabetes patients from southern Brazil. DESIGN AND SETTING: Validation study in two cities in southern Brazil. METHODS: The psychometric properties of IMDSES were evaluated in a population of type 1 diabetes patients (n = 213), from September to December 2004, who were attended within the Brazilian public healthcare system. Principal component analysis was conducted to develop the subscales. Cronbach’s alpha was used as the reliability coefficient. RESULTS: The analysis of psychometric properties resulted in an IMDSES consisting of 20 items and three subscales: diet (alpha: 0.83), insulin (alpha: 0.92) and general management (alpha: 0.78) and accounted for 53% of the variance. Criteria validity was investigated through two parameters: glycohemoglobin, which showed significant association with self-efficacy on the insulin subscale (p = 0.04), and the variable "adherence", which was significantly associated with self-efficacy on two subscales (p < 0.05). CONCLUSIONS: This study shows that the IMDSES is valid and reliable, and can be used to measure results from diabetes educational programs and to measure self-efficacy relating to diabetes management, for possible interventions. CONTEXTO E OBJETIVOS: Diabetes é um problema de saúde pública e sabe-se que o controle glicêmico adequado pode prevenir ou retardar as complicações e, sendo a auto-eficácia fator chave para atingir as metas comportamentais com sucesso, o objetivo deste estudo foi analisar as propriedades psicométricas da escala de auto-eficácia no manejo da insulina (IMDSES) em uma população de diabéticos tipo 1 do sul do Brasil. TIPO DE ESTUDO E LOCAL: Estudo de validação, realizado em uma população de diabéticos tipo 1 de duas cidades do sul do Brasil. METODOS: As propriedades psicométricas da IMDSES foram avaliadas em 213 diabéticos tipo 1, de setembro a dezembro de 2004, que eram atendidos pelo sistema único de saúde (SUS). A análise dos componentes principais para o desenvolvimento de subescalas e o coeficiente alfa de Cronbach foi utilizado na avaliação de confiabilidade da escala. RESULTADOS: Após analise das propriedades psicométricas, a escala ficou com 20 itens e três sub-escalas, dieta (alpha = 0,83), insulina (alpha = 0,92) e cuidados gerais (alpha = 0,78) que correspondiam a 53% da variância. Validade de critério foi investigada através de dois parâmetros: glicohemoglobina, através da qual foi possível verificar associação significativa com auto-eficácia na subescala insulina (p = 0,04) e com a variável "adesão", que foi significativamente associada com auto-eficácia em duas sub-escalas (p < 0,05). CONCLUSÃO: Este estudo verificou que IMDSES é válida e confiável e pode ser utilizada para avaliar resultados de programas educacionais em diabetes e auto-eficácia no manejo do diabetes para possíveis intervenções.

Aim: To investigate the relationship between maternal depression and childhood caries in a cohort of adolescent mothers. Methods: This cross-sectional study nested in a cohort evaluated a sample of 538 mother/child dyads. When the children were 24-36 months of age, data regarding oral health from children and mothers were collected by clinical dental examination. A mother's major depressive disorder was assessed by using the Mini International Neuropsychiatric Interview (MINI [Plus]), at the current moment. Independent variables were obtained by using questionnaires. The outcome on dental caries experience was dichotomized by using 2 cut points: dmfs ≥1 and dmfs ≥3. Poisson regression analysis, using a hierarchical approach, was applied to assess the association between major depressive disorder in mothers with and those without caries experience and the outcome. Results: The prevalence of dental caries in children was 15.1% (n = 82). The mean dmfs index was 1.12 (SD = 3.72). The prevalence of major depressive disorder was 32.6% (n = 168). An interaction between caries status and depressive disorder was found, and after adjusted analysis, children from mothers with major depressive disorder with negative caries experience presented a higher caries prevalence (prevalence ratio 4.00, 95% confidence interval 1.29-12.41). Conclusion: Our findings suggest that maternal psychiatric disorders could have a negative impact on children's oral health.

Objective: To assess the relationship between crack cocaine use and dimensions of quality of life and social functioning in young adults. Methods: This was a cross-sectional, population-based study involving 1,560 participants in Pelotas, Brazil. Crack cocaine use and abuse were investigated using the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) inventory. Outcomes of interest were quality of life, religiosity, and social functioning in terms of education, occupational status, family structure, and medical treatment history. Results: Lifetime crack cocaine use was associated with poor quality of life, worse functioning, impaired academic performance, and lower religious involvement. A greater maternal presence and higher paternal absence were more also more pronounced in crack cocaine users, who were also more likely to seek psychological and psychiatric treatment than the general population. Conclusion: Quality of life was severely impacted by crack cocaine use, especially in terms of general and physical health. Social functioning also differed between the general population and crack users, who had lower educational attainment and religious involvement. Maternal presence, paternal absence, and mental health-seeking behaviors were also more frequent among crack cocaine users, although these individuals reported lower rates of treatment satisfaction. Crack cocaine users also had significant social impairment, so that interventions involving family management and a greater focus on general health, quality of life, and functioning may make crucial contributions to the recovery of this group.

Objective: To evaluate the association between social anxiety disorder (SAD) and perceived maternal bonding styles among young women during pregnancy and 30 months after childbirth. Methods: A cohort of young women from the city of Pelotas, Brazil was followed up from pregnancy to 30 months postpartum. The Mini Neuropsychiatric Interview Plus was used to assess SAD and the Parental Bonding Instrument was administered to measure maternal bonding styles. Poisson regression with robust variance was used for multivariable analysis. Results: After adjusting for potential confounding factors, SAD prevalence was 6.39 times higher among young women who perceived their mothers as neglectful (prevalence ratio [PR] 6.39; 95% confidence interval [95%CI] 1.2-32.0), and 5.57 times higher in women who perceived their mothers as affectionless controlling (PR = 5.57; 95%CI 1.5-19.7) when compared with those who received optimal care. Conclusion: Maternal bonding style may have an influence on the development of SAD. Therefore, support and early prevention strategies should be offered to the family.

Background Poor nutrition and growth during fetal life and childhood might be associated with depression in adulthood; however, studies evaluating these associations present controversial results, especially when comparing studies using different proxies for fetal growth. We evaluated the association of fetal and childhood growth/nutrition with depression, in adulthood, using different approaches and measurement methods. Method In 1982, hospital births (n = 5914) in Pelotas, southern Brazil, were examined and have been prospectively followed. At 30 years, the presence of major depression and depressive symptoms severity was evaluated using the Mini International Neuropsychiatric Interview (MINI) and Beck Depression Inventory (BDI-II). The present study assessed their association with birth weight, premature birth, small for gestational age (SGA), stunting and conditional growth during childhood. Results At 30 years, 3576 individuals were evaluated and 7.9% had major depression. Low birth weight (PR = 1.01 95%CI [0.64–1.60]), having been born SGA (PR = 0.87 95%CI [0.64–1.19]) and premature birth (PR = 1.22 95%CI [0.72–2.07]) were not associated with major depression in multivariable models. However, those born SGA who were also stunted in childhood had a higher prevalence of major depression (PR = 1.87 95%CI [1.06–3.29]) and greater odds of scoring a higher level of depression in the BDI-II (OR = 2.18 95%CI [1.34–3.53]). Conclusion In this Brazilian cohort of young adults, those born SGA who were also stunted during childhood had a higher risk of depression in adulthood. Our results show that the effect of growth impairment on depression is cumulative.

OBJETIVO: Avaliar a associação entre depressão e dispepsia funcional. PACIENTES E MÉTODOS: Estudo transversal onde foram avaliados 348 pacientes com diagnóstico de dispepsia no Ambulatório de Gastroenterologia do Hospital Universitário de Pelotas, RS, cidade de médio porte do sul do Brasil, durante o período de 1 ano (de março de 2001 a março de 2002). Após o diagnóstico de dispepsia avaliou-se a presença de depressão, tanto em pacientes com dispepsia funcional, quanto naqueles com dispepsia orgânica. Utilizou-se a análise univariada para descrição das freqüências das variáveis de interesse e da análise bivariada, com o teste qui-quadrado, para comparação entre proporções das variáveis categóricas. A técnica da regressão logística foi utilizada para estabelecer a chance dos pacientes com depressão apresentarem dispepsia funcional e para controlar o efeito das variáveis intervenientes sobre a variável de desfecho RESULTADOS: Evidenciaram maior prevalência de deprimidos entre os pacientes com dispepsia funcional (30,4%) em relação àqueles com dispepsia orgânica (11,2%). As mulheres apresentaram maior chance de dispepsia funcional (OR: 1,74, IC 95%, 1,05-2,89) e, em relação à idade, os intervalos entre 31 e 50 anos (OR: 0,28 IC 95%, 0,13-0,54) e de 51 a 60 anos (OR: 0,41, IC 95%, 0,17-0,96) mostraram efeito protetor, ou seja, indivíduos nessas faixas etárias têm menor risco de apresentar dispepsia funcional. Após a análise multivariada, pacientes deprimidos apresentaram chance três vezes maior de co-morbidade com dispepsia funcional do que pacientes não-deprimidos (OR 3,13; IC 95%; 1,71-5,74). AIM: To assess the association between depression and functional dyspepsia. PATIENTS AND METHODS: Three hundred and forty eight dyspeptic patients were included in a cross-sectional study in the gastroenterology outpatient clinic of a University Hospital in southern Brazil (Pelotas, RS) within a 1-year period (from March, 2001 to March, 2002). The assessment of depression occurred after the diagnosis of dyspepsia. The presence (or not) of depression was verified in both functional and organic dyspeptic patients. In a second moment, the results were compared, an univariate analysis was used to describe the frequencies of the interest variables and a chi-square for the comparison between proportions of the categorical variables. The logistic regression technique was used to establish the odd of functional dyspeptic patients to present depression and to control the effect of other variables in the outcome variable RESULTS: Showed greater prevalence of depression among functional dyspepsia patients (30,4%), when compared to organic dyspepsia patients (11,2%). Women showed greater risk to present functional dyspepsia (OR: 1,74, IC 95%, 1,05-2,89) and in terms of age, the group with ages between 31 to 50 years (OR: 0,28 IC 95%, 0,13-0,54) and 51 to 60 years (OR: 0,41, IC 95%, 0,17-0,96) showed protection effect (subjects within this age groups have minor risk to present functional dyspepsia). After the multivariate analysis depressed patients showed three times greater comorbidity with functional dyspepsia when compared to non-depressed patients (OR 3, 13; IC 95%; 1, 71-5, 74). DISCUSSION: The adjustment for the gender, age and marital status variables confirmed the association between functional dyspepsia and depression. Results point the need to assess the presence of depression in functional dyspepsia patients and to establish specific treatment strategies for these patients.

OBJETIVO: Determinar a prevalência e os fatores associados ao sobrepeso e à obesidade em adolescentes de zona urbana. MÉTODOS: Estudo transversal de base populacional, realizado no município de Pelotas, Rio Grande do Sul, de 2001 a 2002. Adolescentes entre 15 e 18 anos de idade foram medidos, pesados e responderam a questionário auto-aplicável. De 90 setores sorteados, foram visitados 86 domicílios em cada setor, totalizando 960 adolescentes. A prevalência de sobrepeso e obesidade foi definida a partir do índice de massa corporal, mediante a utilização dos pontos de corte, ajustados à idade e ao sexo. Realizou-se análise multivariada com regressão de Poisson, considerando um modelo hierárquico das variáveis associadas ao sobrepeso e à obesidade. RESULTADOS: A prevalência de sobrepeso e de obesidade foi 20,9% e 5%, respectivamente. A relação entre a obesidade e idade e escolaridade do adolescente foi inversa. Verificou-se associação de sobrepeso e obesidade com o relato de obesidade dos pais (p=0,03) e maturação sexual do adolescente (p=0,01). Os hábitos de fazer dieta e omitir refeições foram associados à obesidade, com riscos de 3,98 (IC 95%: 1,83-8,67) e 2,54 (IC 95%: 1,22-5,29), respectivamente. CONCLUSÕES: A prevalência de sobrepeso e obesidade na região são preocupantes a despeito do comportamento dos adolescentes para prevenir a obesidade. É necessária a implantação de campanhas mais eficazes, direcionadas a orientar melhor os adolescentes.

OBJETIVO: Avaliar a prevalência e os fatores associados à depressão pós-parto. MÉTODOS: O estudo foi realizado na cidade de Pelotas, entre outubro e novembro de 2000. As mães (n=410) foram entrevistadas no hospital, utilizando dois questionários sobre informações obstétricas e psicossociais. Posteriormente, as puérperas foram visitadas em casa, entre 30 a 45 dias depois do parto, quando foi aplicada a Escala de Hamilton com o objetivo de medir e caracterizar a presença de sintomas depressivos. O teste do qui-quadrado foi utilizado na comparação entre proporções e a regressão logística não condicional, na análise multivariada. Os dados foram analisados hierarquicamente: no primeiro nível as variáveis socioeconômicas, no segundo, as variáveis demográficas, no terceiro, estavam as variáveis obstétricas e no último nível, as variáveis psicossociais. RESULTADOS: A prevalência de depressão pós-parto encontrada foi de 19,1%. As variáveis renda familiar (OR=5,24; IC 95%: 2,00-13,69), preferência pelo sexo da criança (meninos: OR=3,49; IC 95%: 1,76-6,93) e pensar em interromper a gestação (OR=2,52; IC 95%: 1,33-4,76), apresentaram associação com a ocorrência de depressão. CONCLUSÕES: Os achados sugerem que baixas condições socioeconômicas de vida da puérpera e a não aceitação da gravidez são elementos-chave no desenvolvimento da depressão pós-parto.OBJECTIVE: To assess the prevalence of postpartum depression and associated factors. METHODS: The study was carried out in Pelotas, a city in the Southern region of Brazil, between October and November 2000. Mothers (n=410) were interviewed in the hospital using two questionnaires on obstetric and psychosocial data. Later, these mothers were visited at home, within 30 to 45 days after delivery. Occurrence of postpartum depressive symptoms was assessed by the Hamilton Scale for Depression. Chi-square test was used for comparison between proportions and non conditional logistic regression was utilized in the multivariate analysis. Data analysis was conducted hierarchically: economic variables in the first level, sociodemographic in the second level, the obstetrics variables in the third level and, in the fourth level, the psychosocial variables. RESULTS: The prevalence of postpartum depression observed in this sample was 19.1%. Family income (OR=5.24; CI 95%: 2.00-13.69), preference as to the child's gender (boys: OR=3.49; CI 95%: 1.76-6.93) and thinking about interrupting the pregnancy (OR=2.52; CI 95%: 1.33-4.76), were variables associated with postpartum depression. CONCLUSIONS: These results indicate that low economic status of the puerperal woman and nonacceptance of pregnancy are key elements in the development of postpartum depression.

CONTEXTO: A depressão pós-parto (DPP) é uma condição freqüente cujo manejo clínico é complexo. OBJETIVO: Neste artigo, delineamos questões relacionadas a eficácia, segurança e tolerabilidade relevantes ao tratamento da DPP com antidepressivos. MÉTODOS: Revisão da literatura nas seguintes bases de dados: Medline, PsychINFO, Biological Abstracts, Lilacs, Cochrane Controlled Trials Register e CINAHL. RESULTADOS: Diretrizes atuais de tratamento da depressão se aplicam a mulheres com DPP que não estejam amamentando. Níveis significativos de antidepressivo são encontrados em maior proporção de crianças expostas a fluoxetina e citalopram. É possível que lactentes expostos sofram efeitos colaterais e ganhem menos peso que os não-expostos. CONCLUSÕES: Até que o impacto do uso de antidepressivos sobre o desenvolvimento de lactentes seja esclarecido, uma possibilidade clínica seria prescrever antidepressivos que não fossem geralmente detectáveis no plasma dos lactentes, como sertralina e paroxetina.CONTEXT: Postpartum depression (PPD) is a frequent complication of childbirth, with complexities in its clinical management. OBJECTIVE: In this review article, we propose clinical questions which are relevant to the pharmacological treatment of PPD. METHOD: Searches were performed in MEDLINE, PsychInfo, CINAHL, Biological Abstracts, Lilacs and in the Cochrane Central Register of Controlled Trials. RESULTS: Current treatment guidelines for the treatment of depression apply to women with PPD which are not breastfeeding. Significant antidepressant levels are more often detected in children exposed to fluoxetine or citalopram. In those who are exposed, untoward effects and reduced growth are possible. CONCLUSIONS: Until the impact of antidepressant exposure through breastfeeding is better understood, a possible clinical approach would be to prescribe antidepressants generally not detected in the infants' plasma, such as sertraline or paroxetine.

Objetivo: Avaliar a prevalência e os fatores associados à depressão pós-parto. Métodos: O estudo foi realizado na cidade de Pelotas, entre outubro e novembro de 2000. As mães (n=410) foram entrevistadas no hospital, utilizando dois questionários sobre informações obstétricas e psicossociais. Posteriormente, as puérperas foram visitadas em casa, entre 30 a 45 dias depois do parto, quando foi aplicada a Escala de Hamilton com o objetivo de medir e caracterizar a presença de sintomas depressivos. O teste do qui-quadrado foi utilizado na comparação entre proporções e a regressão logística não condicional, na análise multivariada. Os dados foram analisados hierarquicamente: no primeiro nível as variáveis socioeconômicas, no segundo, as variáveis demográficas, no terceiro, estavam as variáveis obstétricas e no último nível, as variáveis psicossociais. Resultados: A prevalência de depressão pós-parto encontrada foi de 19,1%. As variáveis renda familiar (OR=5,24; IC 95%: 2,00-13,69), preferência pelo sexo da criança (meninos: OR=3,49; IC 95%: 1,76-6,93) e pensar em interromper a gestação (OR=2,52; IC 95%: 1,33-4,76), apresentaram associação com a ocorrência de depressão. Conclusões: Os achados sugerem que baixas condições socioeconômicas de vida da puérpera e a não aceitação da gravidez são elementos-chave no desenvolvimento da depressão pós-parto. Objective: To assess the prevalence of postpartum depression and associated factors. Methods: The study was carried out in Pelotas, a city in the Southern region of Brazil, between October and November 2000. Mothers (n=410) were interviewed in the hospital using two questionnaires on obstetric and psychosocial data. Later, these mothers were visited at home, within 30 to 45 days after delivery. Occurrence of postpartum depressive symptoms was assessed by the Hamilton Scale for Depression. Chisquare test was used for comparison between proportions and non conditional logistic regression was utilized in the multivariate analysis. Data analysis was placonducted hierarchically: economic variables in the first level, sociodemographic in the second level, the obstetrics variables in the third level and, in the fourth level, the psychosocial variables. Results: The prevalence of postpartum depression observed in this sample was 19.1%. Family income (OR=5.24; CI 95%: 2.00-13.69), preference as to the child’s gender (boys: OR=3.49; CI 95%: 1.76-6.93) and thinking about interrupting the pregnancy (OR=2.52; CI 95%: 1.33-4.76), were variables associated with postpartum depression. Conclusions: These results indicate that low economic status of the puerperal woman and nonacceptance of pregnancy are key elements in the development of postpartum depression.

OBJETIVO: Determinar a prevalência e fatores associados ao sedentarismo em adolescentes residentes em uma área urbana. MÉTODOS: Realizou-se estudo transversal em uma amostra representativa de 960 adolescentes com idades entre 15 e 18 anos, em 2002, em Pelotas, Estado do Rio Grande do Sul. Os dados foram coletados por meio de um questionário anônimo e auto-aplicado. Foi definindo como sedentário o adolescente que participava de atividades físicas por um tempo menor do que 20 minutos diários e uma freqüência menor do que três vezes por semana. Variáveis sociodemográficas e comportamentais foram avaliadas. Para as comparações entre proporções, utilizou-se o teste do qui-quadrado, e para a análise multivariada, a regressão de Poisson com ajuste robusto para as variâncias. Foi feito controle para efeito de delineamento. RESULTADOS: Foram entrevistados 960 adolescentes, dos quais 39% foram considerados sedentários. As meninas foram mais sedentárias do que os meninos, 2,45 (IC 95% 2,06-2,92). Os adolescentes das classes sociais mais baixas foram mais sedentários, 1,35 (IC 95% 1,06-1,72). Escolaridade inferior a quatro anos de estudo do adolescente 1,30 (IC 95% 1,01-1,68) e da mãe 1,75 (IC 95% 1,31-2,23) apresentaram maior risco para o sedentarismo. Após controle para possíveis fatores de confusão, mostrou-se também positiva a associação entre o sedentarismo e a presença de transtornos psiquiátricos menores e relação inversa, fator de proteção para os sexualmente ativos 0,84 (IC 95% 0,71-0,99). CONCLUSÕES: Ser do sexo feminino, pertencer à classe social baixa, ter uma baixa escolaridade e ser filho de mãe com baixa escolaridade são fatores associados ao sedentarismo. OBJECTIVE: To evaluate the prevalence and determinants of sedentarism among adolescents living in Pelotas, State of Rio Grande do Sul, Brazil. METHODS: A cross-sectional study was carried out in Pelotas, in 2002. An anonymous, self-administered questionnaire was answered by a representative sample of 960 adolescents with ages ranging from 15 to 18 years old. Those who reported that their participation in some kind of physical activity amounted to less than 20 minutes a day with a frequency of less than 3 times a week were considered to have a sedentary lifestyle. Sociodemographic and behavioral variables were evaluated. The chi-squared test was used for comparisons between proportions. The Poisson regression was used for multivariate analysis with robust adjustment for variances. Corrections were made for study design effects. RESULTS: Interviews were held with 960 adolescents. Of these, 39% were classified as having a sedentary lifestyle. The prevalence of sedentarism was higher among girls than among boys (prevalence ratio of 2.45; 95% CI 2.06-2.95). The adolescents from lower social levels had the highest percentage of sedentarism (prevalence ratio of 1.35; 95% CI 1.06-1.72). There was an inverse relationship between the adolescent's and the mother's schooling and sedentarism. After adjusting for confounding factors, there was also a positive association between sedentarism and minor psychiatric disturbances, and in relation to sexual activity. CONCLUSIONS: Higher prevalences of sedentarism are associated with girls, low social class, low levels of schooling and being the child of a mother with a low level of schooling.

The belief that good analysts do not ask, and do not answer, questions is a still-living strange recommendation, transmitted throughout psychoanalytic generations. The authors have extensively reviewed electronic databases and technical texts. They found that interrogative acts are largely omitted from technical considerations, generating a prejudice that does not consider questions as proper psychoanalytic tools, and they discuss possible foundations for this belief. The authors believe that the few authors that have touched on this issue have done so in a non-systematic and frequently incomplete form. Linguistic philosophy presents questions as speech acts: actions that are able to alter the equilibrium of dialogical discourses. This view permits psychoanalysts to understand the potentiality of questions to introduce psychic change because they can, simultaneously, interfere in the self, in the other and in the intersubjective relationship. An internal state of curiosity is described as a component of the mind of the analyst. Based on the argument of the ubiquity of the state of curiosity of the analyst, the authors carried out a set of technical propositions, regarding, on the one hand, when questions are not to be introduced (for instance, in the presence of free associations) and, on the other hand, when they would be useful as expanding factors of the preconscious-conscious system. Considering psychoanalyses as experiences of curiosity, they emphasize that both the internal state of curiosity of the analyst, and the eventual verbal questions put to the patient are potentially positive factors for psychic change. The authors present several clinical vignettes.

Objective To assess the associations of birthweight, nutritional status and growth in childhood with IQ, years of schooling, and monthly income at 30 years of age. Study design In 1982, the 5 maternity hospitals in Pelotas, Brazil, were visited daily and 5914 live births were identified. At 30 years of age, 3701 subjects were interviewed. IQ, years of schooling, and income were measured. Results On average, their IQ was 98 points, they had 11.4 years of schooling, and the mean income was 1593 reais. After controlling for several confounders, birthweight and attained weight and length/height for age at 2 and 4 years of age were associated positively with IQ, years of years of schooling, and income, except for the association between length at 2 years of age and income. Conditional growth analyses were used to disentangle linear growth from relative weight gain. Conditional length at 2 years of age ≥1 SD score above the expected value, compared with ≥1 SD below the expected, was associated with an increase in IQ (4.28 points; 95% CI, 2.66-5.90), years of schooling (1.58 years; 95% CI, 1.08-2.08), and monthly income (303 Brazilian reais; 95% CI, 44-563). Relative weight gain, above what would be expected from linear growth, was not associated with the outcomes. Conclusion In a middle-income setting, promotion of linear growth in the first 1000 days of life is likely to increase adult IQ, years of schooling, and income. Weight gain in excess of what is expected from linear growth does not seem to improve human capital.

Background It has been shown that maternal mental health is associated with poorer skills development in the offspring. However, the evidence evaluating the association between social anxiety disorder (SAD) and cognitive or language development, is scarce. Aim To evaluate the association between maternal SAD and performance in cognitive and language tests in 30-month old children. Study design This was a cohort study involving young women evaluated since pregnancy. Subjects We evaluated 520 mother–child dyads who received prenatal medical assistance through the National Public Health System in a southern Brazilian city, from October 2009 to March 2011. Outcome measures We used the Mini Neuropsychiatric Interview Plus (MINI Plus) to assess SAD among young mothers. Cognitive and language performance in their offspring was analyzed using the Bayley Scales of Infant and Toddler Development – 3rd Edition. Results We found an association between maternal SAD and performance in cognitive and language tests. Children of mothers with SAD had in average 4.5 less points in the Bayley scale, when compared to those with mothers without SAD: in the cognitive (β=−4.53 [95% CI −7.8; −1.1] p=0.008) and language subscales (β=−4.54 [95% CI −9.0; −0.5] p=0.047). Conclusions Our findings suggest that children with mothers suffering from SAD have poorer cognitive abilities and language skills.

This research aims to evaluate factors associated with the presence of comorbidities between mood and anxiety disorders in young adults aged 18 to 24 years, from Pelotas, Rio Grande do Sul State, Brazil. This was a cross-sectional, population-based study with a probabilistic sample by conglomerates. The Mini International Neuropsychiatric Interview (MINI) was used to assess mood and anxiety disorders. The prevalence of mental disorders in the sample (n = 1,561) was of 26.8% of which 9.7% had comorbidities between mood and anxiety disorders. The prevalence of comorbidities on mood and anxiety disorders is almost three times higher among women than men (p < 0.001). Lower education levels, socioeconomic status (p < 0.001) and a history of divorced parents (p < 0.050) was associated with comorbidities between mood and anxiety disorders. The main conclusion is that social factors are highly associated with comorbidities between mood and anxiety disorders. Prevention strategies on mental health should focus particularly on women in vulnerable social conditions. Esta investigação teve como objetivo avaliar a presença de comorbidades entre transtornos de humor e ansiedade, assim como seus fatores associados, em adultos jovens entre 18 e 24 anos de idade em Pelotas, Rio Grande do Sul, Brasil. Em estudo transversal de base populacional a seleção amostral foi feita por conglomerados. O Mini International Neuropsychiatric Interview (MINI) foi utilizado para avaliar os transtornos de humor e ansiedade. A prevalência de transtornos mentais na amostra estudada (n = 1.561) foi de 26,8%, dos quais 9,7% apresentaram comorbidade entre transtornos de humor e ansiedade. A comorbidade entre transtornos de humor e ansiedade foi quase três vezes maior entre as mulheres quando comparadas aos homens (p < 0,001). Níveis mais baixos de escolaridade, nível socioeconômico (p < 0,001) e histórico de pais divorciados (p < 0,050) apresentaram-se associados com comorbidade entre transtornos de humor e ansiedade. A principal conclusão é que os fatores sociais são altamente associados com comorbidade entre transtornos de humor e ansiedade. Esta investigación tuvo como objetivo evaluar la presencia de comorbilidad entre el estado de ánimo y la ansiedad, así como sus factores asociados en adultos jóvenes entre 18 y 24 años de edad, en Pelotas, sur de Brasil. Es un estudio poblacional transversal, basado en una selección de la muestra realizada por conglomerados. Se utilizó el Mini International Neuropsychiatric Interview (MINI) para evaluar los trastornos del estado de ánimo y la ansiedad. La prevalencia de los trastornos mentales en la muestra de estudio (n = 1.561) fue de 26,8%, de los cuales 9,7% tenían trastornos del estado de ánimo comórbidos y ansiedad. La comorbilidad entre el estado de ánimo y la ansiedad fue casi tres veces mayor entre las mujeres en comparación con los hombres (p < 0,001). Los niveles más bajos de educación, nivel socioeconómico (p < 0,001), y con padres divorciados (p < 0,050) se asociaron con trastornos del estado de ánimo comórbidos y ansiedad. La principal conclusión es que los factores sociales están altamente asociados con la comorbilidad entre el estado de ánimo y la ansiedad.

Background Maternal depression may be a risk factor for childhood trauma (CT), with resultant offspring development of mood disorders (MD) in adult life. Objective To verify the relationship between maternal depression (as a risk factor for childhood trauma) and mood disorders in young adults. Methods The sample was composed of 164 young adults and their mothers. Maternal depression was identified through the Mini International Neuropsychiatric Interview (M.I.N.I.). Mood Disorders in the young adults were confirmed with the Structured Interview for the DSM-IV (SCID), whereas the CT was evaluated using the Childhood Trauma Questionnaire (CTQ). Results In the group of young adults with MD, individuals who had depressed mothers presented higher mean scores of CT in comparison to the ones who did not have mothers with Depression (p < 0.005). Childhood trauma was also associated with lower social classes (p < 0.005). In the group of young adults without MD, the only variable that was associated with CT was the young adult’s (not) current work (p < 0.005). Discussion Maternal depression was considered to be a risk factor for CT and MD in young adults. Thus, preventing and treating maternal psychiatric disorders may diminish the risk of offspring childhood trauma, and, consequently, avoid negative effects in the offspring’s adult life. Contexto Depressão materna pode ser um fator de risco para trauma na infância (TI), com consequente desenvolvimento de transtornos de humor (TH) em seus filhos na vida adulta. Objetivo Verificar a relação entre depressão materna (como fator de risco para TI) e TH em jovens. Métodos A amostra foi composta de 164 jovens adultos e suas mães. A depressão materna foi identificada por meio do Mini International Neuropsychiatric Interview (M.I.N.I.). Transtornos de humor nos jovens foram confirmados pela entrevista estruturada para o DSM-IV (SCID), enquanto o TI foi avaliado pelo Questionário de Trauma na Infância (CTQ). Resultados No grupo de jovens com TH, indivíduos que tiveram mães deprimidas apresentaram escores médios de TI mais altos em comparação aos que não tinham mães com depressão (p < 0,05). Trauma na infância também esteve associado com classes sociais desfavorecidas (p < 0,05). No grupo de jovens sem TH, a única variável associada ao TI foi o (não) trabalho do jovem (p < 0,05). Conclusões A depressão materna foi considerada fator de risco para TI e TH nos jovens. Portanto, prevenir e tratar transtornos psiquiátricos maternos pode diminuir o risco de trauma infantil no filho e, por consequência, evitar efeitos negativos na vida adulta da prole.

The diagnosis of alcohol use disorder is based on clinical signs and on the measurement of biological markers. However, these markers are neither sufficiently sensitive, nor specific enough, for determining the effects of alcohol abuse on the central nervous system. Serum neurotrophins are important regulators of neural survival, development, function, and plasticity and have been found to be reduced in alcohol use disorder. The aim of this study was to investigate the alterations in serum neurotrophin levels (brain-derived neurotrophic factor [BDNF], glial-derived neurotrophic factor [GDNF], and nerve growth factor [NGF]) in alcohol use disorder in a young population, and thus possibly representing the early stages of the illness.This is a cross-sectional study, nested in a population-based study of people aged 18 to 35, involving 795 participants. The participants responded to the CAGE questionnaire, and a CAGE score of ≥2 was considered to be a positive screen for the abuse/dependence or moderate to severe alcohol use disorder. Serum BDNF, GDNF, and NGF levels were measured by ELISA.In the CAGE ≥ 2 group, GDNF (p ≤ 0.001) and NGF (p ≤ 0.001) serum levels were significantly increased, and the BDNF elevation was near a statistical significance (p = 0.068) when compared to the CAGE 2 group. A significantly positive correlation was observed only in the CAGE ≥ 2 group for BDNF/GDNF (r = 0.37, p 0.001) and GDNF/NGF (r = 0.84, p 0.001) levels. The correlation between the NGF and BDNF levels was significantly positive in both groups (r = 0.28, p 0.001 for the CAGE 2 group, and r = 0.30, p = 0.008 for the CAGE ≥ 2 group).These results suggest that elevated neurotrophins are candidate markers for the early stages of alcohol misuse.

OBJETIVO: Descrever a prevalência e os fatores de risco para o tabagismo em uma amostra de base populacional de adolescentes residentes em área urbana. MÉTODOS: Em 1997, realizou-se um estudo transversal com uma amostragem em múltiplos estágios dos adolescentes com idade entre 12 e 18 anos completos residentes na zona urbana da cidade de Pelotas, Rio Grande do Sul, Brasil. Foi definido como sendo fumante todo aquele adolescente que informou ter fumado pelo menos um cigarro por semana no último mês. Para as comparações entre proporções, utilizou-se o teste do qui-quadrado com correção de Yates para tabelas 2X2. A regressão logística não condicional foi utilizada na análise multivariada. RESULTADOS/ CONCLUSÕES: Foram entrevistados 632 adolescentes, sendo que com outros 38 não foi possível realizar a entrevista. Na amostra estudada, 11,1% dos adolescentes eram fumantes, 6,8% eram ex-fumantes e 82,1% nunca haviam fumado regularmente. A prevalência de tabagismo foi diretamente relacionada com a idade do adolescente. Mesmo após controle para possíveis fatores de confusão, aqueles adolescentes que não estavam estudando, que eram repetentes, cujos pais estavam separados ou que relataram terem abusado de bebidas alcoólicas no último mês apresentaram uma maior razão de odds para tabagismo. OBJECTIVE: To evaluate the prevalence of tobacco smoking and its determinants among adolescents. METHODS: A cross-sectional study, using a multiple stage sampling, was carried out in 1997 and a sample of adolescents aged between 12 and 18 years who were living in the urban area of Pelotas, Brazil, was studied. Those who reported having smoked at least one cigarette per week during the last month were considered smokers. Chi-square test was used to compare proportions and conditional logistic regression was applied in the multivariate analysis. RESULTS/ CONCLUSIONS: Six hundred and thirty-two adolescents were interviewed, among which 38 were non-respondents. Of those interviewed, 11.1% were smokers at time of the study, 6.8% were former smokers and 82.1% had never smoked. Prevalence of tobacco smoking was directly related to the age. Even after adjusting for confounding factors, those who had left or failed at school, their parents were divorced or reported alcohol abuse in the last month showed a higher odds ratio for smoking.

Objective: To assess the prevalence of anxiety disorders and associated factors in young adults.Methods: Cross-sectional population-based study of individuals between the ages of 18 and 24 yearsrandomly selected from 89 census-based sectors to ensure an adequate sample size. Householdselection within the sectors was performed according to a systematic sampling process. Anxietydisorders were assessed using the Mini International Neuropsychiatric Interview (MINI). The finalsample comprised 1,560 young adults.Results: Of the participants who were diagnosed with anxiety disorders, 12.3% had agoraphobia,9.7% had generalised anxiety disorder, 4.0% had social phobia, 3.3% had obsessive-compulsivedisorder, 2.5% had panic disorder, and 2.1% had post-traumatic stress disorder; only 23.8% hadreceived any previous treatment. Anxiety disorders were associated with sex, socioeconomic status,psychiatric problems in parents, alcohol abuse, and tobacco use.Conclusions: The identification of factors associated with anxiety disorders in young people enablesus to develop intervention strategies. Anxiety disorders are not only highly prevalent but are alsoassociated with significant functional impairment, significant reductions in quality of life, lowerproductivity, and higher rates of comorbidities.Keywords: Anxiety disorders; youth; epidemiology

Suicide is among the main causes of death of people aged between 15 and 44 years old. Childhood trauma is an important risk factor for suicide. Hence, the objective of this study was to verify the relationship between childhood trauma and current suicide risk (suicidal behavior and ideation) in individuals aged 14-35 years, in the city of Pelotas, Brazil. This is a cross-sectional, population-based study. Sample selection was performed by clusters. Suicide risk was evaluated using the Mini International Neuropsychiatric Interview (MINI) and Childhood trauma was assessed with the Childhood Trauma Questionnaire (CTQ). Moreover, the participants responded to a questionnaire concerning socioeconomic status, work, and substance use. The sample was composed of 1,380 individuals. The prevalence of suicide risk was 11.5%. The prevalence figures of childhood trauma were 15.2% (emotional neglect), 13.5% (physical neglect), 7.6% (sexual abuse), 10.1% (physical abuse), and 13.8% (emotional abuse). Suicide risk was associated (p

Mood disorders are a consequence of the interaction between environmental and biological factors. The objective of this study was to identify associations between stressful life events (LEs) and mood disorders in a community sample of young people in southern Brazil. It is a cross-sectional population-based study on young people between 18 and 24 years of age. The selection of the sample was conducted via conglomerates. Mini International Neuropsychiatric Interviews were used to evaluate mood disorders, and the Social Readjustment Rating Scale to assess stressful life events. The sample included 1172 young people. Of the total sample, the proportion of stressful life events in the last year in each category was: 53.8% work, 42.4% loss of social support, 63.8% family, 50.9% environmental changes, 61.1% personal difficulties, and 38.7% finances. A significant relationship was found between categories of stressful life events and mood disorder episodes. A higher incidence of stressful life events was found among young people in a mixed episode compared to young people in a depressive, (hypo)maniac episode with controls. This finding suggests a psychosocial interaction between stressful life events and the occurrence of mood disorders.

To estimate the prevalence of lifetime use of crack cocaine and to assess associations with violent and sexual behaviors in young adults selected from the general population of Pelotas, Southern Brazil.This cross-sectional population-based study included 1,560 participants aged 18-24 years. The use of alcohol and other substances, including crack cocaine, was assessed using the alcohol, smoking and substance involvement screening test. Other variables included violent behaviors, firearm possession, and sexual risk behaviors. The frequency of antisocial personality disorder was also investigated. Associations were analyzed using a crude model and models adjusted for sex, social class, and the use of snorted cocaine.Lifetime prevalence of crack cocaine use was 2.51 %, and it was higher among males and individuals coming from more vulnerable social classes (D or E). In the final multivariate models, lifetime use of crack cocaine was associated with episodes of aggression and firearm possession, as well as with a higher chance of not having used condom in the last sexual intercourse. In less conservative models, crack cocaine use was associated with other violent and sexual risk behaviors.The strong association observed between lifetime use of crack cocaine and different violent and sexual risk behaviors underscores relevant characteristics of people who use crack cocaine. Improving our understanding of possible causal chains leading to such associations should be a priority in future studies.

This research aimed to compare the prevalence rates of major depressive disorder (MDD) and to differentiate the presence and severity of depressive symptoms between women and men aged 18-24 years. In this population-based, cross-sectional study (n = 1560), young adults were screened with the Mini International Neuropsychiatric Interview for MDD (n = 137). Participants then completed a self-report questionnaire to gather sociodemographic data, and the presence of each symptom of depression was assessed with the Beck Depression Inventory. The proportion of women (12.2%) with MDD was higher than that of men (5.3%). The symptoms of depression found to be significantly more prevalent in women were sadness, crying, difficulty making decisions, and lack of energy, as well as self-criticism, irritability, changes in self-image, work difficulty, and loss of interest in sex. Sadness and self-criticism were significantly more severe in women than in men. The presentation of depressive symptoms in young adults with MDD differed between men and women.

We conducted a cross-sectional study nested within a cohort study with 276 postpartum women to evaluate the role of a serotonin transporter gene polymorphism (5-HTTLPR) and the stressful life events (SLE) on the risk of postpartum depression (PPD) symptoms in a community sample. Participants were assessed between 45 and 90 days after delivery with the Edinburgh Postnatal Depression Scale (EPDS) and the Mini International Neuropsychiatric Interview (MINI). Data regarding socio-demographic variables, alcohol consumption, tobacco smoking and SLE occurring during pregnancy, were also collected. In the adjusted analysis, the women carrying the long (L) allele (LL) who experienced SLE showed higher prevalence ratios (PR) for PPD symptoms (EPDS ≥13) than those with two copies of the short (S) allele (SL) (PR = 9.91; 95% confidence interval: 1.70-57.87). In contrast, a trend of association was found between prior history of major depressive disorder (MDD) and the S allele carrier status (p = 0.07). No association was found between the formal diagnosis of current MDD and the 5-HTTLPR genotypes. In line with previous reports, we find in this sample that the L allele carrier status was associated with a heighten risk of depressive symptoms in postpartum when SLE were experienced during pregnancy.

The present study aimed to determine whether any gender-related difference exists concerning oxidative stress parameters in a population of 231 subjects, and if these changes might be related to gender-associated differences in major depressive disorder (MDD) or bipolar disorder (BD) vulnerability. This is a case-control nested in a population-based study. The initial psychopathology screen was performed with the Mini-International Neuropsychiatric Interview and the diagnostic was further confirmed with the Structured Clinical Interview for DSM-IV. Blood samples were obtained after the interview and the oxidative stress parameters such as uric acid, advanced oxidation protein product (PCC) and lipid hydroperoxides (TBARS) were determined. Our results indicated a higher prevalence of MDD and BD in women when compared to men. In addition, significant gender differences were found in the levels of PCC (0.27 ± 0.27 vs. 0.40 ± 0.31 nmol CO/mg protein, men vs. women, respectively; P = 0.02) and uric acid (4.88 ± 1.39 mg/dL vs. 3.53 ± 1.02 mg/dL, men vs. women, respectively; P = 0.0001), but not in TBARS (0.013 ± 0.01 nmol/mg of protein vs. 0.017 ± 0.02 nmol/mg of protein, men vs. women respectively; P = 0.243). After sample stratification by gender, no association was found between oxidative stress parameters and clinical diagnosis of MDD and BD for women (P = 0.516 for PCC; P = 0.620 for TBARS P = 0.727 for uric acid) and men (P = 0.367 for PCC; P = 0.372 for TBARS P = 0.664 for uric acid). In this study, women seem more susceptible to oxidative stress than male. However, these gender-based differences do not seem to provide a biochemical basis for the epidemiologic differences in mood disorders susceptibility between sexes.

O baixo peso ao nascer está relacionado com morbimortalidade e sequelas no desenvolvimento infantil, impactando nos custos dos sistemas de saúde, por isso é importante avaliar fatores que o influenciam, estimando seu impacto no Sistema Único de Saúde (SUS). Este é um estudo prospectivo aninhado a uma coorte de gestantes que realizaram pré-natal e parto exclusivamente pelo SUS nos hospitais com UTI da cidade de Pelotas, Rio Grande do Sul, Brasil. Entre os resultados, concluiu-se que mães com episódios de depressão gestacional apresentam quase quatro vezes mais chances de ter um filho com baixo peso ao nascer (RP = 3,94; IC: 1,49-10,36). Valendo-se do cálculo da fração atribuível na população, estima-se que, na população geral, 36,17% dos bebês com baixo peso ao nascer são filhos de mães que tiveram episódio depressivo, estimando-se um custo que pode chegar a mais de R$ 76 milhões no Brasil. Sugere-se que se ampliem as ações preventivas e curativas para as gestantes na área da saúde mental, possibilitando melhor desfecho de saúde dos recém-nascidos, e que se utilizem adequadamente os recursos do SUS. Low birth weight is related to morbidity and mortality and sequelae during infant development, thereby impacting health system costs. It is thus important to evaluate factors that influence low birth weight and to estimate their impact on the Brazilian Unified National Health System (SUS). This was a nested prospective study in a cohort of pregnant women who received prenatal care and gave birth in the National Health System in hospitals with ICUs in the city of Pelotas, Rio Grande do Sul State, Brazil. Gestational depression was associated with a fourfold risk of low birth weight (PR = 3.94; CI: 1.49-10.36). Based on the population-attributable fraction, in the overall population an estimated 36.17% of low birth weight infants are born to mothers with an episode of depression during pregnancy, with an estimated cost of more than R$76 million (U$38 million) in Brazil. The study recommends the expansion of preventive and therapeutic mental health care measures for pregnant women and the adequate use of resources in the Unified National Health System to improve neonatal outcomes.

OBJECTIVES: To evaluate the prevalence of suicide risk and comorbidities in postpartum women. METHODS: This is a cross-sectional study of postpartum women. The sample comprised mothers who have received prenatal care from the Brazilian National System of Public Heath in the city of Pelotas. Suicide risk and other mental disorders were evaluated using the Mini International Neuropsychiatric Interview (MINI). A yes answer on one of the six interview questions was considered a sign of suicide risk. RESULTS: The sample consisted of 919 postpartum women. The 11.5% suicide prevalence was 4.62 (CI 2.45, 8.73) times higher in women with low educational levels. Women with comorbid depression or an anxiety disorder showed a 17.04 (CI 2.27; 19.96) times greater risk of suicide than those who did not suffer from any mood disorder. CONCLUSION: Lower education levels and psychiatric disorders are associated with suicide risk. Bipolar disorder is the psychiatric disorder with the highest impact on suicide risk. OBJETIVOS: Avaliar a prevalência do risco de suicídio e de comorbidades em mulheres pós-parto. MÉTODOS: Este foi um estudo em corte transversal com mulheres pós-parto. A amostra foi constituída de mães que receberam cuidados pré-natais prestados pelo Sistema Nacional de Saúde Pública do Brasil na cidade de Pelotas. O risco de suicídio e outros transtornos mentais foram avaliados pela Mini International Neuropsychiatric Interview (MINI). Uma resposta afirmativa a qualquer das seis perguntas é considerada um risco de suicídio. RESULTADOS: A amostra consistiu de 919 mulheres pós-parto. A prevalência do risco de suicídio foi de 11,5%. Ela foi 4,62 vezes mais alta (IC de 95% 2,45; 8,73) em mulheres de baixo nível educacional. Mulheres apresentando qualquer comorbidade para depressão e transtornos ansiosos tiveram uma chance 17,04 vezes maior (IC 95% 2,27; 19,96) àquelas que não apresentaram nenhum transtorno afetivo. CONCLUSÃO: Um nível educacional mais baixo e a presença de um transtorno psiquiátrico se associam ao risco de suicídio. O transtorno bipolar é o diagnóstico psiquiátrico com maior impacto sobre o risco de suicídio.

OBJECTIVE: To assess the sociodemographic risk factors for the prevalence and incidence of relevant postpartum depressive symptoms. METHOD: We studied a cohort of women in their perinatal period with the assistance of the public health system in the city of Pelotas-RS, Brazil. We assessed depressive symptoms with the Edinburgh Postnatal Depression Scale (EPDS) in the prenatal and postnatal periods. RESULTS We interviewed 1,109 women. The prevalence of meaningful depressive symptoms during pregnancy was 20.5% and postpartum was 16.5%. Women with prenatal depression were at higher risk for postpartum depression. CONCLUSION: The mother's poverty level, psychiatric history, partner absence and stressful life events should be considered important risk factors for relevant postpartum depressive symptoms. OBJETIVO: Avaliar os fatores sociodemográficos de risco quanto à prevalência e à incidência de sintomas depressivos pós-parto relevantes. MÉTODO: Estudou-se um grupo de mulheres em seu período perinatal sendo assistidas pelo sistema público de saúde na cidade de Pelotas, RS, Brasil. Foram avaliados os sintomas depressivos com o uso da Edinburgh Postnatal Depression Scale (EDPS) nos períodos pré-natal e pós-natal. RESULTADOS: Foram entrevistadas 1.019 mulheres. A prevalência de sintomas depressivos significativos durante a gravidez foi de 20,5% e no período pós-parto de 16,5%. As mulheres com depressão pré-natal apresentaram um risco maior de depressão pós-parto. CONCLUSÃO: O nível de pobreza, a história psiquiátrica, a ausência do parceiro e eventos vitais estressantes devem ser considerados fatores de risco importantes para sintomas depressivos pós-parto relevantes.

To assess the associations of the perceived quality of parental bonding with suicidality in a sample of pregnant adolescents. A cross-sectional study with a sample size of 828 pregnant teenagers receiving prenatal medical assistance in the national public health system in the urban area of Pelotas, southern Brazil. Suicidality and psychiatric disorders were assessed using the Mini International Neuropsychiatric Interview (MINI), and the Parental Bonding Instrument (PBI) was employed to measure the perceived quality of parental bonding. A self-report questionnaire was used to collect sociodemographic, obstetric and other psychosocial data. Forty-three (4.94 %) teenagers from a consecutive sample of 871 refused to participate, resulting in 828 participants. Prevalence of suicidality was 13.3 %, lifetime suicide attempts were 7.4 % with 1.3 % reporting attempting suicide within the last month. Significant associations of suicidality with the 18–19-year-old subgroup, low education, prior abortion, physical abuse within the last 12 months were present, and most psychiatric disorders were associated with a higher suicidality prevalence. Additionally, after adjustment in the multivariate analysis, the style of parental bonding was independently associated with suicidality in the pregnant adolescent, with a PR of 2.53 (95 % CI 1.14–5.59) for the maternal ‘affectionless control’ and a PR of 2.91 (95 % CI 1.10–7.70) for the paternal ‘neglectful parenting.’ We found that maternal ‘affectionless control’ and paternal ‘neglectful parenting’ were independent predictors of suicidality in this sample of pregnant teenagers.

Este estudo teve por objetivo verificar a relação entre a presença de transtornos de ansiedade e risco de suicídio em jovens. Em delineamento transversal de base populacional, os jovens respondiam a um questionário sobre questões sociodemográficas, comportamentais e de saúde. Avaliou-se o bem-estar psicológico através da Escala de Faces de Andrews e consumo de substâncias foi efetuado pelo Teste de Triagem do Envolvimento com Álcool, Cigarro e Outras Substâncias, (Alcohol, Smoking and Substance Involviment Screening Test - ASSIST). A Mini Internacional Neuropsychiatric Interview 5.0 avaliou transtornos de ansiedade e o risco de suicídio. Dos 1.621 jovens entrevistados, 20,9% apresentaram algum transtorno de ansiedade e 8,6% risco de suicídio. A presença de algum transtorno de ansiedade esteve significativamente associada ao risco de suicídio (RP 6,10 IC95% 3,95 a 9,43). Dessa forma, salienta-se a importância de maior atenção ao risco de suicídio também em pacientes com transtornos de ansiedade. This study aimed at investigating the relationship between the presence of anxiety disorders and suicide risk in young adults. In a cross-sectional population-based design young adults answered a questionnaire about sociodemographic, behavioral and health characteristics. The measure of psychological well-being was made by Faces Scale of Andrews while the substances use evaluation was performed according to the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). The Mini International Neuropsychiatric Interview 5.0 evaluated anxiety disorders and suicide risk. Among the 1.621 young adults interviewed, 20.9% had some anxiety disorders and 8.6% suicide risk. After multivariate analysis, the presence of any anxiety disorder was significantly associated with suicide risk (PR 6.10 95% CI 3.95 to 9.43). Thus, it is highlighted the importance of greater attention to suicide risk in those patients with anxiety disorders. Este estudio tubo por objetivo verificar la relación entre la presencia de trastornos de ansiedad y riesgo de suicidio en jóvenes. En delineamiento transversal de base poblacional, los jóvenes respondían a un cuestionario sobre cuestiones sociodemográficas, comportamentales y de salud. Se evaluó el bienestar psicológico por medio de la escala de fases de Andrews y consumo de sustancias efectuada por la prueba de detección del envolvimiento con alcohol, cigarrillo y otras sustancias, (Alcohol, Smoking and Substance Involviment Screening Test - ASSIST). La Mini Internacional Neuropsychiatric Interview 5.0 evaluó trastornos de ansiedad y el riesgo de suicidio. De los 1.621 jóvenes entrevistados, 20,9% presentaron algún trastorno de ansiedad y 8,6% riesgo de suicidio. La presencia de algún trastorno de ansiedad estuvo significativamente asociada al riesgo de suicidio (RP 6,10 IC95% 3,95 a 9,43). De esa forma, se resalta la importancia de mayor atención al riesgo de suicidio también en pacientes con trastornos de ansiedad.

The objective of this report is to evaluate functioning in bipolar disorder in a population-based sample of young adults (18 to 24 years old). To this end, people with bipolar disorder were compared with matched participants with only depressive episodes and control subjects without a history of mood episodes.Case-control study nested in a population-based sample. Caseness was confirmed with the Structured Clinical Interview for DSM-IV. The Functioning Assessment Short Test was used as a measure of general functioning. A multivariate model was elaborated to account for potential confounders.The sample consisted of 231 subjects. Both bipolar disorder (coef=0.60, SE=0.14, p0.001) and major depression (coef=0.44, SE=0.14, p=0.001) were associated with functioning in the multivariate model. Current depressive symptoms appeared to influence functioning in those with major depression (Z=2.05, p=0.04), but not in those with bipolar disorder (Z=0.78, p=0.43).Neuropsychological testing was not performed and we see it as an important limitation of this study.This population-based study further reinforces the notion that functional impairment is a fundamental characteristic of bipolar illness. It is present from early stages and is not completely explained by mood symptoms.

O objetivo foi avaliar risco de suicídio e comportamentos de risco em jovens. Estudo transversal na zona urbana de Pelotas, Rio Grande do Sul, Brasil, realizado por amostragem sistemática. Foram incluídos jovens de 18 a 24 anos, com capacidade cognitiva e que assinaram termo de consentimento. Foram aferidos risco de suicídio (MINI); comportamentos de risco (YRBSS); abuso/dependência de substâncias (ASSIST); e nível socioeconômico (ABEP). Os dados foram analisados no programa SPSS. A amostra constituiu-se de 1560 jovens e a prevalência de risco de suicídio foi de 8,6%. O risco de suicídio foi associado com: ter sofrido acidente com necessidade de ir ao pronto-socorro (p = 0,011), ter entrado em briga com agressão física (p = 0,016), ter carregado arma branca (p = 0,001) e arma de fogo (p < 0,001), ter abuso/dependência de substâncias (p < 0,001), não ter utilizado preservativo na última relação sexual (p = 0,025), não ter parceiro fixo (p < 0,001) e ter relação sexual com cinco ou mais pessoas (p = 0,018). Jovens com comportamentos de risco também demonstram indícios de risco de suicídio. The aim of this study was to assess suicide risk and risk behavior in young people. A cross-sectional study in the urban area of Pelotas, Rio Grande do Sul State, Brazil was performed using systematic sampling with young people between the ages of 18 to 24 years. We measured the risk of suicide (MINI), behavior (YRBSS), abuse/substance dependence (ASSIST) and socioeconomic status (ABEP). Data was analyzed using SPSS software. The sample consisted of 1,560 young people and the prevalence of suicide risk was 8.6%. Suicide risk was associated with: having suffered an accident that required a visit to the emergency room (p = 0.011), fighting (p = 0.016), carrying a weapon (p = 0.001) and carrying a firearm (p < 0.001), substance abuse/dependence (p < 0.001), not having used a condom during the last sexual relationship (p = 0.025), not having a steady partner (p < 0.001) and having sex with five or more people (p = 0.018). Young people that present risk behavior also represent a suicide risk.

INTRODUCTION: Bullying among adolescents has become the subject of extensive research due to its negative effects on attitude and behavior. However, Brazilian literature on the topic is scarce. OBJECTIVE: To assess bullying and associated factors among adolescents in a population-based sample in southern Brazil. METHOD: Population-based, cross-sectional study with adolescents aged 11 to 15 years living in the municipality of Pelotas, state of Rio Grande do Sul, Brazil. RESULTS: A total of 1,145 adolescents were included. Bullying behaviors and attitudes were found to be associated with the following factors: intentionally skipping classes, failing at school, using alcohol, smoking cigarettes, using illegal drugs, having engaged in sexual intercourse, carrying a weapon, being involved in an accident/being run over by any vehicle, and being involved in fights with physical aggression. CONCLUSION: Bullying is associated with several behaviors that pose risk to the adolescents' physical and psychological health. INTRODUÇÃO: O bullying entre adolescentes tem sido objeto de várias pesquisas devido aos prejuízos comportamentais que acarreta. Contudo, a literatura brasileira sobre o tema é escassa. OBJETIVO: Avaliar comportamentos de bullying e fatores associados em uma amostra de base populacional de adolescentes vivendo no sul do Brasil. MÉTODO: Estudo transversal, de base populacional, com adolescentes de 11 a 15 anos de idade residentes na cidade de Pelotas, RS, Brasil. RESULTADOS: Um total de 1.145 adolescentes foram selecionados. Os comportamentos e atitudes de bullying mostraram-se associados aos seguintes fatores: faltar aula intencionalmente, reprovar algum ano na escola, usar álcool, cigarro e/ou drogas ilícitas, ter tido relações sexuais, portar arma, sofrer algum acidente ou atropelamento e brigar e/ou agredir alguém. CONCLUSÃO: O bullying esteve associado com vários comportamentos considerados de risco para a saúde física e psicológica dos adolescentes.

CONTEXTO: A depressão é um importante problema de saúde global e vem causando impacto negativo na vida dos indivíduos e na de suas famílias, além de elevar a demanda dos serviços de saúde. OBJETIVO: Verificar a prevalência de depressão e de fatores associados em indivíduos com idade superior a 14 anos que buscaram atendimento na atenção primária. MÉTODOS: Estudo transversal em três Unidades Básicas de Saúde vinculadas à Universidade Católica de Pelotas. A depressão, os transtornos de ansiedade e o risco de suicídio foram avaliados por meio da Mini International Neuropsychiatric Interview (MINI), enquanto os fatores associados, como idade, gênero, vive ou não com o/a companheiro/a, escolaridade e uso de substâncias psicoativas, foram avaliados por meio de questionário sociodemográfico. RESULTADOS: A prevalência de depressão foi de 23,9% (n = 256), apresentando-se mais evidente nas mulheres, com 4 a 7 anos de escolaridade, de classe socioeconômica D ou E, que abusam ou são dependentes de álcool, com algum transtorno de ansiedade e com risco de suicídio (p < 0,050). CONCLUSÃO: Diante de tais resultados, salientamos a inserção de cuidados em saúde mental por meio de avaliações diagnósticas e de protocolos de atendimento que abarquem a depressão e suas comorbidades na atenção primária. BACKGROUND: Depression, an important global health problem, negatively impacts the lives of individuals and their families beyond simply increasing the demand for health services. OBJECTIVE: To assess the prevalence of depression and associated mental health issues in individuals older than 14 years of age seeking primary care. METHODS: A cross-sectional study was conducted in three primary care units involved with the Catholic University of Pelotas. Depression, anxiety disorders, and suicide risk were assessed using the Mini International Neuropsychiatric Interview (MINI). Factors such as age, gender, solitary living, education, and psychoactive substance use were evaluated using a sociodemographic questionnaire. RESULTS: The overall prevalence of depression was 23.9% (n = 256). Depression was more prevalent in women with only 4-7 years of education, in women who belong to socioeconomic class D or E, in those who abuse or are dependent on alcohol, or in women who showed an anxiety disorder or suicide risk (p < 0.050). DISCUSSION: Based on these findings, we emphasize the integration of mental health care into primary care through diagnostic evaluations and treatment protocols that cover depression and its comorbidities.

Low birth weight is related to morbidity and mortality and sequelae during infant development, thereby impacting health system costs. It is thus important to evaluate factors that influence low birth weight and to estimate their impact on the Brazilian Unified National Health System (SUS). This was a nested prospective study in a cohort of pregnant women who received prenatal care and gave birth in the National Health System in hospitals with ICUs in the city of Pelotas, Rio Grande do Sul State, Brazil. Gestational depression was associated with a fourfold risk of low birth weight (PR = 3.94; CI: 1.49-10.36). Based on the population-attributable fraction, in the overall population an estimated 36.17% of low birth weight infants are born to mothers with an episode of depression during pregnancy, with an estimated cost of more than R$76 million (U$38 million) in Brazil. The study recommends the expansion of preventive and therapeutic mental health care measures for pregnant women and the adequate use of resources in the Unified National Health System to improve neonatal outcomes.

OBJECTIVE: We describe the prevalence of depressive and bipolar spectrum episodes in fathers in antenatal and postnatal periods, as well as at 12 months after childbirth. METHOD: A longitudinal follow-up study was conducted with a representative sample of 739 fathers whose children were born between April 2007 and May 2008 in maternity wards in the city of Pelotas, southern Brazil. Paternal psychopathology was measured with the Mini Neuropsychiatric Interview (MINI) across three time points: between 28 and 34 weeks of pregnancy (T1), 30 to 60 days postpartum (T2), and 12 months after childbirth (T3). RESULTS: The prevalence of depressive episodes was 5.0% at T1, 4.5% at T2, and 4.3% at T3. Mixed episodes were present in 3%, 1.7%, and 0.9% of subjects, respectively, and accounted for 61.1% of the cases of depression in the antenatal period, 37.5% in postpartum, and 21.4% at 12 months. Depressive and manic/hypomanic episodes were significantly associated during pregnancy and in postpartum, but not at 12 months after childbirth. CONCLUSION: Bipolar episodes were common in men with depressive symptoms during their partner's pregnancy in the postpartum period and, to a lesser extent, 12 months after childbirth. Therefore, this population should be carefully investigated for manic and hypomanic symptoms.

OBJETIVO: Analisar a associação entre abuso de álcool durante a gestação e baixo peso ao nascer. MÉTODOS: Estudo transversal de base populacional aninhado a uma coorte de 957 gestantes que realizaram acompanhamento pré-natal no Sistema Único de Saúde da cidade de Pelotas, RS, e deram à luz entre setembro de 2007 e setembro de 2008. As mães foram entrevistadas em dois momentos distintos: no período de pré-parto e após o parto. Para verificar o abuso do álcool foi utilizada a escala Cut down, Annoyed by criticism, Guilty and Eye-opener. Foram realizadas análises bivariadas e regressão logística múltipla, ajustada pelas variáveis prematuridade e abuso de álcool. O nível de significância adotado foi de 95%. RESULTADOS: Das mulheres que participaram do estudo, 2,1% abusaram de álcool na gestação e, entre essas, 26,3% tiveram filhos com baixo peso. Houve associação entre o abuso de álcool e baixo peso ao nascer (p < 0,038). CONCLUSÕES: Os achados indicam que o abuso de álcool durante a gestação está associado ao baixo peso ao nascer. OBJECTIVE: To assess the association between alcohol abuse during gestation and low birth weight. METHODS: Cross-sectional, population-based nested study from a cohort of 957 pregnant women who received prenatal assistance through Sistema Único de Saúde (National Health System) in the city of Pelotas, Southern Brazil, and delivered their babies between September 2007 and September 2008. The mothers were interviewed at two distinct moments: prenatal and postpartum periods. In order to verify alcohol abuse, the CAGE (Cut down, Annoyed by criticism, Guilty and Eye-opener) scale was used. Bivariate analyses were carried out, as well as multiple logistic regression adjusted by the variables prematurity and alcohol abuse. The level of significance that was adopted was 95%. RESULTS: Of the women who participated in the study, 2.1% abused alcohol during pregnancy and, among these, 26.3% had low birth weight children. There was an association between alcohol abuse and low birth weight (p

OBJETIVO: Verificar o impacto da percepção de baixo suporte social durante a gestação como fator de risco para a depressão no período de 30 a 60 dias pós-parto. MÉTODO: Este estudo de coorte teve como população-alvo gestantes atendidas no Sistema Único de Saúde na cidade de Pelotas (RS). Para avaliar depressão pós-parto, foi utilizada a Edinburgh Postnatal Depression Scale (EPDS). Foram consideradas deprimidas as parturientes que atingiram ≥ 13 pontos na escala. RESULTADOS: Das 1.019 mulheres avaliadas, 168 (16,5%) apresentaram depressão pós-parto. Aquelas que não receberam suporte do companheiro (p = 0,000), de familiares (p = 0,000) e de amigos (p = 0,000) demonstraram maior risco de ter depressão pós-parto. CONCLUSÃO: Nossos achados sugerem que a percepção de suporte social durante a gravidez pode ser um fator protetor para a depressão pós-parto. OBJECTIVE: To assess the impact of low perceived social support during pregnancy as a risk factor for depression within 30 to 60 days postpartum. METHOD: This cohort study included pregnant women treated at public hospitals (Brazilian Unified Health System) in the city of Pelotas, state of Rio Grande do Sul, southern Brazil. Postpartum depression was assessed using the Edinburgh Postnatal Depression Scale (EPDS). Women with scores ≥ 13 points were considered to be depressed. RESULTS: Of the total of 1,019 women assessed, 168 (16.5%) presented postpartum depression. Women who did not receive support from their partners (p = 0.000), their families (p = 0.000), and friends (p = 0.000) were at higher risk for developing postpartum depression. CONCLUSION: Our findings suggest that perceived social support during pregnancy may be a protective factor against postpartum depression.

The aim of this study was to assess suicide risk and risk behavior in young people. A cross-sectional study in the urban area of Pelotas, Rio Grande do Sul State, Brazil was performed using systematic sampling with young people between the ages of 18 to 24 years. We measured the risk of suicide (MINI), behavior (YRBSS), abuse/substance dependence (ASSIST) and socioeconomic status (ABEP). Data was analyzed using SPSS software. The sample consisted of 1,560 young people and the prevalence of suicide risk was 8.6%. Suicide risk was associated with: having suffered an accident that required a visit to the emergency room (p = 0.011), fighting (p = 0.016), carrying a weapon (p = 0.001) and carrying a firearm (p ≤ 0.001), substance abuse/dependence (p ≤ 0.001), not having used a condom during the last sexual relationship (p = 0.025), not having a steady partner (p ≤ 0.001) and having sex with five or more people (p = 0.018). Young people that present risk behavior also represent a suicide risk.

O objetivo foi verificar a prevalência de transtornos mentais comuns (TMC) e sua associação com qualidade de vida em jovens da cidade de Pelotas, Rio Grande do Sul, Brasil. Estudo transversal de base populacional com jovens de 18 a 24 anos. A seleção amostral foi realizada por conglomerados. Para a investigação dos transtornos mentais comuns foi aplicado o Self Report Questionnaire (SRQ-20), enquanto os níveis de qualidade de vida foram mensurados por intermédio da Medical Outcomes Survey Short-form General Health Survey (SF-36). A prevalência de TMC na amostra estudada foi de 24,5% (N = 382), apresentando-se mais evidente entre as mulheres, entre aqueles que pertenciam à menor classe socioeconômica (D ou E), não estavam estudando, não estavam trabalhando, consumiram álcool e usaram tabaco pelo menos uma vez na última semana e que fizeram uso de alguma substância ilícita nos últimos três meses. Os jovens com TMC obtiveram uma menor média nos escores da SF-36 em todos os domínios de qualidade de vida avaliados. Deve-se investir em medidas preventivas de TMC no intuito de proporcionar uma melhor qualidade de vida à população. This study aimed to assess the prevalence of common mental disorders (CMD) and their association with quality of life among young adults in Pelotas, Rio Grande do Sul State, Brazil. This was a cross-sectional population-based study of young people 18 to 24 years of age. Sampling used simple cluster selection. Investigation of CMD used the Self-Report Questionnaire (SRQ-20), while quality of life was measured with the Medical Outcomes Survey Short-Form General Health Survey (SF-36). Prevalence of CMD in the study sample was 24.5% (N = 382), and was positively associated with: female gender, lower socioeconomic status (classes D or E), not studying, not working, alcohol consumption, smoking, and substance abuse. Young adults with CMD had lower mean scores on the SF-36 in all the assessed quality of life domains. Measures to prevent CMD are necessary to provide better quality of life for this age group.

This study aimed to identify factors associated with psychological well-being among young people 18 to 24 years of age in Pelotas, Rio Grande do Sul State, Brazil. In a population-based cross-sectional study, 1,621 subjects answered a structured questionnaire on socio-demographic data, religion, employment, and substance use, as well as the Mini International Neuropsychiatric Interview (MINI) to assess psychiatric disorders. The Faces Scale (Andrews) was used to evaluate psychological well-being. Poisson regression was used for multivariate analysis. Of the total sample, 85.3% displayed psychological well-being, which was positively associated with non-use of illicit drugs, current employment, religion, socioeconomic status (classes A and B), higher educational levels, and absence of psychiatric disorders. Programs to reduce poverty and encourage education and identification and prevention of drug use among youths are of paramount importance to improve their health and psychological well-being.

OBJETIVO: Analisar a associação entre comportamentos violentos de adolescentes e a coabitação parento-filial. MÉTODOS: Estudo transversal de base populacional realizado na área urbana de Pelotas, RS, em 2002, com amostragem em múltiplos estágios. Foram entrevistados 960 adolescentes com utilização de questionário auto-aplicado. As variáveis dependentes (uso de armas e envolvimento em brigas no último ano foram referidos pelos adolescentes) e a variável independente coabitação parento-filial foram submetidas a análise pelo teste de qui-quadrado e razão de prevalências, ajustada para idade, sexo, nível socioeconômico e relato de uso na vida e recente de álcool, tabaco ou drogas ilícitas. RESULTADOS: O envolvimento em brigas no último ano foi referido por 23% dos sujeitos e o uso de armas por 9,6%. A razão de prevalência de ocorrência desses comportamentos foi de 1,38 (IC95%: 0,71; 2,68, p = 0,34) para envolvimento em brigas e de 1,68 (IC95%: 1,06; 2,67, p = 0,03) para uso de armas, tendo como referência sujeitos que coabitavam com pai, com mãe ou com ambos. CONCLUSÕES: A coabitação parento-filial deve ser considerada em políticas de prevenção ao uso de armas por crianças e adolescentes, mas recomenda-se o cuidado de não estigmatizar crianças e adolescentes que não coabitam com pais e mães. OBJECTIVE: To analyze the association between violent behavior in adolescents and parent-child cohabitation. METHODS: A population-based cross-sectional study with multiple-stage sampling was performed in the urban area of the city of Pelotas, Southern Brazil, in 2002. A total of 960 adolescents were interviewed using a self-applied questionnaire. The dependent variables (use of weapons and involvement in fights in the previous year were reported by adolescents) and the independent variable (parent-child cohabitation) were analyzed with the chi-square test and prevalence ratios, adjusted for age, sex, socioeconomic level and reporting of alcohol, tobacco or illicit drug use, both recently and throughout life. RESULTS: Involvement in fights in the previous year was reported by 23% of participants and use of weapons by 9.6%. Prevalence ratios of occurrence of such behaviors was 1.38 (95% CI: 0.71; 2.68, p=0.34) for involvement in fights and 1.68 (95% CI: 1.06; 2.67, p=0.03) for use of weapons, including "adolescents living with the father, mother or both" as reference. CONCLUSIONS: Parent-child cohabitation must be considered in policies aimed at preventing the use of weapons by children and adolescents, although it is recommended that care should be taken not to stigmatize children and adolescents who do not live with their fathers and mothers. OBJETIVO: Analizar la asociación entre comportamientos violentos de adolescentes y la co-habitabilidad parental-filial. MÉTODOS: Estudio transversal de base poblacional realizado en el área urbana de Pelotas, Sur de Brasil, en 2002, con muestreo en múltiples fases. Fueron entrevistados 960 adolescentes con utilización de cuestionario auto-aplicado. Las variables dependientes (uso de armas y envolvimiento en peleas en el último año fueron referidos por los adolescentes) y la variable independiente co-habitabilidad parental-filial fueron sometidas a análisis por la prueba e chi-cuadrado y la tasa de prevalencias, ajustada para edad, sexo, nivel socioeconómico relato de uso en la vida y reciente de alcohol, tabaco o drogas ilícitas. RESULTADOS: El envolvimiento en peleas en el último año fue referido por 23% de los sujetos y el uso de armas por 9,6%. La tasa de prevalencia de ocurrencia de estos comportamientos fue de 1,38 (IC 95%: 0,71;2,68, p=0,34) para envolvimiento en peleas y de 1,68 (IC 95%: 1,06;2,67, p=0,03) para uso de armas, teniendo como referencia sujetos que co-habitaban con padre, con madre o con ambos. CONCLUSIONES: La co-habitabilidad parental-filial debe ser considerada en políticas de prevención al uso de armas por niños y adolescentes, pero se recomienda el cuidado de no estigmatizar niños y adolescentes que no co-habitan con padres y madres.

O objetivo do presente estudo foi verificar a prevalência de transtornos mentais comuns (TMC) e sua relação com auto-estima, bem como outros fatores associados à ocorrência de TMC em gestantes. Foi realizado um estudo transversal aninhado a uma coorte no qual participaram gestantes atendidas no serviço de saúde do Sistema Único de Saúde na cidade de Pelotas, Estado do Rio Grande do Sul, Brasil. Foi utilizado para o rastreamento de transtornos mentais comuns o Self-Reporting Questionnaire (SRQ-20) e, para avalia a auto-estima, a Escala de Auto-Estima de Rosenberg. A amostra constituiu-se de 1.267 gestantes, que tinham em média 25 anos (dp = 6,53). A média de auto-estima foi de 9,3 pontos (dp = 4,76) e a prevalência de TMC em gestantes foi de 41,4%. Evidenciou-se, também, que quanto menor a auto-estima da grávida maiores são as chances de associação a TMC (p < 0,001). Houve uma significativa associação entre maior prevalência de TMC e baixa auto-estima. The aim of this study was to assess the prevalence of common mental disorders and the association with self-esteem and other factors in pregnant women. A nested cross-sectional study was performed in a cohort of pregnant women treated in the public health system in Pelotas, Rio Grande do Sul State, Brazil. The Self-Reporting Questionnaire (SRQ-20) was used to screen for common mental disorders and the Rosenberg's Self-Esteem Scale for self-esteem. The sample consisted of 1,267 pregnant women with a mean age of 25 years (SD = 6.53). Mean self-esteem was 9.3 points (SD = 4.76), and prevalence of common mental disorders was 41.4%. Lower self-esteem was associated with higher odds of common mental disorders (p < 0.001). There was a significant association between higher prevalence of common mental disorders and low self-esteem.

To assess the association between alcohol abuse during gestation and low birth weight.Cross-sectional, population-based nested study from a cohort of 957 pregnant women who received prenatal assistance through Sistema Único de Saúde (National Health System) in the city of Pelotas, Southern Brazil, and delivered their babies between September 2007 and September 2008. The mothers were interviewed at two distinct moments: prenatal and postpartum periods. In order to verify alcohol abuse, the CAGE (Cut down, Annoyed by criticism, Guilty and Eye-opener) scale was used. Bivariate analyses were carried out, as well as multiple logistic regression adjusted by the variables prematurity and alcohol abuse. The level of significance that was adopted was 95%.Of the women who participated in the study, 2.1% abused alcohol during pregnancy and, among these, 26.3% had low birth weight children. There was an association between alcohol abuse and low birth weight (p0.038).The findings indicate that alcohol abuse during pregnancy is associated with low birth weight.

First sexual intercourse is considered an important event in young people's lives and has occurred at an increasingly early age. The aim of this study was to identify factors associated with early age at first intercourse in individuals 18 to 24 years of age in Pelotas, Rio Grande do Sul State, Brazil. This was a population-based cross-sectional study in a representative sample of 1,621 young people from August 2007 to December 2008. Subjects answered a questionnaire on health behaviors, including items related to their sexual lives. Cox regression was used to assess the association between early age at sexual initiation. After multivariate analysis, variables that are directly related to early sexual initiation were: male gender, low socioeconomic status, low schooling, divorced parents, living with a partner, not practicing a religion, smoking, drug use in the previous three months, and non-use of condoms during last intercourse. Considering the current social context, the study highlights the need for adequate sexual orientation with a preventive approach.

This study aimed to assess the prevalence of common mental disorders (CMD) and their association with quality of life among young adults in Pelotas, Rio Grande do Sul State, Brazil. This was a cross-sectional population-based study of young people 18 to 24 years of age. Sampling used simple cluster selection. Investigation of CMD used the Self-Report Questionnaire (SRQ-20), while quality of life was measured with the Medical Outcomes Survey Short-Form General Health Survey (SF-36). Prevalence of CMD in the study sample was 24.5% (N = 382), and was positively associated with: female gender, lower socioeconomic status (classes D or E), not studying, not working, alcohol consumption, smoking, and substance abuse. Young adults with CMD had lower mean scores on the SF-36 in all the assessed quality of life domains. Measures to prevent CMD are necessary to provide better quality of life for this age group.

O objetivo deste estudo foi avaliar os fatores associados ao número de parceiros sexuais, no último ano, e ao uso de preservativo nas últimas três relações sexuais, entre jovens de quinze e dezoito anos de idade. Trata-se de um estudo transversal com 960 adolescentes. Foram consideradas duas variáveis dicotomizadas como indicativas de comportamentos sexuais de risco: dois ou mais parceiros sexuais nos últimos doze meses e uso ocasional de camisinha nas três últimas relações. Foi investigada a associação destes comportamentos com nível socioeconômico, sexo, escolaridade do adolescente e dos pais, idade, religião, morar com os pais, trabalho remunerado, uso de drogas, tabagismo, consumo de álcool e uso de bebidas alcoólicas na última relação sexual. Para a análise estatística, utilizou-se o modelo de regressão de Poisson. O número de parceiros sexuais nos últimos doze meses associou-se ao sexo, escolaridade do adolescente, uso de drogas ilícitas e cigarro no último mês, assim como consumo de bebida alcoólica antes da última relação sexual. O uso ocasional de preservativo associou-se ao sexo feminino e à baixa escolaridade materna. Os fatores associados ao aumento do número de parceiros sexuais apontam para a forte inter-relação entre comportamentos de risco. The objective of this article is to evaluate the number of sexual partners in the last twelve months and the use of condom in the last three sexual relations of adolescents aged between 15 and 18 years old. It was a cross-sectional study with 960 adolescents. Two dichotomized variables were considered as risk sexual behaviors: two or more sexual partners in the last twelve months, and occasional use of condom in the last three sexual relations. We assessed whether these behaviors were associated with socioeconomic status, gender, adolescent and parental schooling, age, living with the parents, remunerated work, religiosity, drugs use, tobacco, alcohol consumption, alcoholic beverages consume before the last sexual relation. The Poisson regression was used for each outcome. The adolescent gender, schooling, the use of illicit drugs and tobacco in the last month as well as alcoholic beverages consume before the last sexual relation indicates greater risk of keeping sexual relations with two or more partners in the last 12 months. With regard to the occasional use of condom in the last three sexual relations, females and those whose mothers have low schooling presented increased risk. Our study suggests that there is a strong relation between risky behaviors.

A cohort study was conducted with 397 women randomly selected from the Brazilian National System of Public Health, to describe the prevalence rates of infant sleep problems at 12-month of life, and its association with chronicity and severity of maternal depressive symptoms. Mothers were assessed, first, from the 9th to the 12th week postpartum and then at 12 months after delivery, with EPDS and a self-rating questionnaire regarding babies' sleep behavior. After controlling for possible confounders, babies whose mothers had severe chronic depressive symptoms were at higher risk for sleep disorder at 12 months of birth.