Fatores individuais e contextuais associados à depressão autorreferida no Brasil

Abstract

Introduction: Depression is considered a complex and multidimensional phenomenon, which causes disorders that impair quality of life and social life. It is one of the most prevalent health problems worldwide. Brazil leads the ranking of the prevalence of depression among developing nations, pointing out that the forms of illness / mental suffering may have a strong relationship with individual conditions and the social context. Objective: to analyze the association of individual and contextual factors with selfreported depression in the Brazilian population. Methods: cross-sectional study with data from the National Health Survey (2019). The outcome was based on question Q092 (Has any doctor or mental health professional (such as a psychiatrist or psychologist) ever given you a diagnosis of depression?). Among the individual independent variables, sociodemographic, lifestyle and health conditions were considered. The predisposing contextual variables selected were the Human Development Index (HDI) and coverage of primary care. Descriptive and bivariate analysis was performed and Prevalence Ratios were calculated in a multilevel Poisson Regression (95% CI) to verify the association of individual and contextual variables with the outcome. Only variables that showed statistical significance (p <0.05) remained in the final model. All analyzes were performed using the software Stata version 13. Results: The prevalence of depression in the Brazilian population was 9.9% (95%CI 9.5-10.3), and it is associated with being female (PR=2.28), aged 30-59 years ( RP=1.14), divorced (RP=1.26), with higher education (RP=1.70), with per capita income above 3 minimum wages (RP=1.23), living in the urban area ( RP=1.14), who rate their health as fair, bad or very bad (RP=1.89), who have another NCD (RP=2.81), smokers (RP=1.49) and with a time of screen on cell phones of 3 hours or more (RP=1.06). The variables 'Human Development Index (HDI)' and 'primary care coverage' were associated with the outcome, showing that depression is less prevalent in areas with less human development and less coverage of primary care. Conclusion: the findings indicate the high prevalence of depression in Brazil and that this outcome is associated with individual factors and the context of the federation unit. Our results point to the emergency nature of policy planning and the implementation of actions to promote mental health for this portion of the population that aim at intervention based on the prevention of disease and its injuries and on health promotion.