Abstract

Psychiatric diagnoses and STI among severely mental health patients in Brazil: a national multicenter study

H. Nunes¹, C. Machado², M. Guimarães³, L. Campos⁴, F. Acurcio<sup>5

1</sup>Instituto Raul Soares - FHEMIG, Belo Horizonte, Brazil, ²UFMG, CEDEPLAR, Belo Horizonte, Brazil, ³UFMG, DMPS, Belo Horizonte, Brazil, ⁴Hospital Eduardo de Menezes - FHEMIG, Belo Horizonte, Brazil, ⁵UFMG, Faculdade de Farmácia, Belo Horizonte, Brazil

Background: To identify profiles of psychiatric diagnoses (PD) among severely mental health patients (SMHP) with recent risk for HIV and others sexually transmitted infections (STI) in Brazil.
Methods: Cross-sectional study, with a national representative sample of SMHP randomly selected from 26 mental health institutions proportional to type of care (hospital or outpatient) and number of reported AIDS cases by region. Elegibility criteria included age >17 y.o., written consent and ability to answer questionnaire. Socio-demographic, risk behavior and clinical data were obtained from interviews and medical charts. For each medical chart up to three principal PD in the last year were obtained. Profiles of PD were yielded by Grade of Membership model (GoM).
Results: 2475 patients participated and 1238 not always used condom during the last six months (recent risk). Among these patients with risk to STI, 706 were women, 806 outpatients and 632 age >39 y.o. Four profiles were found for PD groups. Individuals that totally resembled characteristics of the profile one had recent risk to STI higher, were mostly females and were mostly with mood disorders and without schizophrenia diagnosis; profile two, indicated a mixed profile of PD (licit or illicit substance use, anxious disorders, personality disorders and others diagnoses), without schizophrenia or mood disorders; profile three was more prevalent and revealed male with schizophrenia without mood disorders; finally, in profile four predominated organic disorders and mental retardation, without schizophrenia or mood disorders.
Conclusions: Mood disorders and schizophrenia were clearly separated in different profiles. Profile one with female patients and mood disorders showed higher recent risk for STI. The public health prevention strategies to STI should observe mental disorders, psychiatry comorbidities and sex diferences, because each PD have special features and should be handled by health providers in different ways.
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