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British Journal of Healthcare and Medical Research - Vol. 9, No. 1

Publication Date: February, 25, 2022

DOI:10.14738/jbemi.91.11873. Gianini, R. J., & Salvestro, G. (2022). Common Mental Disorders and Circulatory Diseases Associated Prevalence: Age Related

Differences from a Health Survey Analysis. British Journal of Healthcare and Medical Research, 9(1). 153-165.

Services for Science and Education – United Kingdom

Common Mental Disorders and Circulatory Diseases Associated

Prevalence: Age Related Differences from a Health Survey

Analysis

Reinaldo José Gianini

Faculty of Health and Medical Sciences

Pontifical Catholic University of São Paulo

Gabriel Salvestro

Faculty of Health and Medical Sciences

Pontifical Catholic University of São Paulo

ABSTRACT

Background: Epidemiological studies reveals that there is a progressive increasing

in the incidence of Mental Disorders. Concomitantly, Circulatory Diseases (CD) are

a major adult health problem worldwide being the leading causes of death. Aims:

This study aims to evaluate aspects related to the prevalence and its association

between Common Mental Disorders (CMD) and CD in different age groups. Methods:

It has been evaluated data from the 2015 São Paulo City Health Survey, which have

classified CMD patients employing the Self Report Questionnaire-20, and have

collected information of referred CD. To analyze the association between CMD and

CD, Pearson chi-square, Satterthwaite corrected tests, univariate and multivariate

Poisson regression has used. Results: Among the elderly, there was a greater

strength of association between CMD and all the CD studied: Hypertension, Angina,

Acute Myocardial Infarction, Cardiac Arrhythmias and Stroke (all with p<0.01). The

CD more strongly associated with CMD was Cardiac Arrhythmias (adjusted PR=2.84;

95%IC=1.75-3.52). For Angina, the CMD was considered important risk factor

because their precocious association (PR=5.42 for 15-29 years of age). Conclusion:

CMD and CD share biopsychosocial factors and result in higher expenses for the

Health System and for those patients. The action of multidisciplinary teams,

especially in the sphere of Primary Care, is essential to reduce damage and better

meet the specific needs of CMD and CD patients, with special attention to young

people with CMD as a risk factor for CD and to elderly people already affected by

such association.

Key words: Circulatory Diseases, Health System, Common Mental Disorders,

Epidemiological Surveys, Mental Health.

BACKGROUND

According to epidemiological studies, there is a progressive increase in the incidence of Mental

Disorders (MD) globally, especially in developing countries (1). Because of this process, it can

be observed that, in 2000, the WHO attributed 12% of the years of lives lost due to disability

because MD worldwide, forecasting the growth of this figure to 15% by 2020 (2). They defined

such disorders as deleterious conditions that manifest on the affective-cognitive functions of

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British Journal of Healthcare and Medical Research (BJHMR) Vol 9, Issue 1, February - 2022

Services for Science and Education – United Kingdom

patients due to biopsychosocial, genetic, physical and chemical disorders, with impact on their

global performance in the personal, social, occupational and family spheres (3). Their impact

on such spheres of life of the affected, together with their prevalent character, makes them

represent five of the ten pathologies most strongly associated with disabilities in the world,

with emphasis on conditions such as depression (13%), alcoholism (7.1%), bipolar disorders

(3.3%) and schizophrenia (4%) (4).

Among the MD the so-called Common Mental Disorders (CMD) stand out, whose clinic does not

fully meet the formal prerequisites for the diagnosis of depression and anxiety recommended

by the DSM-5 and ICD-11 classifications, although even so result in symptoms such as insomnia,

fatigue, somatization, forgetfulness, irritability and difficulty concentrating, having not only

biopsychosocial but also socioeconomic impacts (5–7). CMD present in 14.7 to 21.8% of the

world population (6) may be closely associated with Circulatory Diseases (CD) in order to

participate as an important risk factor for its pathogenesis, and as a result of its chronicity, both

scenarios of worse prognosis compared to the presence of CMD or CD alone (7). The described

association is stronger with aging (7), and is a great challenge for the Health Systems (HS),

especially due to the need for understanding its genesis, for treatments and interventions that

interdisciplinary teams can implement (7–9). CD is a major challenge facing the HS (10), as they

affect more than a third of adult worldwide, generating high costs for their treatment in the

Public Health sphere (11). The WHO considers CD as the leading cause of death around the

world (12). It is necessary to consider for understanding of this process the presence of worse

health conditions demonstrated by individuals from precarious socioeconomic realities,

reinforcing the existence of a pattern of health risk. Thus, the services offered by the HS act by

intervening in the health-disease process so that the inequalities produced by society on health

can be minimized (13). The equity linked with access to such services can be considered,

therefore, stakeholder, however insufficient, to minimize inequalities surrounding the getting

sick (14). Facing all direct and indirect contact with health services, the study of the association

between CMD and CD and its relationship with sociodemographic factors reveals itself as a tool

to identify the most needed population groups, as well as to maximize possibilities of planning

in such a sphere that equity can be achieved (13). These studies, when applied to realities

affected by socioeconomic and geographical inequalities that tear apart most of the

opportunities for maintenance and access to health for certain groups, have their reiterated

importance (15).

In Brazil, the State is legally responsible for strategic planning in health.

The Ministry of Health defined it through the implementation of the National Policy on Primary

Care. Any inhabitant can access health care in an unrestricted way, wherever they reside. That

should act, as a preferential access tool to HS, as well as the Family Health Strategy should

present itself as a model of Primary Care and a key mechanism for its functioning (13).

However, the services in Primary Care are insufficient and incapable of correctly managing such

patients when placed in front of scenarios in which it is necessary MD diagnoses and

treatments. These problems are present in great volume in this sphere of health, demonstrating

the urgency of acquiring knowledge about the management of mental health at this level of care

(16, 17). To this end, it is necessary crucial epidemiological studies mediated by population

surveys, through which their data used for the formulation and evaluation of public health

policies (14).