Fatores associados à depressão e às redes de assistência segundo a pesquisa nacional em saúde

Abstract

Depression is one of the most common mental disorders, being one of the conditions that contributes most to the global burden of mental health-related diseases, presenting a significant gap between prevalence and care, whether due to lack of access to effective care, unavailability or inaccessibility of services. The determinants of access to and use of health care networks occur as a result of factors related to the disorder, as well as sociodemographic and cultural features of the population. This paper analyzes the factors associated with depression and care networks according to the National Health Survey. This is a population-based, cross-sectional study, based on a sample of 11,195 Brazilians, 15 years of age or older, who were interviewed in the National Health Survey, conducted by IBGE in partnership with the Ministry of Health, carried out in 2019, with publicly available data. The prevalence of depression was analyzed according to the sociodemographic profile and the behavior of continuity of care for the disorder, with absolute and relative frequencies being estimated. The potential factors associated with depression and care networks, stratified between supplementary health and SUS, were investigated using the chi-square test (X2), considering a p-value <0.001, using Stata software. According to the sociodemographic profile, the factors associated between depression and supplementary health were women (63.8%), elderly (61.2%), married (45.7%), urban residents (85.6%) and unemployed (65.2%); in the public sector, the factors associated were Brazilians with a low level of education (65.5%), residents of the Northeast region (34.8%) and with a family income of up to one minimum wage (62.8%). Among the items of continuity of care in depression, it was found that not having a diagnosis of another mental illness (91.3%) and not having used medication in the week of the interview were the only factors that indicated an association between depression and the public service (SUS); while the distance in the location of the health service (83.4%), resulting in seeking care only when a problem related to the disorder arises (71.9%), treatment with psychotherapy (71.5%) and medication (68.6%) were the factors that demonstrated an association between depression and supplementary health. The results of the study confirmed the prevalence of depression in Brazilians and that the associated factors differ between supplementary health and the SUS both in the sociodemographic profile and in the characteristics of continuity of care, expressing behavioral disparities that impact the health conditions among people affected by the disorder. Knowing the factors associated with depression and the care networks may be predictive of the health behaviors of the population and guide actions to promote mental health and prevent harm, contributing to the development of specific public policies for people with psychological distress.