Lifetime Prevalence, Age and Gender Distribution and Age-of-Onset of Psychiatric Disorders in the Sao Paulo Metropolitan Area, Brazil: Results from the Sao Paulo Megacity Mental Health Survey

Objectives: To estimate prevalence, age-of-onset, gender distribution and identify correlates of lifetime psychiatric disorders in the Sao Paulo Metropolitan Area (SPMA). Methods: The Sao Paulo Megacity Mental Health Survey assessed psychiatric disorders on a probabilistic sample of 5,037 adult residents in the SPMA, using the World Mental Health Survey Version of the Composite International Diagnostic Interview. Response rate was 81.3%. Results: Lifetime prevalence for any disorder was 44.8%; estimated risk at age 75 was 57.7%; comorbidity was frequent. Major depression, specific phobias and alcohol abuse were the most prevalent across disorders; anxiety disorders were the most frequent class. Early age-of-onset for phobic and impulse-control disorders and later age-of-onset for mood disorders were observed. Women were more likely to have anxiety and mood disorders, whereas men, substance use disorders. Apart from conduct disorders, more frequent in men, there were no gender differences in impulse-control disorders. There was a consistent trend of higher prevalence in the youngest cohorts. Low education level was associated to substance use disorders. Conclusions: Psychiatric disorders are highly prevalent among the general adult population in the SPMA, with frequent comorbidity, early age-of-onset for most disorders, and younger cohorts presenting higher rates of morbidity. Such scenario calls for vigorous public health action.

State of Sao Paulo Research Foundation (FAPESP) [03/00204-3]

State of Sao Paulo Research Foundation (FAPESP)

Vitoria Foundation for Science and Technology (FACITEC) [002/2003]

Vitoria Foundation for Science and Technology (FACITEC)

Sao Paulo State Secretaria de Seguranca Publica, through Professor Wagner Farid Gattaz

Sao Paulo State Secretaria de Seguranca Publica, through Professor Wagner Farid Gattaz

United States National Institute of Mental Health [R01MH070884]

United States National Institute of Mental Health

John D. and Catherine T. MacArthur Foundation

John D. and Catherine T. MacArthur Foundation

Pfizer Foundation

Pfizer Foundation

U.S. Public Health Service [R13-MH066849, R01-MH069864, R01 DA016558]

US Public Health Service

Fogarty International Center

Fogarty International Center [FIRCA R03-TW006481]

Pan American Health Organization

Pan American Health Organization

Eli Lilly & Company Foundation

Eli Lilly & Company Foundation

OrthoMcNeil Pharmaceutical, Inc.

Ortho-McNeil Pharmaceutical, Inc.

GlaxoSmithKline

GlaxoSmithKline

BristolMyers Squibb

Bristol-Myers Squibb

Shire

Shire