Prevalência e fatores associados a sintomas ansiosos e depressivos em mulheres privadas de liberdade em Juiz de Fora-MG

Abstract

Psychic suffering and the development of mental disorders in prisons are public health issues recognized worldwide. This population has a worse quality of mental health compared to the general population, with anxiety and depression being the most prevalent mental disorders, with higher prevalence in the incarcerated female population. However, there are few studies that address the issue in this specific population. Most of the studies are on a mixed incarcerated population and do not provide data broken down by gender. The objective was to identify the prevalence of anxious and depressive symptoms and associated factors in cautious women over 18 years of age, in the provisional, closed and semi-open regimes in Juiz de Fora-MG. This is a cross-sectional, census-type study with a sample of 99 women. Data collection was by face-to-face contact, through a semi-structured and multidimensional questionnaire, between September 2019 and February 2020, on the premises of the penal establishment. Outcomes were assessed by the Patient Health Questionannaire-4 (PHQ-4). For the association analysis, a theoretical model of determination was constructed with three hierarchical blocks, being block 1, more proximal, composed of sociodemographic variables, block 2, composed of variables referring to the health of women deprived of liberty, and block 3, more distal, composed of variables related to incarceration. Crude prevalence ratios were estimated using the chi-square test and adjusted for each other within each block (p ≤ 0.20). For the final Poisson regression model with robust variance, p ≤ 0.05 was adopted. The prevalence of anxious and depressive symptoms was, respectively, 75.8% (95%CI 66.1% - 83.8%) and 65.7% (95%CI 55.4% - 74.9%). In the final model, the presence of anxious symptoms was associated with the presence of depressive symptoms, AdjustedPR (95%CI) = 6.42 (1.96 - 21.06). The presence of depressive symptoms was associated with the age group from 20 to 29 years, AdjustedPR (95%CI) = 4.85 (1.48 - 15.87), and with the presence of anxiety symptoms, AdjustedPR (95%CI) = 12.67 (3.92 - 40.98). There was a high prevalence of outcomes. It is noteworthy that the outcomes were mutually associated. As both are subject to intervention, actions to reduce the presence of one of the types of symptoms have the potential to reduce the presence of the other. It is possible to think that the association between the age group from 20 to 29 years and the presence of depressive symptoms is related to the previous history of ignorance and shame about the condition itself, combined with the underdiagnosis of depressive disorder and the lack of adequate treatment. Despite the reduction in the number of factors associated with outcomes in the final model, it was possible to verify that the presence of outcomes dialogues with sociodemographic, health and incarceration conditions, based on the associations verified in the bivariate analysis and in the blocks proposed in the determination model. This study highlights essential elements to reflect on the mental health of women deprived of their liberty, something that is sometimes invisible. Thus, it has the potential to support the development of actions, strategies and public policies aimed at the existing health needs of the study population.