PREVALENCE OF SELF-REFERRED DEPRESSION IN THE POPULATION BRAZILIAN: INDIVIDUAL AND CONTEXTUAL FACTORS ASSOCIATED IN A MULTILEVEL ANALYSIS
Depression. Disparities in health levels. Socioeconomic Factors. Epidemiological surveys. Multilevel Analysis.
Introduction: Depression is considered a complex and multidimensional phenomenon, which causes disorders that impair quality of life and social life. It is one of the most prevalent health problems worldwide. Brazil leads the ranking of the prevalence of depression among developing nations, pointing out that the forms of illness / mental suffering may have a strong relationship with individual conditions and the social context. Objective: to analyze the association of individual and contextual factors with self-reported depression in the Brazilian population in a multilevel analysis. Methods: cross-sectional study with data from the National Health Survey (2019). The outcome was based on question Q092 (Has any doctor or mental health professional (such as a psychiatrist or psychologist) ever given you a diagnosis of depression?). Among the individual independent variables, sociodemographic, lifestyle and health conditions were considered. The predisposing contextual variables selected were the Human Development Index (HDI) and coverage of primary care. Descriptive and bivariate analysis was performed and Prevalence Ratios were calculated in a multilevel Poisson Regression (95% CI) to verify the association of individual and contextual variables with the outcome. Only variables that showed statistical significance (p <0.05) remained in the final model. All analyzes were performed using the software Stata version 13. Results: The prevalence of depression in the Brazilian population was 9.9% (95% CI 9.5-10.3), and is associated with being female (PR = 2.28), age 30-59 years ( PR = 1.17), divorced (PR = 1.23), with higher education (PR = 1.68), with per capita income above 3 minimum wages (PR = 1.20), living in the urban area ( PR = 1.15), who assess their health as regular, bad or very bad (PR = 1.89), who have another NCD (PR = 2.80), smokers (PR = 1.48) and with screen on cell phones of 3 hours or more (PR = 1.13). Factors such as having black or yellow skin color, not having a pet, being 60 years old or more and living in households with 4 or more residents were associated with a lower prevalence of the outcome. The variables 'Human Development Index (HDI)' and 'coverage of primary care' were associated with the outcome, showing that depression is less prevalent in areas with less human development and with less coverage of primary care. Conclusion: the findings indicate the high prevalence of depression in Brazil and that this outcome is associated with individual factors and the context of the federation unit.