Time series of hospitalizations of adolescents due to mental and behavioral disorders

Bertelli, Ellen Vanuza Martins; Oliveira, Rosana Rosseto de; Santos, Marcia Lorena Alves dos; Souza, Eniuce Menezes; Fernandes, Carlos Alexandre Molena; Higarashi, Ieda Harumi

doi:10.1590/0034-7167-2018-0800

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ORIGINAL ARTICLE • Rev. Bras. Enferm. 72 (6) • Nov-Dec 2019 • https://doi.org/10.1590/0034-7167-2018-0800 copy

Time series of hospitalizations of adolescents due to mental and behavioral disorders

Serie temporal de las internaciones de adolescentes por trastornos mentales y comportamentales

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to analyze the trend of hospitalizations of adolescents due to mental and behavioral disorders in Paraná, from 1998 to 2015.

Method:

ecological study of time series. Data were analyzed by means of segmented linear regression modeling for time series, estimated for each of the four health macro-regions.

Results:

the East macro-region showed a greater trend to increase hospitalizations from January 1998 to November 2003 (β₁=0.006, p<0.001). In other macro-regions, there were similar trends with a sudden increase in February 2010, but with a further gradual decrease until December 2015. In the quadrennium 2012-2015, 38.06% of the hospitalizations lasted 29 or more days, and in the Northwest macro-region, hospitalizations lasted for up to seven days. The main cause of hospitalization was the use of alcohol and other drugs.

Conclusion:

there is a need to strengthen health actions to prevent drug use and improvements in the care network.

Descriptors:
Adolescent, Hospitalized; Mental disorders; Epidemiology; Health Policy; Mental Health

Parameters	Estimate	Standard Error	t value	p value	Trend
East
β₀	1.088	0.055	19.838	<0.001	1.088
β₁	0.006	0.001	5.587	<0.001	0.006
β₂	-0.027	0.002	-13.845	<0.001	-0.02
β₃	1.571	0.094	16.646	<0.001	-
β₄	0.018	0.003	5.628	<0.001	-0.002
β₅	-0.045	0.006	-8.032	<0.001	-0.048
North
β₀	0.58	0.05	11.679	<0.001	0.58
β₁	-0.002	0.001	-1.719	0.087	-0.002
β₂	-0.004	0.002	-2.526	0.012	-0.006
β₃	1.792	0.089	20.106	<0.001	-
β₄	-0.02	0.003	-5.938	<0.001	-0.026
β₅	0.012	0.005	2.344	0.02	-0.014
West
β₀	0.6	0.05	11.973	<0.001	0.6
β₁	-0.002	0.001	-3.773	<0.001	-0.002
β₂	2.152	0.088	24.359	<0.001	-
β₃	-0.025	0.002	-13.478	<0.001	-0.027
Northwest
β₀	0.562	0.054	10.448	<0.001	0.562
β₁	0.002	0.001	3.417	0.001	0.002
β₂	1.366	0.096	14.288	<0.001	-
β₃	-0.026	0.002	-12.998	<0.001	-0.024

	1998 – 2001		2005 - 2008		2012 – 2015		Total
	n	%	n	%	n	%	n	%
Paraná
0 a 7 days	932	18.84	1273	39.01	1257	24.30	3462	25.87
8 a 28 days	2860	57.81	1310	40.15	1947	37.64	6117	45.71
≥ 29 days	1155	23.35	680	20.84	1969	38.06	3804	28.42
Total	4947	36.96	3263	24.38	5173	38.65	13383	100.00
East macro-region
0 a 7 days	646	19.55	733	37.86	364	15.14	1743	22.80
8 a 28 days	2003	60.61	856	44.21	763	31.73	3622	47.37
≥ 29 days	656	19.85	347	17.92	1278	53.14	2281	29.83
Total	3305	43.22	1936	25.32	2405	31.45	7646	100.00
North macro-region
0 a 7 days	84	16.83	44	27.50	168	25.00	296	22.24
8 a 28 days	274	54.91	60	37.50	304	45.24	638	47.93
≥ 29 days	141	28.26	56	35.00	200	29.76	397	29.83
Total	499	37.49	160	12.02	672	50.48	1331	100.00
West macro-region
0 a 7 days	96	16.49	64	18.34	300	26.43	460	22.27
8 a 28 days	305	52.41	153	43.84	554	48.81	1012	48.98
≥ 29 days	181	31.10	132	37.82	281	24.76	594	28.75
Total	582	28.17	349	16.89	1135	54.93	2066	100.00
Northwest macro-region
0 a 7 days	106	18.89	432	52.81	425	44.22	963	41.15
8 a 28 days	278	49.55	239	29.22	326	33.92	843	36.03
≥ 29 days	177	31.55	147	17.97	210	21.85	534	22.82
Total	561	23.97	818	34.95	961	41.06	2340	100.00

	1998 – 2001		2005 – 2008		2012 – 2015		Total
	n	%	n	%	n	%	n	%
Paraná
Mental and behavioral disorders due to the use of psychoactive substances	2410	48.72	1820	55.78	3329	64.35	7559	56.48
Schizophrenia, schizotypal disorders and delusional disorders	1600	32.34	706	21.64	849	16.41	3155	23.57
Mood disorders	237	4.79	304	9.32	408	7.89	949	7.09
Organic mental disorders, including symptomatic mental disorders	284	5.74	233	7.14	172	3.32	689	5.15
Intellectual Disability	199	4.02	53	1.62	165	3.19	417	3.12
Other Diagnosis	217	4.39	147	4.51	250	4.83	614	4.59
Total	4947	100.0	3263	100.0	5173	100.00	13383	100.00
East macro-region
Mental and behavioral disorders due to the use of psychoactive substances	1873	56.67	1178	60.85	1524	63.37	4575	59.84
Schizophrenia, schizotypal disorders and delusional disorders	1016	30.74	426	22.00	606	25.20	2048	26.79
Mood disorders	149	4.51	199	10.28	164	6.82	512	6.70
Organic mental disorders, including symptomatic mental disorders	108	3.27	56	2.89	29	1.21	193	2.52
Intellectual Disability	53	1.60	10	0.52	23	0.96	86	1.12
Other Diagnosis	106	3.21	67	3.46	59	2.45	232	3.03
Total	3305	100.0	1936	100.0	2405	100.00	7646	100.00
North macro-region
Mental and behavioral disorders due to the use of psychoactive substances	119	23.85	41	25.63	480	71.43	640	48.08
Schizophrenia, schizotypal disorders and delusional disorders	179	35.87	60	37.50	40	5.95	279	20.96
Mood disorders	22	4.41	8	5.00	38	5.65	68	5.11
Organic mental disorders, including symptomatic mental disorders;	84	16.83	36	22.50	57	8.48	177	13.30
Intellectual Disability	63	12.63	1	0.63	26	3.87	90	6.76
Other Diagnosis	32	6.41	14	8.75	31	4.61	77	5.79
Total	499	100.0	160	100.0	672	100.00	1331	100.00
West macro-region
Mental and behavioral disorders due to the use of psychoactive substances	253	43.47	188	53.87	781	68.81	1222	59.15
Schizophrenia, schizotypal disorders and delusional disorders	194	33.33	92	26.36	93	8.19	379	18.34
Mood disorders	31	5.33	34	9.74	86	7.58	151	7.31
Organic mental disorders, including symptomatic mental disorders;	56	9.62	19	5.44	33	2.91	108	5.23
Intellectual Disability	8	1.37	9	2.58	74	6.52	91	4.40
Other Diagnosis	40	6.87	7	2.01	68	5.99	115	5.57
Total	582	100.0	349	100.0	1135	100.00	2066	100.00
Northwest macro-region
Mental and behavioral disorders due to the use of psychoactive substances	166	29.59	413	50.49	544	56.61	1123	47.99
Schizophrenia, schizotypal disorders and delusional disorders	211	37.61	128	15.65	110	11.45	449	19.19
Mood disorders	35	6.24	63	7.70	120	12.49	218	9.32
Organic mental disorders, including symptomatic mental disorders;	36	6.42	122	14.91	53	5.52	211	9.02
Intellectual Disability	75	13.37	33	4.03	42	4.37	150	6.41
Other Diagnosis	38	6.77	59	7.21	92	9.57	189	8.08
Total	561	100.0	818	100.0	961	100.00	2340	100.00

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[1] Corresponding Author: Ellen Vanuza Martins Bertelli. E-mail: ellenvanuza@gmail.com