Psicose e Urbanidade: Qual a Relação? Um Estudo Comparativo entre uma Área Urbana e uma Rural em Portugal
DOI:
https://doi.org/10.51338/rppsm.416Palavras-chave:
Perturbações Psicóticas, População Rural, População UrbanaResumo
Introdução: Os estudos sobre urbanidade e psicose apresentam resultados contraditórios. Nos países do Norte da Europa e China existe uma relação positiva; nos países do sul da Europa e países subdesenvolvidos não se encontraram diferenças significativas entre as taxas rurais e urbanas de psicose.
Métodos: Realizamos um estudo retrospetivo observacional, com os doentes admitidos em duas unidades de internamento por primeiro episódio psicótico (PEP) durante 5 anos, numa área rural (Évora) e numa área urbana (Lisboa). Excluímos psicoses afetivas ou orgânicas. Extraímos e analisamos estatisticamente dados sociodemográficos e clínicos.
Resultados: A prevalência de PEP foi igual para ambas as áreas (42/100 000 habitantes), com predomínio de indivíduos desempregados (63%) e sem relacionamento afetivo (81% em Évora versus 72% em Lisboa). A média de idades foi semelhante (43,4 anos vs 41,4 anos). Lisboa apresentou maior diversidade de nacionalidade (16,3% vs 4,6%) e maior taxa de perturbação psicótica devido ao uso de substâncias (26,5% vs 21,6%). O diagnóstico mais prevalente em Lisboa foi perturbação psicótica não especificada (PPNE) (34,7%), enquanto em Évora foram perturbação delirante (PD) (21,5%) e perturbação psicótica aguda e transitória (21,5%). A PD foi um diagnóstico prevalente em ambas as áreas, afetando sobretudo mulheres e com idade média superior. A duração da psicose não tratada (DPNT) inferior a 1 mês
foi maior em Lisboa (24,5% vs 4,5%), mas houve uma elevada prevalência de DPNT superior a 2 anos em ambas as amostras (20,4% vs 23,1%).
Discussão: A idade média de PEP foi superior do que em outros estudos, o que pode traduzir uma prevalência significativa de PD ou refletir uma DPNT mais elevada. Uma reduzida DPNT inferior a 1 mês na área rural pode
ser explicada por maior isolamento da população, menor literacia em saúde ou maior integração dos doentes na comunidade. A prevalência de PPNE foi maior na área urbana, possivelmente por diferentes formas de registos ou uma menor DPNT.
Conclusão: Os resultados estão em linha com estudos reportados em países do sul da Europa, onde não foi encontrada associação entre psicose e urbanidade, sendo necessários mais estudos para elucidar esta questão.
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