Adriana Loureiro

Suicide in Portugal: Spatial determinants in a context of economic crisis.

This study compares the existing statistical association between suicide mortality and the characteristics of places of residence (municipalities), before and during the current economic crisis, in Portugal. We found that (1) the traditional culture-based North/South pattern of suicidal behaviour has faded away, while the socioeconomic urban/rural divide has become more pronounced; (2) suicide is associated with higher levels of rurality and material deprivation; and (3) recent shifts in suicidal trends may result from the current period of crisis. Strategies targeting rural areas combined with public policies that address area deprivation may have important implications for tackling suicide.

The socio-spatial context as a risk factor for hospitalization due to mental illness in the metropolitan areas of Portugal

Abstract This study’s aims are: (i) identifying spatial patterns for the risk of hospitalization due to mental illness and for the potential risk resulting from contextual factors with influence on mental health; and (ii) analyzing the spatial association between risk of hospitalization due to mental illness and potential risk resulting from contextual factors in the metropolitan areas of Lisbon and Porto, Portugal. A cross-sectional ecological study was conducted by applying statistical methods for assessing spatial dependency and heterogeneity. Results reveal a spatial association between risk of hospitalization due to mental illness and potential risk resulting from contextual factors with a statistical relevance of moderate intensity. 20% of the population under study lives in areas with a simultaneously high potential risk resulting from contextual factors and risk of hospitalization due to mental illness. Porto Metropolitan Area show the highest percentage of population living in parishes with a significantly high risk of hospitalization due to mental health, which puts forward the need for interventions on territory-adjusted contextual factors influencing mental health.This studys aims are: (i) identifying spatial patterns for the risk of hospitalization due to mental illness and for the potential risk resulting from contextual factors with influence on mental health; and (ii) analyzing the spatial association between risk of hospitalization due to mental illness and potential risk resulting from contextual factors in the metropolitan areas of Lisbon and Porto, Portugal. A cross-sectional ecological study was conducted by applying statistical methods for assessing spatial dependency and heterogeneity. Results reveal a spatial association between risk of hospitalization due to mental illness and potential risk resulting from contextual factors with a statistical relevance of moderate intensity. 20% of the population under study lives in areas with a simultaneously high potential risk resulting from contextual factors and risk of hospitalization due to mental illness. Porto Metropolitan Area show the highest percentage of population living in parishes with a significantly high risk of hospitalization due to mental health, which puts forward the need for interventions on territory-adjusted contextual factors influencing mental health.

Short-term impacts of air temperature on hospitalizations for mental disorders in Lisbon

BACKGROUND Individuals with mental disorders are often susceptible to the effects of extreme ambient temperatures. The aim of this study is to assess the short-term impacts of daily mean temperature on hospitalizations for mental disorders in the Lisbon Metropolitan Area, Portugal. METHODS To assess the short-term impacts of daily mean temperature on hospitalizations for mental disorders (2008-2014), a quasi-Poisson generalized additive model combined with a distributed lag non-linear model was applied. The model was adjusted for day of the week, air pollution, relative humidity, time and seasonality. RESULTS The number of hospital admissions for mental disorder during the study period was 30,139. Hospital admissions increase significantly with high temperatures on day of exposure, at lag 0-1 and at lag 0-2. Women are more vulnerable than men, and there was no difference between the age groups studied. CONCLUSIONS The exposure to high temperatures should be considered a significant risk factor for mental disorders; therefore, patient management services may need to be strengthened when extreme high temperature alerts are given.

Mortality from Suicide in the Municipalities of Mainland Portugal: Spatio-Temporal Evolution between 1980 and 2015

INTRODUCTION Suicide is considered a public health priority. It is a complex phenomenon resulting from the interaction of several factors, which do not depend solely on individual conditions. This study analyzes the spatio-temporal evolution of suicide mortality between 1980 and 2015, identifying areas of high risk, and their variation, in the 278 municipalities of Continental Portugal. MATERIAL AND METHODS Based on the number of self-inflicted injuries and deaths from suicide and the resident population, the spatio-temporal evolution of the suicide mortality rate was assessed via: i) a Poisson joinpoint regression model, and ii) spatio-temporal clustering methods. RESULTS The suicide mortality rate evolution showed statistically significant increases over three periods (1980 - 1984; 1999 - 2002 and 2006 - 2015) and two statistically significant periods of decrease (1984 - 1995 and 1995 - 1999). The spatio-temporal analysis identified five clusters of high suicide risk (relative risk >1) and four clusters of low suicide risk (relative risk < 1). DISCUSSION The periods when suicide mortality increases seem to overlap with times of economic and financial instability. The geographical pattern of suicide risk has changed: presently, the suicide rates from the municipalities in the Center and North are showing more similarity with those seen in the South, thus increasing the ruralization of the phenomenon of suicide. CONCLUSION Between 1980 and 2015 the spacio-temporal pattern of mortality from suicide has been changing and is a phenomenon that is currently experiencing a growing trend (since 2006) and is of higher risk in rural areas.

Padrão geográfico e sazonal de internamentos por perturbações mentais

Res_por:A incidencia da doenca mental apresenta variacoes territoriais, entre paises e entre regioes do mesmo pais. Apesar disso, o conhecimento sobre a distribuicao geografica da doenca mental e ainda insuficiente. O objetivo deste trabalho e analisar o padrao espacial e sazonal da morbilidade hospitalar por perturbacoes mentais em Portugal Continental, entre 2008 e 2012. Com base na informacao proveniente da base de dados dos Grupos de Diagnosticos Homogeneos (GDH) fornecida pela Administracao Central do Sistema de Saude (ACSS), foram analisados os internamentos hospitalares cuja principal causa foi perturbacao mental (CID 9: 290-319) ou causa externa (principal) de suicidio e lesao auto-infligida (CID9: E95), agregando a informacao para as 28 NUT III do Continente. Foram calculadas taxas de internamento padronizadas, razoes padronizadas de internamento e testou-se a possivel existencia de aumentos sazonais estatisticamente significativos atraves do teste chi-square goodness of fit. Verificou-se que a morbilidade hospitalar por perturbacoes mentais e superior nas mulheres, principalmente nas classes etarias mais envelhecidas. Foram identificados importantes contrastes territoriais, destacando-se a regiao Centro pelos valores elevados. Contrariamente a maioria das causas de internamento, e de morte, as perturbacoes mentais sao superiores na primavera e verao e muito inferiores no inverno. A identificacao de territorios de risco proporciona importantes informacoes que devem ser incorporadas no desenvolvimento de politicas e estrategias que resultem em melhores resultados em saude.

The Impact of the Economic Crisis On Psychiatric Admissions in Portugal: the Smaile Research Project

Introduction Mental illness results from biological, psychological, social and contextual factors and is influenced by global events such as economic crises. Objectives/Aims To describe the profiles of psychiatric admissions in four Portuguese hospitals located in the metropolitan areas of Lisboa and Porto, and to assess their evolution in 2002, 2007 and 2012, and the changes associated with the economic crisis effects. Methods The information was retrieved from the medical charts of all patients (n= 3,647) admitted at three periods: 2002 (no crisis), 2007 (pre-crisis) and 2012 (crisis). Demographic, social and clinical variables were obtained. The statistical binomial test was used to verify the existence of significantly differences between 2007 and 2012. Results The number of admissions increased from 2007 to 2012, with greater variation (22%) in the Disorders related to substance use (ICD-9: 291, 292, 303, 304 e 305). Statistically significant positive changes were found in the admissions of: i) patients aged 50 to 64 years (17%, p=0.022), divorced (25%, p=0.032), and unemployed (58%, p Conclusions Our findings suggest the influence of the economic crisis in the number and profile of people admitted for mental disorders (greater effect in unemployed patients), and its association with an increase of admissions in people with suicide attempts and suicidal ideation, and particularly in women aged 50 to 64.

O contexto socioespacial como fator de risco de internação por doença mental nas áreas metropolitanas de Portugal

Abstract This study’s aims are: (i) identifying spatial patterns for the risk of hospitalization due to mental illness and for the potential risk resulting from contextual factors with influence on mental health; and (ii) analyzing the spatial association between risk of hospitalization due to mental illness and potential risk resulting from contextual factors in the metropolitan areas of Lisbon and Porto, Portugal. A cross-sectional ecological study was conducted by applying statistical methods for assessing spatial dependency and heterogeneity. Results reveal a spatial association between risk of hospitalization due to mental illness and potential risk resulting from contextual factors with a statistical relevance of moderate intensity. 20% of the population under study lives in areas with a simultaneously high potential risk resulting from contextual factors and risk of hospitalization due to mental illness. Porto Metropolitan Area show the highest percentage of population living in parishes with a significantly high risk of hospitalization due to mental health, which puts forward the need for interventions on territory-adjusted contextual factors influencing mental health.This studys aims are: (i) identifying spatial patterns for the risk of hospitalization due to mental illness and for the potential risk resulting from contextual factors with influence on mental health; and (ii) analyzing the spatial association between risk of hospitalization due to mental illness and potential risk resulting from contextual factors in the metropolitan areas of Lisbon and Porto, Portugal. A cross-sectional ecological study was conducted by applying statistical methods for assessing spatial dependency and heterogeneity. Results reveal a spatial association between risk of hospitalization due to mental illness and potential risk resulting from contextual factors with a statistical relevance of moderate intensity. 20% of the population under study lives in areas with a simultaneously high potential risk resulting from contextual factors and risk of hospitalization due to mental illness. Porto Metropolitan Area show the highest percentage of population living in parishes with a significantly high risk of hospitalization due to mental health, which puts forward the need for interventions on territory-adjusted contextual factors influencing mental health.

El contexto socioespacial como riesgo de hospitalización por enfermedad mental en áreas metropolitanas de Portugal

Abstract This study’s aims are: (i) identifying spatial patterns for the risk of hospitalization due to mental illness and for the potential risk resulting from contextual factors with influence on mental health; and (ii) analyzing the spatial association between risk of hospitalization due to mental illness and potential risk resulting from contextual factors in the metropolitan areas of Lisbon and Porto, Portugal. A cross-sectional ecological study was conducted by applying statistical methods for assessing spatial dependency and heterogeneity. Results reveal a spatial association between risk of hospitalization due to mental illness and potential risk resulting from contextual factors with a statistical relevance of moderate intensity. 20% of the population under study lives in areas with a simultaneously high potential risk resulting from contextual factors and risk of hospitalization due to mental illness. Porto Metropolitan Area show the highest percentage of population living in parishes with a significantly high risk of hospitalization due to mental health, which puts forward the need for interventions on territory-adjusted contextual factors influencing mental health.This studys aims are: (i) identifying spatial patterns for the risk of hospitalization due to mental illness and for the potential risk resulting from contextual factors with influence on mental health; and (ii) analyzing the spatial association between risk of hospitalization due to mental illness and potential risk resulting from contextual factors in the metropolitan areas of Lisbon and Porto, Portugal. A cross-sectional ecological study was conducted by applying statistical methods for assessing spatial dependency and heterogeneity. Results reveal a spatial association between risk of hospitalization due to mental illness and potential risk resulting from contextual factors with a statistical relevance of moderate intensity. 20% of the population under study lives in areas with a simultaneously high potential risk resulting from contextual factors and risk of hospitalization due to mental illness. Porto Metropolitan Area show the highest percentage of population living in parishes with a significantly high risk of hospitalization due to mental health, which puts forward the need for interventions on territory-adjusted contextual factors influencing mental health.

Pre-School Facilities and Catchment Area Profiling: a Planning Support Method

For the effective implementation of social support facilities or infrastructures, knowledge of the physical and sociodemographic characteristics of the catchment area is required. However, it is precisely the definition and profiling of this catchment area that causes the main problems.

Gli spazi verdi urbani e il loro impatto sulla salute della popolazione

Walkable urban green spaces (WUGS) have immediate as well as indirect effects on health, improving not only the general health of the population but also the quality of the environment. However, in creating these new green urban places the health situation is not given due consideration. This article deals with the relationship between green urban places and physical exercise and the impact on public health in the city of Amadora, located in the metropolitan area of Lisbon. The results of this study show interesting relationships between the location of the green areas, the characteristics of the settlements and the types of greenery provided, indicating the necessity of an urgent interdisciplinary effort for the well-being of the future city.