Local understandings of PTSD and complex PTSD among health professionals working with adolescents in violent neighbourhoods of Sao Paulo city, Brazil

被引：2

作者：

Massazza, Alessandro ^{[1
]}

de Almeida, Juliana Feliciano ^{[2
]}

Quinlan-Davidson, Meaghen ^{[3
]}

da Silva, Renata Teixeira ^{[4
]}

Devakumar, Delanjathan ^{[3
]}

Tourinho Peres, Maria Fernanda ^{[2
]}

Lewis, Glyn ^{[5
]}

Kiss, Ligia ^{[3
]}

机构：

[1] London Sch Hyg & Trop Med, Dept Hlth Serv Res & Policy, 15-17 Tavistock Pl, London WC1H 9SH, England

[2] Univ Sao Paulo, Sch Med, Dept Prevent Med, Sao Paulo, Brazil

[3] UCL, Inst Global Hlth, London, England

[4] Sao Paulo Municipal Hlth Dept, Med Residency Program Psychiat, Sao Paulo, Brazil

[5] UCL, Div Psychiat, London, England

来源：

BMC PSYCHIATRY | 2022年 / 22卷 / 01期

基金：

英国医学研究理事会;

关键词：

Community violence; Brazil; Adolescents; PTSD; CPTSD; ICD-11; Health professionals; POSTTRAUMATIC-STRESS-DISORDER; MENTAL-HEALTH; COMMUNITY VIOLENCE; EXPOSURE; COMORBIDITY; PREVALENCE; FIELD;

D O I：

10.1186/s12888-022-03821-6

中图分类号：

R749 [精神病学];

学科分类号：

100205 ;

摘要：

Background Adolescents in low-resource urban settings in Brazil are often exposed to high levels of trauma that can result in post-traumatic stress disorder (PTSD). However, preliminary evidence indicates that PTSD tends to be under-reported in Brazilian health services, despite the high prevalence of trauma. Additionally, little is known about the perceived applicability among clinicians of the new ICD-11 diagnosis of complex PTSD (CPTSD), despite its potential relevance for contexts of chronic trauma. The current study investigated local understandings of PTSD and CPTSD among health professionals working with adolescents in violent neighbourhoods of Sao Paulo city. Methods Semi-structured interviews were conducted with 58 health professionals working at both the primary care and specialized mental health levels in two areas of Sao Paulo city with high levels of community violence. Results Most participants knew about PTSD, but most did not know about CPTSD. There were mixed views concerning the commonality of PTSD among adolescents exposed to community violence. Many participants reported having no experience working with patients with the PTSD diagnosis. According to some, community violence was normalized by adolescents and health professionals, and did not result in PTSD. Others highlighted how they did not use psychiatric diagnoses in their practice, had critical perspectives towards psychiatric diagnoses and/or PTSD, or simply knew little about PTSD. Furthermore, many highlighted how the chronic nature of multiple traumas experienced by adolescents often resulted in complex clinical presentations characterised by many symptoms beyond PTSD. The diagnosis of CPTSD was considered appropriate to the context by many participants as it captured the complex traumatic histories and symptom presentations of adolescents exposed to community violence in Brazil. Conclusions These findings have important implications for the assessment and treatment of mental health among adolescents exposed to community violence in Brazil.

引用

页数：15