Mental disorders' hospital admissions associated with the economic crisis period in Portugal: Fact or artifact?

Wednesday, 20 August 2014
Exhibit hall (Dena'ina Center)
Paulo J Nogueira, PhD , Directorate-General of Health, Lisboa, Portugal
Andreia J Silva, PhD , Directorate-General of Health, Lisboa, Portugal
Matilde V Rosa, MS , Directorate-General of Health, Lisboa, Portugal
INTRODUCTION:  

The global crisis which flared in the United States in 2008 had a substantial impact in Portugal. The economic situation raised several serious social phenomena. People began to feel upset, worried and stressed with the evolution of Portugal, with the increasing unemployment rates and wages cuts. And as times passes, people’s manifestations are still raging. 

METHODS:  

This study aimed at understanding if the crisis and eventually associated actions affected the number of mental disorders in Portugal mainland. For this study, data was taken from the Database Diagnostic Groups (DRG) referring to general Mental Disorders (ICD-9: 290-319). To better understand the differences of the mental disorders incidence before and after 2008, data was taken from 2000 to 2012 and just for individual aged 25 years or more. A Generalized Linear Model was performed, where the main effects: health region, age group (25 years or more), sex, year, and crisis (period from 2008) were estimated. Afterwards the crisis’s period effect adjusted for the other factors and covariate was removed from model’s predict total number of hospital admissions and results were compared.

RESULTS:  

Results showed a sustainable increase from 2000 to 2012 with a special rise on the year of 2008. Mental Disorders increased from 10657 to 20305, in 2008 there was a rise of 5634 hospitalizations. Comparing predictions differences, with and without the crisis´ period effect (p < 0.001), they were associated with an increase in hospital production for Mental Disorders in about 25% per year, an annual increase of more than 4000 admissions per year.

CONCLUSIONS:  

Though it is not possible to uniquely attribute the observed total excess number of mental disorders’ hospitalizations to the economic crisis it is clearly associated with the respective period. It is of paramount importance to study if there are other causes that may explain this observed difference.