Elton Diniz - Academia.edu (original) (raw)

Papers by Elton Diniz

Research paper thumbnail of A 10-year ecological study of the methods of suicide used by Brazilian adolescents

Cadernos de Saúde Pública

Suicide among adolescents has become a major public health problem worldwide. Our study sought to... more Suicide among adolescents has become a major public health problem worldwide. Our study sought to describe the most commonly used methods of suicide among adolescents aged 10 to 19 years in Brazil between 2006 and 2015. Complete data were obtained from the Brazilian Health Informatics Department (DATASUS) and coded into seven categories of suicide methods. The following statistical analyzes were performed: chi-square (χ 2) tests to examine the association between the frequency of each suicide method and the year; odds ratios (OR) and 95% confidence intervals (95%CI) compared the relative chances of each suicide method occurring between boys and girls. In total, 8,026 suicides among Brazilian adolescents were registered over the analyzed period. The most commonly used method of suicide by both sexes was hang

Research paper thumbnail of Implementation of early psychosis services in Latin America: A scoping review

Early Intervention in Psychiatry

Research paper thumbnail of Population neuroscience: challenges and opportunities for psychiatric research in low- and middle-income countries

Brazilian Journal of Psychiatry

Objective: Population neuroscience is an emerging field that combines epidemiology and neuroscien... more Objective: Population neuroscience is an emerging field that combines epidemiology and neuroscience to study how genes and the environment shape typical and atypical brain functioning. The objective of this study was to review key studies on population neuroscience from low-and middle-income countries (LMICs) and to identify potential gaps vis-à-vis studies conducted in highincome countries. Methods: We conducted a systematic review to search for longitudinal cohort studies investigating the development of psychiatric disorders in children and adolescents in LMICs. We performed an electronic search in the EMBASE and MEDLINE databases from inception to July 5th, 2019. Results: We found six cohorts from four countries that met our search criteria: three cohorts from Brazil, one from China, one from South Africa, and one from Mauritius. Relevant examples of findings from these studies are reported. Conclusion: Our results demonstrate the impact of the valuable science output these cohort designs promote, allowing LMICs to have a share in frontline global psychiatry research. National and international funding agencies should invest in LMIC population neuroscience in order to promote replication and generalization of research from high-income countries.

Research paper thumbnail of The association between adolescent suicide rates and socioeconomic indicators in Brazil: a 10-year retrospective ecological study

Brazilian Journal of Psychiatry

Objective: To examine suicide rates among adolescents from six large cities in Brazil and to anal... more Objective: To examine suicide rates among adolescents from six large cities in Brazil and to analyze the relationship between adolescent suicide rates and socioeconomic indicators between 2006 and 2015. Methods: Generalized estimating equation models were used to assess the impact of socioeconomic factors-including social inequality and unemployment rates-on adolescent suicide rates. Results: The rate of adolescent suicide increased by 24% over the course of the study period. Social inequality (assessed using the Gini index), was positively associated with overall adolescent suicide rates (b = 10.68; 95%CI = 2.32-19.05; p p 0.012). After disaggregating the findings by age (10-14 and 15-19 years), social inequality was associated with suicide rate only for adolescents aged 15-19 years (b = 9.63; 95%CI = 2.31-16.96; p p 0.005). Disaggregating these findings by sex, the association with economic variables became significant only among females. Males had a higher overall suicide rate than females, and the highest rate was observed in male adolescents aged 15-19 years. Higher levels of unemployment were associated with higher suicide rates. Conclusion: Our findings suggest that socioeconomic indicators, particularly unemployment and social inequality, are relevant social determinants of suicide in adolescence.

Research paper thumbnail of Ten-year evolution of suicide rates and economic indicators in large Brazilian urban centers

Current opinion in psychiatry, 2018

This was a retrospective ecological study to examine the relationship between suicide rates and e... more This was a retrospective ecological study to examine the relationship between suicide rates and economic indicators in large Brazilian urban centers. Data on macroeconomic indicators (GDP and unemployment rates) and suicide rates of the largest Brazilian cities were collected from January 2006 to December 2015. Six cities were included in the study: Porto Alegre in the South, Recife and Salvador in the Northeast, and Belo Horizonte, São Paulo and Rio de Janeiro in the Southeast region. We observed a 4% increase in the age-adjusted suicide rate in these large Brazilian urban centers from 2006 to 2015, which is less pronounced than the 9% increase in the national rates of suicide observed in the same period. The effect of economic indicators was heterogeneous among the centers, but, overall, the variation in suicide rates was inversely related to unemployment and did not show a significant relationship with GDP. These findings indicate a more complex link between economics and suicide...

Research paper thumbnail of Schizophrenia and COVID-19: risks and recommendations

Brazilian Journal of Psychiatry

Is my son at risk in view of COVID-19?'' A patient's mother contacted our Schizophrenia Outpatien... more Is my son at risk in view of COVID-19?'' A patient's mother contacted our Schizophrenia Outpatient Clinic as soon as news about the coronavirus pandemic reached Brazilian headlines. I immediately remembered how we hear in mental health services that ''patients with severe mental illness are immune deficient.'' But is this true? What are the implications of the COVID-19 pandemic for schizophrenia patients and their families? Coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has affected over 750,000 people worldwide and has led to 36,405 deaths, 1 becoming a major concern for all health systems. Although the global prevalence of schizophrenia is D 0.4%, 2 it represents a large burden to families and society. These patients also have high mortality rates and comorbid medical conditions. If they are more susceptible to SARS-CoV2 infection, have worse clinical outcomes once contaminated, or have psychotic relapses in the context of the COVID-19 pandemic, there will be an additional burden to a system that is already pressed to the limit. To help families and policy makers make better informed decisions and develop preventive measures, we intend to address the following questions: Are schizophrenia patients at higher risk of: 1) being contaminated; 2) mortality; and 3) suffering a psychotic relapse? Regarding the first question, we performed a literature review through Medline, searching from inception to March 16, 2020. We included original, peer-reviewed articles in English assessing any diagnosis of respiratory infection, regardless of causal agent, among schizophrenia patients. All 315 reports were screened blindly by two authors in two phases (title and abstract; and full-text review), resulting in 18 articles selected for data retrieval. Few reports specifically addressed viral infections. Overall, the articles suggested higher odds of pneumonia and mortality. Although community-acquired pneumonia is nontransmissible, it could indicate immunodeficiency. 3,4 Thus, our search indicated that this population could be at higher risk of developing respiratory infections, especially when

Research paper thumbnail of Differences in community, hospital and intensive care unit-acquired acute kidney injury: observational study in a nephrology service of a developing country

Clinical Nephrology, 2012

Research paper thumbnail of A 10-year ecological study of the methods of suicide used by Brazilian adolescents

Cadernos de Saúde Pública

Suicide among adolescents has become a major public health problem worldwide. Our study sought to... more Suicide among adolescents has become a major public health problem worldwide. Our study sought to describe the most commonly used methods of suicide among adolescents aged 10 to 19 years in Brazil between 2006 and 2015. Complete data were obtained from the Brazilian Health Informatics Department (DATASUS) and coded into seven categories of suicide methods. The following statistical analyzes were performed: chi-square (χ 2) tests to examine the association between the frequency of each suicide method and the year; odds ratios (OR) and 95% confidence intervals (95%CI) compared the relative chances of each suicide method occurring between boys and girls. In total, 8,026 suicides among Brazilian adolescents were registered over the analyzed period. The most commonly used method of suicide by both sexes was hang

Research paper thumbnail of Implementation of early psychosis services in Latin America: A scoping review

Early Intervention in Psychiatry

Research paper thumbnail of Population neuroscience: challenges and opportunities for psychiatric research in low- and middle-income countries

Brazilian Journal of Psychiatry

Objective: Population neuroscience is an emerging field that combines epidemiology and neuroscien... more Objective: Population neuroscience is an emerging field that combines epidemiology and neuroscience to study how genes and the environment shape typical and atypical brain functioning. The objective of this study was to review key studies on population neuroscience from low-and middle-income countries (LMICs) and to identify potential gaps vis-à-vis studies conducted in highincome countries. Methods: We conducted a systematic review to search for longitudinal cohort studies investigating the development of psychiatric disorders in children and adolescents in LMICs. We performed an electronic search in the EMBASE and MEDLINE databases from inception to July 5th, 2019. Results: We found six cohorts from four countries that met our search criteria: three cohorts from Brazil, one from China, one from South Africa, and one from Mauritius. Relevant examples of findings from these studies are reported. Conclusion: Our results demonstrate the impact of the valuable science output these cohort designs promote, allowing LMICs to have a share in frontline global psychiatry research. National and international funding agencies should invest in LMIC population neuroscience in order to promote replication and generalization of research from high-income countries.

Research paper thumbnail of The association between adolescent suicide rates and socioeconomic indicators in Brazil: a 10-year retrospective ecological study

Brazilian Journal of Psychiatry

Objective: To examine suicide rates among adolescents from six large cities in Brazil and to anal... more Objective: To examine suicide rates among adolescents from six large cities in Brazil and to analyze the relationship between adolescent suicide rates and socioeconomic indicators between 2006 and 2015. Methods: Generalized estimating equation models were used to assess the impact of socioeconomic factors-including social inequality and unemployment rates-on adolescent suicide rates. Results: The rate of adolescent suicide increased by 24% over the course of the study period. Social inequality (assessed using the Gini index), was positively associated with overall adolescent suicide rates (b = 10.68; 95%CI = 2.32-19.05; p p 0.012). After disaggregating the findings by age (10-14 and 15-19 years), social inequality was associated with suicide rate only for adolescents aged 15-19 years (b = 9.63; 95%CI = 2.31-16.96; p p 0.005). Disaggregating these findings by sex, the association with economic variables became significant only among females. Males had a higher overall suicide rate than females, and the highest rate was observed in male adolescents aged 15-19 years. Higher levels of unemployment were associated with higher suicide rates. Conclusion: Our findings suggest that socioeconomic indicators, particularly unemployment and social inequality, are relevant social determinants of suicide in adolescence.

Research paper thumbnail of Ten-year evolution of suicide rates and economic indicators in large Brazilian urban centers

Current opinion in psychiatry, 2018

This was a retrospective ecological study to examine the relationship between suicide rates and e... more This was a retrospective ecological study to examine the relationship between suicide rates and economic indicators in large Brazilian urban centers. Data on macroeconomic indicators (GDP and unemployment rates) and suicide rates of the largest Brazilian cities were collected from January 2006 to December 2015. Six cities were included in the study: Porto Alegre in the South, Recife and Salvador in the Northeast, and Belo Horizonte, São Paulo and Rio de Janeiro in the Southeast region. We observed a 4% increase in the age-adjusted suicide rate in these large Brazilian urban centers from 2006 to 2015, which is less pronounced than the 9% increase in the national rates of suicide observed in the same period. The effect of economic indicators was heterogeneous among the centers, but, overall, the variation in suicide rates was inversely related to unemployment and did not show a significant relationship with GDP. These findings indicate a more complex link between economics and suicide...

Research paper thumbnail of Schizophrenia and COVID-19: risks and recommendations

Brazilian Journal of Psychiatry

Is my son at risk in view of COVID-19?'' A patient's mother contacted our Schizophrenia Outpatien... more Is my son at risk in view of COVID-19?'' A patient's mother contacted our Schizophrenia Outpatient Clinic as soon as news about the coronavirus pandemic reached Brazilian headlines. I immediately remembered how we hear in mental health services that ''patients with severe mental illness are immune deficient.'' But is this true? What are the implications of the COVID-19 pandemic for schizophrenia patients and their families? Coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has affected over 750,000 people worldwide and has led to 36,405 deaths, 1 becoming a major concern for all health systems. Although the global prevalence of schizophrenia is D 0.4%, 2 it represents a large burden to families and society. These patients also have high mortality rates and comorbid medical conditions. If they are more susceptible to SARS-CoV2 infection, have worse clinical outcomes once contaminated, or have psychotic relapses in the context of the COVID-19 pandemic, there will be an additional burden to a system that is already pressed to the limit. To help families and policy makers make better informed decisions and develop preventive measures, we intend to address the following questions: Are schizophrenia patients at higher risk of: 1) being contaminated; 2) mortality; and 3) suffering a psychotic relapse? Regarding the first question, we performed a literature review through Medline, searching from inception to March 16, 2020. We included original, peer-reviewed articles in English assessing any diagnosis of respiratory infection, regardless of causal agent, among schizophrenia patients. All 315 reports were screened blindly by two authors in two phases (title and abstract; and full-text review), resulting in 18 articles selected for data retrieval. Few reports specifically addressed viral infections. Overall, the articles suggested higher odds of pneumonia and mortality. Although community-acquired pneumonia is nontransmissible, it could indicate immunodeficiency. 3,4 Thus, our search indicated that this population could be at higher risk of developing respiratory infections, especially when

Research paper thumbnail of Differences in community, hospital and intensive care unit-acquired acute kidney injury: observational study in a nephrology service of a developing country

Clinical Nephrology, 2012