O uso de psicotrópicos na atenção básica: uma revisão da literatura brasileira dos últimos dez anos (2007-2017)

Abstract

In societies with a great level of social injustice, people living under vulnerable state suffer with lack of basic human rights like housing, health care, adequate nutrition, health and security. The experience of social suffering lived by these people are brought to the medical appointment in the form of sadness, distress or another emotion that could be identify as a common mental disorder, which includes mild forms of depression and anxiety, and be treated accordingly to the diagnosis. So the symptom is treated while there are no changes on the social background, therefore sustaining the condition of lack of assistance. From this perspective, the last ten years literature were reviewed in a qualitative evaluation of psychotropic use characteristics of the Brazilian population. In our results aspects like sex, age and employment status are similar to that presented worldwide. On the other hand, local characteristics could be observed like the predominance of quantitative researches at small to median size cities condensed in specific parts of the country, and the ambiguous reality of underdiagnosed and undertreated groups mixed up with overdiagnosed and overtreated groups and its complicated relationship with specific realities witch make easier or harder obtaining treatment for free or buying it according to local and group characteristics. Only a few researches discussed the relation of health care giver, physician and patient with the prescribed drug, and one alone described the drug as a mechanism of maintaining undersupport. The idea of overprescription appears at an expressive number of researches, but the evidence to support this idea lacks. As a conclusion, the social aspects which aroused this research on the first place, only appears in a small number of articles and are discussed very superficially, suggesting that we pay more attention to the background of our pour patients which suffer from mental disorders on our researches from now on.