BMJ global health · 2026
The science of child and adolescent mental health in Brazil: a nationwide systematic review and compendium of evidence-based resources.
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Marchionatti Lauro Estivalete, Campello André Cardoso, Veronesi Jessica Azevedo, Ziebold Carolina, Tonon André Comiran, Casella Caio Borba, Schafer Julia Luiza, Madyun Aaliyah Nadirah, Caye Arthur, Kieling Christian, Rohde Luis Augusto, Polanczyk Guilherme V, Mari Jair, Rocha Rudi, Rosa Leonardo, Rosa Dayana, Sanchez Zila M, Bressan Rodrigo A, Saxena Shekhar, Evans-Lacko Sara, Cuijpers Pim, Merikangas Kathleen R, Kohrt Brandon A, Bantjes Jason, Reynolds Shirley, Mneimneh Zeina, Salum Giovanni Abrahão
Аннотация
BACKGROUND: Brazil is home to 50 million children and adolescents, whose mental health needs require context-sensitive research. Although scientific output is growing in the country, publications remain scattered and often inaccessible.
METHODS: This systematic review compiles prevalence estimates, assessment instruments and interventions for child and adolescent mental health-related outcomes in Brazil (PROSPERO: CRD42023491393). We searched international (PubMed, Web of Science, PsycINFO, Google Scholar) and regional (Scielo, Lilacs, Brazilian Digital Library of Theses and Dissertations) databases up to July 2024. We consulted reference lists and experts. Extraction followed Consensus-based Standards for the selection of health Measurement Instruments and Cochrane manuals.
RESULTS: We included 734 studies on 2576 prevalence estimates, 908 studies on 912 instruments and 192 studies on 173 intervention trials. The prevalence of any mental disorder ranged from 10.8% (12-year-olds; Pelotas, RS) to 19.9% (ages 7-14; Porto Alegre, RS and São Paulo, SP) although a nationally representative study is lacking. There is an alarming rise in self-harm notifications, reaching 133 in 2019 (per 100 000 aged 10-19). Indigenous youth face suicide rates of 11 (ages 10-14), far exceeding national numbers (0.652). Nationwide surveys reveal severe violence exposure (eg, 21% of adolescents suffer physical violence at home in the previous year), disproportionately impacting Black youth and increasing risk for mental disorders. There are reliable instruments for assessing psychopathology, yet most lack cross-cultural validation. Interventions remain underimplemented. The largest trials adapted substance-use prevention programmes from high-income countries, proving ineffective in Brazil. Public investment is the primary driver of research, which is centralised in wealthier states and misrepresents social minorities.
DISCUSSION: This review provides timely access to appraised evidence-based resources, facilitating uptake into practice. Brazil's historical sociocultural challenges impact youth mental health, with public health priorities including systemic violence, racism and indigenous suicide.
METHODS: This systematic review compiles prevalence estimates, assessment instruments and interventions for child and adolescent mental health-related outcomes in Brazil (PROSPERO: CRD42023491393). We searched international (PubMed, Web of Science, PsycINFO, Google Scholar) and regional (Scielo, Lilacs, Brazilian Digital Library of Theses and Dissertations) databases up to July 2024. We consulted reference lists and experts. Extraction followed Consensus-based Standards for the selection of health Measurement Instruments and Cochrane manuals.
RESULTS: We included 734 studies on 2576 prevalence estimates, 908 studies on 912 instruments and 192 studies on 173 intervention trials. The prevalence of any mental disorder ranged from 10.8% (12-year-olds; Pelotas, RS) to 19.9% (ages 7-14; Porto Alegre, RS and São Paulo, SP) although a nationally representative study is lacking. There is an alarming rise in self-harm notifications, reaching 133 in 2019 (per 100 000 aged 10-19). Indigenous youth face suicide rates of 11 (ages 10-14), far exceeding national numbers (0.652). Nationwide surveys reveal severe violence exposure (eg, 21% of adolescents suffer physical violence at home in the previous year), disproportionately impacting Black youth and increasing risk for mental disorders. There are reliable instruments for assessing psychopathology, yet most lack cross-cultural validation. Interventions remain underimplemented. The largest trials adapted substance-use prevention programmes from high-income countries, proving ineffective in Brazil. Public investment is the primary driver of research, which is centralised in wealthier states and misrepresents social minorities.
DISCUSSION: This review provides timely access to appraised evidence-based resources, facilitating uptake into practice. Brazil's historical sociocultural challenges impact youth mental health, with public health priorities including systemic violence, racism and indigenous suicide.