title: The social adjustment of people with severe mental illness in São Paulo, Brazil.
abstract: OBJECTIVE
  To investigate the social adjustment of individuals with severe mental illness living in the community in a large urban center of a developing country, and the characteristics associated with poor social functioning.
  
  
  METHODS
  A cross-sectional study was performed in the city of Sao Paulo. Eligible subjects were residents of a defined geographic area, aged between 18 and 65, with a diagnosis of functional psychosis who had had contact with any public psychiatric service during a defined period. Structured assessments were used to obtain information on social-demographic characteristics, diagnosis (ICD-10), psychiatric symptoms (PANSS), and social adjustment (DAS).
  
  
  RESULTS
  One hundred and eighty-eight subjects were included, of whom, 120 (63.8%) had some degree of impairment in social functioning. The most frequently affected areas of social functioning were work performance and sexual role. Twenty-four patients (12.8%) showed poor or very poor social adjustment in the month prior to the interview. Negative symptoms, number of previous admissions and general symptoms showed statistically significant associations with global social adjustment scores.
  
  
  CONCLUSIONS
  The proportion of patients showing any degree of impairment in social adjustment was as high as in more developed societies. In order to successfully implement the new mental health policy in Brazil, better provision of community-based mental health services for those with severe mental illnesses is needed.
authors.affiliation: Department of Preventive Medicine, Medical School, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: André
authors.initials: A
authors.lastname: Gulinelli
authors.forename: Lilian R C
authors.initials: LR
authors.lastname: Ratto
authors.forename: Paulo Rossi
authors.initials: PR
authors.lastname: Menezes
mesh_terms: D000328:Adult; D001938:Brazil; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology*; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D012917:Social Adjustment; D012959:Socioeconomic Factors