Objective: This study aimed to determine the prevalence of benzodiazepine (BZD) use in Brazil and to investigate the direct and indirect effects of alcohol consumption, sedentary lifestyle (SL), depressive symptoms (DS), and sleep dissatisfaction (SD) on BZD use. Methods: The Second Brazilian Alcohol and Drugs Survey (II BNADS) used stratified cluster probabilistic sampling to select 4,607 individuals aged 14 years and older from the Brazilian household population. Results: The lifetime and 12-month prevalence of BZD use was 9.8 and 6.1%, respectively. Older participants (age 40 and older) and women had higher rates. Alcohol use disorder, DS, and SD were significantly more prevalent in BZD users. The parallel multiple mediator model showed a positive direct effect of alcohol consumption on BZD use, with significant positive indirect effects of SL, SD, and DS as simultaneous mediators leading to higher BZD intake. Other statistically significant indirect pathways were DS alone, SD alone, and all of the above except SL. Conclusion: The prevalence of BZD use in Brazil is high compared to that of other countries. Knowledge of the main risk factors and pathways to consumption can guide prevention initiatives and underlie the development of better tailored and effective treatment strategies.

Objective:To describe mortality by suicide among physicians in the state of São Paulo, Brazil, between 2000 and 2009.Methods:Secondary analysis of government mortality data. The variable of interest was “underlying cause of death”, specifically deaths classified by the ICD-10 as intentional self-harm (X60 to X84).Results:The analyses examined 2,297 declarations of death, among which suicide accounted for 50 cases, i.e., 1.7% of all causes of death. Women comprised 13.2% of the total sample and represented 24% of the death-by-suicide group, indicating an overrepresentation of women in the latter (p = 0.02). Deaths by suicide occurred on average 20 years earlier than deaths by other causes (46.8±14.2 years and 68.1±15.8 years, respectively; p = 0.001). There was a significant association between single and/or divorced status and suicide (p < 0.001). The average mortality rate during the study period was 4.2 deaths per 100,000 physicians registered with the Regional Board of Medicine of the State of São Paulo.Conclusion:Deaths by suicide occurred 20 years earlier than deaths by other causes. Medical institutions should develop strategies for the prevention and early detection of mental disorders and occupational stressors that elevate the risk of suicide among physicians.

O presente estudo apresenta a distribuição das causas de morte de médicos do Estado de São Paulo, Brasil, cujos óbitos ocorreram entre os anos de 2000 e 2009. Utilizou-se o banco de dados do Sistema de Informações sobre Mortalidade, do Ministério da Saúde, limitando-se às declarações de óbito cujo campo de ocupação estava preenchido como "médico". As causas básicas de morte foram classificadas de acordo com os capítulos da CID-10. O estudo revela que doenças do aparelho circulatório foram a principal causa de morte entre os médicos na última década, seguidas das neoplasias e doenças do aparelho respiratório. As causas externas constituíram as principais causas de morte abaixo de 40 anos. Câncer da mama foi responsável pela maior parte dos óbitos por neoplasias entre mulheres, enquanto entre os homens a neoplasia de pulmão ocupou a primeira posição. Sugere-se a necessidade de se estimular hábitos adequados de saúde e prevenção de doenças entre os médicos, buscando informar e sensibilizar este grupo de profissionais.

This study presents the distribution of causes of death among physicians in the State of São Paulo, Brazil, from 2000 to 2009. The study used the database of the Mortality Information System, Secretariat of Health Surveillance, Brazilian Ministry of Health, limited to death certificates in which the item on occupation was reported as "physician". Underlying causes of death were classified according to ICD-10 chapters. The study showed that cardiovascular diseases were the leading cause of death among physicians, followed by cancer and respiratory diseases. Under age 40, doctors of both genders died mainly from external causes. Among cancer deaths, breast cancer was the leading cause in women and lung cancer the first cause in men. The results show the need to promote adequate health habits and disease prevention among physicians, seeking to raise awareness in this group of professionals.

El estudio presenta la distribución de las causas de muerte de los médicos en el estado de São Paulo, Brasil, entre los años 2000 y 2009. Se utilizó la base de datos del Sistema de Información sobre Mortalidad del Ministerio de Salud, limitándose a los certificados de defunción, cuya ocupación del finado figuraba como "médico". Las principales causas de muerte fueron clasificadas de acuerdo con los capítulos del CIE-10. El estudio muestra que las enfermedades cardiovasculares son la principal causa de muerte entre los médicos durante la última década, seguido del cáncer y las enfermedades respiratorias. Las causas externas fueron las principales causas de muerte en menores de 40 años. El cáncer de mama es responsable de la mayoría de las muertes por cáncer entre las mujeres, mientras que entre los hombres el cáncer de pulmón ocupa el primer lugar. Se sugiere la necesidad de estimular los hábitos adecuados de salud y prevención de enfermedades entre los médicos, buscando informar y sensibilizar a este colectivo de profesionales.

O presente estudo apresenta a distribuição das causas de morte de médicos do Estado de São Paulo, Brasil, cujos óbitos ocorreram entre os anos de 2000 e 2009. Utilizou-se o banco de dados do Sistema de Informações sobre Mortalidade, do Ministério da Saúde, limitando-se às declarações de óbito cujo campo de ocupação estava preenchido como "médico". As causas básicas de morte foram classificadas de acordo com os capítulos da CID-10. O estudo revela que doenças do aparelho circulatório foram a principal causa de morte entre os médicos na última década, seguidas das neoplasias e doenças do aparelho respiratório. As causas externas constituíram as principais causas de morte abaixo de 40 anos. Câncer da mama foi responsável pela maior parte dos óbitos por neoplasias entre mulheres, enquanto entre os homens a neoplasia de pulmão ocupou a primeira posição. Sugere-se a necessidade de se estimular hábitos adequados de saúde e prevenção de doenças entre os médicos, buscando informar e sensibilizar este grupo de profissionais.

This study presents the distribution of causes of death among physicians in the State of São Paulo, Brazil, from 2000 to 2009. The study used the database of the Mortality Information System, Secretariat of Health Surveillance, Brazilian Ministry of Health, limited to death certificates in which the item on occupation was reported as "physician". Underlying causes of death were classified according to ICD-10 chapters. The study showed that cardiovascular diseases were the leading cause of death among physicians, followed by cancer and respiratory diseases. Under age 40, doctors of both genders died mainly from external causes. Among cancer deaths, breast cancer was the leading cause in women and lung cancer the first cause in men. The results show the need to promote adequate health habits and disease prevention among physicians, seeking to raise awareness in this group of professionals.

El estudio presenta la distribución de las causas de muerte de los médicos en el estado de São Paulo, Brasil, entre los años 2000 y 2009. Se utilizó la base de datos del Sistema de Información sobre Mortalidad del Ministerio de Salud, limitándose a los certificados de defunción, cuya ocupación del finado figuraba como "médico". Las principales causas de muerte fueron clasificadas de acuerdo con los capítulos del CIE-10. El estudio muestra que las enfermedades cardiovasculares son la principal causa de muerte entre los médicos durante la última década, seguido del cáncer y las enfermedades respiratorias. Las causas externas fueron las principales causas de muerte en menores de 40 años. El cáncer de mama es responsable de la mayoría de las muertes por cáncer entre las mujeres, mientras que entre los hombres el cáncer de pulmón ocupa el primer lugar. Se sugiere la necesidad de estimular los hábitos adecuados de salud y prevención de enfermedades entre los médicos, buscando informar y sensibilizar a este colectivo de profesionales.