Resultados de una evaluación y seguimiento online de problemas de salud mental en universitarios chilenos / Results of an online mental health problems screening and follow-up with Chilean university students

Resumen Este estudio examina la detección y posterior seguimiento online de problemas de salud mental en estudiantes universitarios y expone los resultados de ambos procesos. Para ello, se aplicó a través de la plataforma de la universidad a 1 707 estudiantes una batería de cuestionarios destinados a detectar desesperanza y riesgo de suicidio, síntomas depresivos y ansiosos, estrés, trastornos de la conducta alimentaria y apoyo social percibido. Una vez aplicados los instrumentos, los estudiantes recibían una retroalimentación acerca de sus niveles de síntomas e información acerca de redes y establecimientos para buscar ayuda y recibir atención en los casos requeridos. A mediados del año siguiente, se realizó una encuesta de seguimiento a 577 de los estudiantes que previamente habían respondido todos los cuestionarios. Los resultados de la batería de cuestionarios aplicados indican altos índices de problemas de salud mental, con diferencias estadísticamente significativas según sexo, siendo las mujeres quienes presentan mayor prevalencia. Estos resultados concuerdan con diversos estudios que muestran altos porcentajes de síntomas de problemas de salud mental en los universitarios. A su vez, el posterior seguimiento permitió evidenciar que el feedback entregado activó la búsqueda de ayuda, y se obtuvieron correlaciones positivas entre sentirse mejor y haber buscado un tratamiento de salud mental o haber pedido ayuda a los amigos o a la familia. El uso de tecnologías de la información en la detección y prevención de salud mental tendría un alcance positivo y resultó ser una herramienta útil, accesible y cercana para los jóvenes.

Abstract The exponential increase in higher education students and the new university profile that incorporates more vulnerable social groups are associated with an increase in mental health problems in this population. Likewise, the complex stage of the life cycle in which these young people find themselves and the stress of the transition between adolescence and adulthood are other risk factors for the development of mental health problems. The emergence of mental health problems in this group could then be due to a confluence of factors, also facilitating risk behaviors. National and international researches have reported the worrying rates of mental health disorders in university students, mainly in relation to the presence of depression, anxiety, stress, alcohol or drug use, eating disorders, and suicidal ideation. These disorders tend to be aggravated, because the university population is prone not to seek help. The stigma of presenting mental health problems, skepticism about treatments, not wanting to worry the closest family and the few economic resources or not having a health plan, lead to not seeking help or do this late. Studies have found that more than half of students who need mental health and support services are not receiving them. On the other hand, a high percentage seeks help late, which implies that the disorders are accentuated or become chronic, which makes subsequent treatment and improvement difficult, even becoming a public health problem due to the high economic and professional demand that these treatments require.

Social and Economic Factors Associated With Subthreshold and Major Depressive Episode in University Students During the COVID-19 Pandemic.

Depression is one of the most frequent mental health disorders in college students and variations according to social and economic factors have been reported, however, whether social and economic variations also exist in subthreshold depression is still unknown, especially during the COVID-19 pandemic. The aim of this study was to estimate the prevalence of subthreshold depressive episode (SDE) and major depressive episode (MDE) and to examine the association between social and economic factors with SDE and MDE in undergraduate students during the COVID-19 pandemic. The participants were 1,577 college students from a university in the south of Chile (64.6% females, 22 years old on average). The participants took an online survey in November 2020 which collected information about social and economic variables, depressive symptoms, and perceived social support. Bivariate and multinomial logistic regression analysis were used. The results showed a high prevalence of SDE (14.3%) and MDE (32.3%) in the sample. Belonging to a social group and perceiving positive social support were the only variables examined that were associated with SDE. Instead, female sex, poorer quintiles, living with other relatives but not parents, economic difficulties due to the pandemic, being a parent, and perceiving positive social support were associated with MDE. Subthreshold and threshold depressive symptoms are frequent in college students, and associations with social and economic factors differ according to the level of such symptoms. These results should be considered in the development of tailored preventive and early interventions for depression in college students.

Socioeconomic and environmental contexts of suicidal rates in a latitudinal gradient: Understanding interactions to inform public health interventions.

Suicide results from complex interactions between biological, psychological, and socioeconomic factors. At the population level, the study of suicide rates and their environmental and social determinants allows us to disentangle some of these complexities and provides support for policy design and preventive actions. In this study we aim to evaluate the associations between environmental and socioeconomic factors and demographically stratified suicide rates on large temporal and spatial scales. Our dataset contains information about yearly suicides rates by sex and age from 2000 through 2017 along a 4000 km latitudinal gradient. We used zero-inflated negative binomial models to evaluate the spatio-temporal influence of each environmental and socioeconomic variable on suicide rates at each sex/age combination. Overall, we found differential patterns of associations between suicide rates and explanatory variables by age and sex. Suicide rates in men increases in middle and high latitude regions and intermediate age classes. For adolescent and adult women, we found a similar pattern with an increase in suicide rates at middle and high latitudes. Sex differences measured by the male/female suicide ratio shows a marked increase with age. We found that cloudiness has a positive effect on suicide rates in both men and women 24 years old or younger. Regional poverty shows a major impact on men in age classes above 35 years old, an effect that was absent in women. Alcohol and marijuana consumption showed no significant effect sizes. Our findings support high spatio-temporal variability in suicide rates in interaction with extrinsic factors. Several strong differential impacts of environmental and socioeconomic variables on suicide rates depending on sex and age were detected. These results suggest that the design of public policies and interventions to reduce suicide prevalence need to consider the local social and environmental contexts of target populations.

The sustained increase of mental health symptoms in Chilean university students over three years / Aumento sostenido de síntomas de salud mental durante tres años en estudiantes universitarios chilenos

Abstract Given the high rates of mental health problems within the general population and, particularly, the university population, the main goal of this paper is to determine the prevalence of symptoms related to mental health in students at the University Austral de Chile between 2015 and 2017. A convenience sample was taken with a non-experimental correlational design of a transversal character. The final samples were composed of 1631 students in the year 2015, 1518 in 2016 and 1707 in 2017. The Instruments used measured depression, anxiety, stress, hopelessness, alimentary restraint, and functional social support. Reliability analysis, descriptive and polynomial contrast analysis which searched for linear and quadratic trends through ANOVA were perform. The results indicate a sustained rise in the percentages of symptomologies and a decline in the perception of social support. There are also statistically significant differences between men and women surveyed, with women showing more symptoms of depression, anxiety and stress over the three years studied. The results are concurrent with findings on a global level concerning the prevalence of mental health problems in university students. This data has allowed university professionals to better direct their efforts in supporting and treating students and promoting health in general.

Resumen Dadas las altas tasas de problemas de salud mental en población general y en particular, en población universitaria, el objetivo principal de este estudio es determinar la prevalencia de síntomas de salud mental en estudiantes de la Universidad Austral de Chile entre los años 2015 y 2017. Se utilizó un muestreo por conveniencia, con un diseño correlacional no experimental de carácter transversal. Las muestras finales se compusieron de 1631 estudiantes en el año 2015, 1518 en 2016 y 1707 en 2017. Los instrumentos utilizados midieron depresión, ansiedad, estrés, desesperanza, restricción alimentaria y apoyo social funcional. Se realizaron análisis de confiabilidad, descriptivos y de contraste polinómico que buscaron tendencias lineales y cuadráticas a través de ANOVA. Los resultados indican un aumento sostenido en los porcentajes de sintomatologías y una disminución en la percepción del apoyo social. También hay diferencias estadísticamente significativas entre hombres y mujeres encuestados, siendo las mujeres quienes muestran más síntomas de depresión, ansiedad y estrés durante los tres años estudiados. Los resultados coinciden con los hallazgos a nivel mundial sobre la prevalencia de problemas de salud mental en estudiantes universitarios. Estos datos han permitido a los profesionales de la universidad dirigir mejor sus esfuerzos para apoyar y tratar a los estudiantes y promover la salud en general.