Cultural contributions to adults' self-rated mental health problems and strengths: 7 culture clusters, 28 societies, 16 906 adults.

BACKGROUND: It is unknown how much variation in adult mental health problems is associated with differences between societal/cultural groups, over and above differences between individuals. METHODS: To test these relative contributions, a consortium of indigenous researchers collected Adult Self-Report (ASR) ratings from 16 906 18- to 59-year-olds in 28 societies that represented seven culture clusters identified in the Global Leadership and Organizational Behavioral Effectiveness study (e.g. Confucian, Anglo). The ASR is scored on 17 problem scales, plus a personal strengths scale. Hierarchical linear modeling estimated variance accounted for by individual differences (including measurement error), society, and culture cluster. Multi-level analyses of covariance tested age and gender effects. RESULTS: Across the 17 problem scales, the variance accounted for by individual differences ranged from 80.3% for DSM-oriented anxiety problems to 95.2% for DSM-oriented avoidant personality (mean = 90.7%); by society: 3.2% for DSM-oriented somatic problems to 8.0% for DSM-oriented anxiety problems (mean = 6.3%); and by culture cluster: 0.0% for DSM-oriented avoidant personality to 11.6% for DSM-oriented anxiety problems (mean = 3.0%). For strengths, individual differences accounted for 80.8% of variance, societal differences 10.5%, and cultural differences 8.7%. Age and gender had very small effects. CONCLUSIONS: Overall, adults' self-ratings of mental health problems and strengths were associated much more with individual differences than societal/cultural differences, although this varied across scales. These findings support cross-cultural use of standardized measures to assess mental health problems, but urge caution in assessment of personal strengths.

Does tobacco use among adolescents come out of style in Czechia and Slovakia? Findings from the Global Youth Tobacco Survey between 2002 and 2016.

OBJECTIVES: The aim of this study is to analyse Global Youth Tobacco Survey (GYTS) data on a prevalence of tobacco use, indicators of tobacco control and pro-tobacco activities in Czechia and Slovakia between 2002 and 2016. METHODS: GYTS is a school-based survey of students aged 13-15 years carried out in Czechia and Slovakia in 2002/2003, 2007, 2011 and 2016. Standardized uniform questionnaires provided representative data. RESULTS: Between 2002 and 2016 the current cigarette smoking declined both in Czechia and Slovakia (from 34.6% and 26.4% to 15.2% and 17.1%, respectively). Indicators of tobacco control activities either did not change (access to buy cigarettes by minors) or decreased (school-based and mass media interventions). Indicators of pro-tobacco activities declined (being ever offered by a free tobacco product and having something with a tobacco product brand logo on it). CONCLUSIONS: Tobacco use is on decline and the situation becomes similar to the most of European countries. Preventive activities are only partially responsible for the process. Rather effect of global trends accelerated by widespread use of social media can play a role.

Alcohol use and its consequences in the Czech Republic.

OBJECTIVE: Alcohol consumption is associated with substantial public health burden. This article summarises available information on the patterns and prevalence of alcohol use in the Czech Republic with a focus on the heavy alcohol use and its health and social consequences. METHODS: A non-systematic literature review was conducted. The data sources included primarily 3 series of surveys in the adult population, 2 series of surveys in the school population, routine monitoring system of per capita alcohol consumption, routine statistics on alcohol-related morbidity and mortality, and alcohol-related crime. RESULTS: In recent years the registered alcohol consumption in the Czech Republic has been very high; 9.8 litres of pure alcohol were consumed per capita in 2017. Recently, the prevalence of hazardous alcohol consumption in the adult population has reached 16.8-17.6% and harmful alcohol consumption 9.0-9.3%. From 12% to 17% of adult population and 12% of adolescent population were heavy episodic drinkers. Alcohol-related disorders are disproportionately higher (2-3 times) among men. Mortality for alcohol-related causes fully attributable to alcohol (AAF = 100%) and their proportion in overall mortality is on increase. CONCLUSIONS: Alcohol consumption as well as the prevalence of heavy episodic drinking in the Czech Republic belongs among the highest globally. On the other hand, declines in alcohol use have been recently observed among children and adolescents. Available data on alcohol-related morbidity indicate stable situation, though alcohol-related mortality is increasing. Alcohol-related burden is rather underestimated and evidence-based alcohol policy should be increasingly implemented.

Socioeconomic and gender inequalities in smoking. Findings from the Czech National Tobacco Surveys 2012-2015.

OBJECTIVE: Smoking significantly affects morbidity and mortality of the population. The incidence of smoking is determined by gender and socioeconomic status (SES) of an individual. The aim of this study is to analyse the relationship between gender and SES indicators and smoking. METHODS: The analysis is based on data from the Czech National Tobacco Surveys from 2012 to 2015 (N∼1,800 per year). The prevalence of smoking, average daily consumption of cigarettes, initiation ratio and quit ratio were monitored. Smoking habits of the respondents were surveyed using the Czech version of the standard Tobacco Questions for Surveys (TQS) questionnaire. SES was measured by a composite index comprising three variables (level of education, income and job prestige); it had four categories: low, lower-middle, upper-middle, and high. RESULTS: In comparison with women, men had a higher smoking prevalence (OR=1.41, 95% CI=1.09-1.84), higher consumption of cigarettes (B=4.11, 95% CI=1.97-6.26), and higher rate of smoking initiation (OR=1.38, 95% CI=1.10-1.74), but they did not differ in the quit rate (OR=0.85, 95% CI=0.60-1.21). Persons in the low SES category had higher prevalence of smoking and higher initiation ratio compared with those in the high SES category (OR=2.59, 95% CI=1.36-4.97; OR=2.23, 95% CI=1.26-3.95). Cigarette consumption and quit ratio did not differ according to SES. The prevalence of smoking in the years 2012-2014 did not differ; in 2015, it was lower compared to the previous three years. CONCLUSIONS: Inequalities in socioeconomic status affect smoking, which significantly contributes to morbidity and mortality. Measures aimed at reducing inequalities in health must take into account both smoking as a risk factor and socioeconomic status, which affects its occurrence. Programmes to reduce tobacco use should reflect the different needs of individuals with different SES levels. It is especially necessary to seek effective approaches for smokers with low socioeconomic status.

Social Costs of Gambling in the Czech Republic 2012.

Evidence about social costs of gambling is scarce and the methodology for their calculation has been a subject to strong criticism. We aimed to estimate social costs of gambling in the Czech Republic 2012. This retrospective, prevalence based cost of illness study builds on the revised methodology of Australian Productivity Commission. Social costs of gambling were estimated by combining epidemiological and economic data. Prevalence data on negative consequences of gambling were taken from existing national epidemiological studies. Economic data were taken from various national and international sources. Consequences of problem and pathological gambling only were taken into account. In 2012, the social costs of gambling in the Czech Republic were estimated to range between 541,619 and 619,608 thousands EUR. While personal and family costs accounted for 63% of all social costs, direct medical costs were estimated to range from 0.25 to 0.28% of all social costs only. This is the first study which estimates social costs of gambling in any of the Central and East European countries. It builds upon the solid evidence about prevalence of gambling related problems in the Czech Republic and satisfactorily reliable economic data. However, there is a number of limitations stemming from assumptions that were made, which suggest that the methodology for the calculation of the social costs of gambling needs further development.

Methodological Aspects of Trend Studies and Development of the HBSC Study in the Czech Republic.

The aim of the study is to present the theoretical background of trend studies in general, to characterize the international Health Behaviour in School-aged Children (HBSC) study and to describe its methodology and changes of the Czech HBSC study between 1994 and 2014. The first part describes various types of trend research studies including their advantages and disadvantages. The second part summarizes the history of the HBSC study in an international context and particularly in the Czech Republic. The final part presents the basic methodological data from six surveys conducted in the Czech Republic between 1994 and 2014.

Trends in Tobacco Smoking among Czech School-aged Children from 1994 to 2014.

OBJECTIVE: The aim of the article is to examine trends in tobacco consumption among the Czech school-age population. METHODS: For the analysis, data from the Czech Health Behaviour in School-aged Children project, conducted between 1994 and 2014 were used. Trends in tobacco smoking were determined separately for boys and girls, applying the binary logistic regression with survey period as an independent variable for the smoking status. RESULTS: The analysis showed that there have been significant changes in adolescent tobacco smoking for the recent 20 years. While the share of current school-aged smokers was continuously increasing since the mid-1990s, the trend reached its peak in the mid-2000s. CONCLUSION: In recent years, the prevalence of adolescent smokers has significantly declined in the Czech Republic. Despite this recent decline, adolescent smoking remains a major challenge for the national health policy.

Trends in Lifetime Cannabis Use among Czech School-aged Children from 2002 to 2014.

OBJECTIVE: The aim of the study was to examine trends in the prevalence of lifetime cannabis use among the Czech 15-year old students. METHODS: Data from the nationally representative Health Behaviour in School-aged Children Survey, conducted in the Czech Republic in 2002, 2006, 2010 and 2014, were used. Trends in cannabis use among both boys and girls were modelled through binary logistic regression with period as a predictor of the lifetime cannabis use. RESULTS: The prevalence of lifetime cannabis use has significantly decreased among young Czechs, particularly among boys. Gender differences in cannabis use have been also gradually decreasing since 2002, with no significant differences between genders in recent period. CONCLUSIONS: Although there are positive changes in the prevalence of adolescent cannabis use, from the European perspective, Czech students still belong to those with significantly higher rates in this respect. Thus, alongside with the use of other substances, adolescent cannabis consumption remains an important challenge for the national public health policy.

Deinstitutionalised patients, homelessness and imprisonment: systematic review.

BACKGROUND: Reports linking the deinstitutionalisation of psychiatric care with homelessness and imprisonment have been published widely. AIMS: To identify cohort studies that followed up or traced back long-term psychiatric hospital residents who had been discharged as a consequence of deinstitutionalisation. METHOD: A broad search strategy was used and 9435 titles and abstracts were screened, 416 full articles reviewed and 171 articles from cohort studies of deinstitutionalised patients were examined in detail. RESULTS: Twenty-three studies of unique populations assessed homelessness and imprisonment among patients discharged from long-term care. Homelessness and imprisonment occurred sporadically; in the majority of studies no single case of homelessness or imprisonment was reported. CONCLUSIONS: Our results contradict the findings of ecological studies which indicated a strong correlation between the decreasing number of psychiatric beds and an increasing number of people with mental health problems who were homeless or in prison.

Attitudes towards the people with mental illness: comparison between Czech medical doctors and general population.

PURPOSE: Stigma among health care professionals is detrimental to the life of those with mental health problems. In the region of post-communist Europe, the level of stigma among health care providers remains understudied. We aimed to compare attitudes towards people with mental illness between Czech medical doctors and the general population. METHODS: The Community Attitudes towards Mentally Ill (CAMI) scale was used to measure stigmatizing attitudes among a nationally representative sample of (1) adults residing in the Czech Republic (n = 1810) and (2) Czech medical doctors (n = 1200). Descriptive statistics and multivariable linear regression were used to assess differences between both samples. RESULTS: Compared to the general adult population in the Czech Republic, Czech medical doctors demonstrated less stigmatizing attitudes toward people with mental illness in 26 of the 27 CAMI items as well as in the total CAMI score. Medical doctors, however, were more likely to consider mental hospitals as an up-to-date method of treating people with mental illness. CONCLUSIONS: Our findings demonstrate more favourable attitudes towards people with mental illness among Czech medical doctors when compared to the Czech general population. Stigma, however, is high among both these groups.

Effectiveness of a Web-Based Screening and Fully Automated Brief Motivational Intervention for Adolescent Substance Use: A Randomized Controlled Trial.

BACKGROUND: Mid-to-late adolescence is a critical period for initiation of alcohol and drug problems, which can be reduced by targeted brief motivational interventions. Web-based brief interventions have advantages in terms of acceptability and accessibility and have shown significant reductions of substance use among college students. However, the evidence is sparse among adolescents with at-risk use of alcohol and other drugs. OBJECTIVE: This study evaluated the effectiveness of a targeted and fully automated Web-based brief motivational intervention with no face-to-face components on substance use among adolescents screened for at-risk substance use in four European countries. METHODS: In an open-access, purely Web-based randomized controlled trial, a convenience sample of adolescents aged 16-18 years from Sweden, Germany, Belgium, and the Czech Republic was recruited using online and offline methods and screened online for at-risk substance use using the CRAFFT (Car, Relax, Alone, Forget, Friends, Trouble) screening instrument. Participants were randomized to a single session brief motivational intervention group or an assessment-only control group but not blinded. Primary outcome was differences in past month drinking measured by a self-reported AUDIT-C-based index score for drinking frequency, quantity, and frequency of binge drinking with measures collected online at baseline and after 3 months. Secondary outcomes were the AUDIT-C-based separate drinking indicators, illegal drug use, and polydrug use. All outcome analyses were conducted with and without Expectation Maximization (EM) imputation of missing follow-up data. RESULTS: In total, 2673 adolescents were screened and 1449 (54.2%) participants were randomized to the intervention or control group. After 3 months, 211 adolescents (14.5%) provided follow-up data. Compared to the control group, results from linear mixed models revealed significant reductions in self-reported past-month drinking in favor of the intervention group in both the non-imputed (P=.010) and the EM-imputed sample (P=.022). Secondary analyses revealed a significant effect on drinking frequency (P=.037) and frequency of binge drinking (P=.044) in the non-imputation-based analyses and drinking quantity (P=.021) when missing data were imputed. Analyses for illegal drug use and polydrug use revealed no significant differences between the study groups (Ps>.05). CONCLUSIONS: Although the study is limited by a large drop-out, significant between-group effects for alcohol use indicate that targeted brief motivational intervention in a fully automated Web-based format can be effective to reduce drinking and lessen existing substance use service barriers for at-risk drinking European adolescents. TRIAL REGISTRATION: International Standard Randomized Controlled Trial Registry: ISRCTN95538913; http://www.isrctn.com/ISRCTN95538913 (Archived by WebCite at http://www.webcitation.org/6XkuUEwBx).

Reverse asymmetry and changes in brain structural volume of the basal ganglia in ADHD, developmental changes and the impact of stimulant medications.

We discussed the cross section studies and the meta-analysis of published data in children and adolescents with ADHD (both drug naive and receiving stimulant medications), in comparison with healthy children and adolescents of the same age. In children and adolescents with ADHD the deceleration of the maturation dynamics of discrete CNS structures is found, volume reduction and decreased grey matter in prefrontal and occipital regions, which is accompanied by reverse asymmetry of the basal ganglia volume (putamen, nucleus caudate). The above mentioned developmental characteristics are valid only for the ADHD children, who have not been treated by stimulant medications. The stimulant treatment eliminates the mentioned changes into various extend. These developmental changes of CNS structures volume are missing in girls.

Long term pharmacotherapy by methylfenidate or atomoxetine DAT 1 10/10 ADHD children in correlation with results of the imaging methods.

OBJECTIVES: ADHD is one of the most significant diagnostic units in child and adolescent psychiatry. The occurrence in children is 5-6% and 50-80% continued to adult age. The presence of individual genes (polymorphism) on particular symptoms and processes in ADHD are not known. It is estimated that ADHD symptoms are up to 80% to genetic. The higher density of resultant DAT 1 protein was observed in ADHD patients in comparison with controls. The question was if DAT 1 10/10 predicted bad prognoses in long term therapy. METHODS: We compared 30 ADHD DAT 1 10/10 adolescents treated for 5-6 years. Patients with 30 control adolescents. They were the same age of probands and controls. All these subjects were examined by child psychiatry scales (Conners, Achenbach…). Biological changes were tested by MRI specific CNS volumometry. RESULTS: We didn't confirm bad prognoses in long term therapy with methylphenidate or atomoxetine in ADHD children DAT 1 10/10 in long term therapy. In MRI specific CNS volumometry were not identify any differences in controls and ADHD probands. Gray matter thickness was significantly higher in prefrontal and occipital areas in patients compared to control in prefrontal and occipital areas with cluster-wise p-value<0.05. By this method were not identify any cerebrum damage in long term therapy by methylphenidate and atomoxetine.

Substance Use among European Students: East - West Comparison between 1995 and 2011.

AIM: The aim of the study was to investigate long-term trends differences in student substance misuse between countries of former Eastern Bloc (FEB) and Western Europe (WEST). Overall data on student substance misuse gathered in five waves of the European School Survey Project on Alcohol and other Drugs (ESPAD) conducted between 1995 and 2011 were pooled and analysed. Findings were compared between FEB and WEST countries at the five time-points of data collection. METHODS: Over 396,000 of 16 years old students from thirteen FEB and thirteen WEST countries completed anonymous ESPAD questionnaires. The following data were compared by Wilcoxon test: proportion of students with experience of taking a legal drug at less than 13 years of age (early onset), regular tobacco use, emerging signs of alcohol abuse, and differences in prevalence of illegal drug use. RESULTS: Significant differences in selected variables were found in the early onset of legal and illegal drug use between FEB and WEST countries. On the contrary, no significant differences were present when several random samples from the pool of 26 participating countries were drawn and compared. This strengthens our confidence that the differences between FEB and WEST countries did not occur due to chance. CONCLUSIONS: Student drug use in FEB countries tended to follow the trends and patterns of legal and illegal drug use in WEST countries with some time lag. At the times of decline in use of both, legal and illegal substances in the WEST countries, the FEB countries were experiencing increase and later on stabilisation in drug use. The possible explanatory factors including the impact of profound political, cultural and socio-economic changes following the fall of the Iron Curtain in 1989 were discussed. The implications of these trends and suggestions for drug prevention strategies were outlined.

Managing alcohol problems in general practice in Europe: results from the European ODHIN survey of general practitioners.

AIMS: To document the attitudes of general practitioners (GPs) from eight European countries to alcohol and alcohol problems and how these attitudes are associated with self-reported activity in managing patients with alcohol and alcohol problems. METHODS: A total of 2345 GPs were surveyed. The questionnaire included questions on the GP's demographics, reported education and training on alcohol, attitudes towards managing alcohol problems and self-reported estimates of numbers of patients managed for alcohol and alcohol problems during the previous year. RESULTS: The estimated mean number of patients managed for alcohol and alcohol problems during the previous year ranged from 5 to 21 across the eight countries. GPs who reported higher levels of education for alcohol problems and GPs who felt more secure in managing patients with such problems reported managing a higher number of patients. GPs who reported that doctors tended to have a disease model of alcohol problems and those who felt that drinking was a personal rather than a medical responsibility reported managing a lower number of patients. CONCLUSION: The extent of alcohol education and GPs' attitudes towards alcohol were associated with the reported number of patients managed. Thus, it is worth exploring the extent to which improved education, using pharmacotherapy in primary health care and a shift to personalized health care in which individual patients are facilitated to undertake their own assessment and management (individual responsibility) might increase the number of heavy drinkers who receive feedback on their drinking and support to reduce their drinking.

Self-experimentations with psychedelics among mental health professionals: LSD in the former Czechoslovakia.

This article enquires into auto-experiments with psychedelics. It is focused on the experiences and current attitudes of mental health professionals who experimented with LSD in the era of legal research of this substance in the former Czechoslovakia. The objective of the follow-up study presented was to assess respondents' long-term views on their LSD experience(s). A secondary objective was to capture the attitude of the respondents toward the use of psychedelics within the mental health field. A total of 22 individuals participated in structured interviews. None of the respondents reported any long-term negative effect and all of them except two recorded enrichment in the sphere of self-awareness and/or understanding to those with mental disorder(s). Although there were controversies with regard to the ability of preventing possible negative consequences, respondents were supportive towards self-experiments with LSD in mental health sciences. This article is the first systematic examination of the self-experimentation with psychedelics that took place east of the Iron Curtain.

Risky Sexual Behaviour and Sexual Victimization among Young People with Risky Substance Use in Europe-Perspectives from Belgium, Sweden, the Czech Republic, and Germany.

BACKGROUND: Research indicates that among the risks associated with young people's alcohol and illicit drug use are sexual risks. However, insights into co-occurrence of substance use and sexual risks in adolescent samples and possible differences across countries are limited. METHODS: A sample of 1449 adolescents from Belgium, Sweden, the Czech Republic, and Germany screened positive for risky alcohol/illicit drug use in a web-based intervention against alcohol and illicit drug use. They also reported incidents of sex while being drunk and/or high on drugs, condomless sex on these occasions, and sexualized touching and sexual victimization while being drunk or high on drugs. RESULTS: In the sample, 21.5% of the participants reported sexualized touching, 9.9% being victim to sexual assault, and 49.8% having had sex while being drunk and/or high on drugs; of the latter, 48.3% had condomless sex. Reports on having had sex while being drunk and/or high on drugs were associated with higher levels of past 30-day binge drinking. Being a victim of sexual assault was associated with past 30-day binge drinking only in young men. CONCLUSION: When devising preventive interventions against risky substance use in adolescents, an additional focus should be set on integrating steps against sexual risks.

Alcohol consumption and marijuana use in young adult Czechs.

OBJECTIVES: The main objective of the study is to explore associations between alcohol consumption and marijuana use in young adults and to discuss the opportunities for brief intervention. METHODS: Face to face structured interviews were carried out with 2,221 young adult Czechs (mean age 29.9, sd. 5.8 years). 51.4% were males. Alcohol consumption was calculated using beverage specific quantity frequency method. Alcohol-related problems were assessed using the Czech version of the AUDIT. Frequency of marijuana use in the last twelve months was asked as well. RESULTS: The overall alcohol consumption was 9.2 litres of pure alcohol per person and year. The last year prevalence of marijuana use was 21.8%. The use of marijuana positively correlated with the frequency of beer drinking (r = 0.27), frequency of heavy episodic drinking [HED] (r = 0.32) and with the summary score in AUDIT (r = 0.39). Harmful or problem drinkers (AUDIT score > or = 16) reported marijuana use more frequently than moderate drinkers (60% compared to 18.8%; OR = 6.54; 95% CI = 4.7; 9.1). OR for marihuana use in heavy episodic drinkers was 4.3 (95% CI = 3.3; 5.6). DISCUSSION: The results suggest that frequent HED and harmful drinking are closely associated with marijuana use in younger adults. Since marijuana use (including heavy use) is rather common in the Czech Republic, it would be recommendable to also extend screening and brief intervention to reduce the use of cannabis. The existing guidelines for brief intervention should be modified in order to cover marijuana consumption as well.

Do Neighbors Have More Peaceful Students? Youth Violence Profiles among Adolescents in the Czech Republic, Hungary, Poland, and Slovakia.

(1) Background: Co-occurrence or overlaps of different forms or involvement in peer violence among adolescents have been broadly studied. The study aimed to assess adolescents' violence profiles related to bullying, cyberbullying, and fighting in the Czech Republic, Hungary, Poland, and Slovakia. The study was to investigate the pattern of bullying, cyberbullying, and fighting involvement among adolescents in these four countries to test the stability of previously identified profiles. (2) Methods: We analyzed the data from the 2017/2018 international Health Behaviour in School-aged Children survey, which used proportionate sampling among adolescents aged 11-15 years old (n = 24,501). A Latent Class Analysis (LCA) was performed to determine violence profiles in each country. (3) Results: In Slovakia, three distinct latent classes were identified, primarily cyber victims, school bullies, and those involved in multiple forms, and in the Czech Republic, Hungary and Poland bully victims was the fourth class. (4) Conclusions: The findings suggest that peer violence prevention programs in adolescents should consider violence profiles and multiple involvements.

Emotional Dysregulation in Adults from 10 World Societies: An Epidemiological Latent Class Analysis of the Adult-Self-Report.

Background/Objective: Emotional dysregulation (ED) is a dimensional psychological domain, previously operationalized by instruments of the Achenbach System of Empirically Based Assessment (ASEBA) for children and adolescents; however, its cross-cultural and bottom-up characteristics among adult populations are still unknown. Method: We examined scores obtained on the Adult Self-Report (ASR) by 9,238 18- to 59-year-olds from 10 societies that differed in social, economic, geographic, and other characteristics. A Latent Class Analysis was performed on the data from each society. Results: In each society, a dysregulated class (DYS) was identified, which was characterized by elevated scores on most ASR syndromes. The mean prevalence of DYS was 9.2% (6.1-12.7%). The best models ranged from three to five latent classes in the different societies. Conclusions: Although the number of identified classes and the prevalence of ED varied across societies, a DYS class was found in each society, suggesting the need to adopt a dimensional view of psychopathology and a cross cultural perspective also in adult populations.

Contexto/Objetivo: La desregulación emocional (DE) es un ámbito dimensional en Psicología, previamente operacionalizado por los instrumentos del Sistema de Evaluación Basado Empíricamente de Achenbach (ASEBA, por sus siglas en inglés) para niños y adolescentes; sin embargo, aún se desconocen sus características interculturales y su enfoque ascendente en su aplicación a la población adulta. Método: Examinamos las puntuaciones obtenidas en el Autoinforme de Adultos (ASR, por sus siglas en inglés) por 9.238 personas de 18 a 59 años de edad pertenecientes a 10 sociedades que diferían en cuanto a sus características sociales, económicas, geográficas y de otro tipo. Se realizó un Análisis de Clases Latentes con los datos de cada sociedad. Resultados: En cada sociedad se identificó una clase desregulada (DES), que se caracterizaba por puntuaciones elevadas en la mayoría de los síndromes ASR. La prevalencia media de DES fue del 9,2% (6,1-12,7%). Los mejores modelos oscilaron entre tres y cinco clases latentes en las diferentes sociedades. Conclusiones: Aunque el número de clases identificadas y la prevalencia de DE variaron entre las diversas sociedades, se encontró una clase DES en cada sociedad, lo que sugiere la necesidad de adoptar una visión dimensional de la psicopatología y una perspectiva intercultural también en las poblaciones adultas.