Psychometric properties of the Alcohol Use Disorders Identification Test (AUDIT) across cross-cultural subgroups, genders, and sexual orientations: Findings from the International Sex Survey (ISS).

INTRODUCTION: Despite being a widely used screening questionnaire, there is no consensus on the most appropriate measurement model for the Alcohol Use Disorders Identification Test (AUDIT). Furthermore, there have been limited studies on its measurement invariance across cross-cultural subgroups, genders, and sexual orientations. AIMS: The present study aimed to examine the fit of different measurement models for the AUDIT and its measurement invariance across a wide range of subgroups by country, language, gender, and sexual orientation. METHODS: Responses concerning past-year alcohol use from the participants of the cross-sectional International Sex Survey were considered (N = 62,943; Mage: 32.73; SD = 12.59). Confirmatory factor analysis, as well as measurement invariance tests were performed for 21 countries, 14 languages, three genders, and four sexual-orientation subgroups that met the minimum sample size requirement for inclusion in these analyses. RESULTS: A two-factor model with factors describing 'alcohol use' (items 1-3) and 'alcohol problems' (items 4-10) showed the best model fit across countries, languages, genders, and sexual orientations. For the former two, scalar and latent mean levels of invariance were reached considering different criteria. For gender and sexual orientation, a latent mean level of invariance was reached. CONCLUSIONS: In line with the two-factor model, the calculation of separate alcohol-use and alcohol-problem scores is recommended when using the AUDIT. The high levels of measurement invariance achieved for the AUDIT support its use in cross-cultural research, capable also of meaningful comparisons among genders and sexual orientations.

Integrating virtual realities and psychotherapy: SWOT analysis on VR and MR based treatments of anxiety and stress-related disorders.

The use of virtual reality (VR) and mixed reality (MR) technology in clinical psychology is growing. Efficacious VR-based treatments for a variety of disorders have been developed. However, the field of technology-assisted psychotherapy is constantly changing with the advancement in technology. Factors such as interdisciplinary collaboration, consumer familiarity and adoption of VR products, and progress in clinical science all need to be taken into consideration when integrating virtual technologies into psychotherapies. We aim to present an overview of current expert opinions on the use of virtual technologies in the treatment of anxiety and stress-related disorders. An anonymous survey was distributed to a select group of researchers and clinicians, using an analytic framework known as Strengths, Weaknesses, Opportunities, and Threats (SWOT). Overall, the respondents had an optimistic outlook regarding the current use as well as future development and implementation of technology-assisted interventions. VR and MR psychotherapies offer distinct advantages that can overcome shortcomings associated with traditional therapy. The respondents acknowledged and discussed current limitations of VR and MR psychotherapies. They recommended consolidation of existing knowledge and encouraged standardisation in both theory and practice. Continued research is needed to leverage the strengths of VR and MR to develop better treatments.Abbreviations: AR: Augmented Reality; MR: Mixed Reality; RCT: Randomised Controlled Trial; SWOT: Strengths, Weaknesses, Opportunities, and Threats; VR: Virtual Reality; VR-EBT: Virtual Reality Exposure-Based Therapy.

Gender, Sexuality, and Relationships in Young Hispanic People.

This study explores the relation between gender differences and sexuality among young Hispanic people. Eight hundred and forty young people from Spain and Mexico filled out a self-administered questionnaire about sexuality (sexual experience, sexual orientation, and sexual relationships) and gender (self-identification). Men in both Spain and Mexico more commonly report the practice of masturbation and vaginal sex, and are more likely to be unfaithful than women. Women in both countries report more steady partners and longer length of relationships. There were greater gender differences for Mexican men and women than for Spanish men and women in terms of sexual frequency, sexual orientation, and infidelity. Therefore, gender may play an important role in young people's sexuality, more so in Mexico than in Spain.

Cross-Cultural Adult ADHD Assessment in 42 Countries Using the Adult ADHD Self-Report Scale Screener.

OBJECTIVE: We analyzed adult ADHD symptoms in a cross-cultural context, including investigating the occurrence and potential correlates of adult ADHD and psychometric examination of the Adult ADHD Self-Report Scale (ASRS) Screener. METHOD: Our analysis is based on a large-scale research project involving 42 countries (International Sex Survey, N=72,627, 57% women, Mage=32.84; SDage=12.57). RESULTS: The ASRS Screener demonstrated good reliability and validity, along with partial invariance across different languages, countries, and genders. The occurrence of being at risk for adult ADHD was relatively high (21.4% for women, 18.1% for men). The highest scores were obtained in the US, Canada, and other English-speaking Western countries, with significantly lower scores among East Asian and non-English-speaking European countries. Moreover, ADHD symptom severity and occurrence were especially high among gender-diverse individuals. Significant associations between adult ADHD symptoms and age, mental and sexual health, and socioeconomic status were observed. CONCLUSIONS: Present results show significant cross-cultural variability in adult ADHD occurrence as well as highlight important factors related to adult ADHD. Moreover, the importance of further research on adult ADHD in previously understudied populations (non-Western countries) and minority groups (gender-diverse individuals) is stressed. Lastly, the present analysis is consistent with previous evidence showing low specificity of adult ADHD screening instruments and contributes to the current discussion on accurate adult ADHD screening and diagnosis.

Why Do People Watch Pornography? Cross-Cultural Validation of the Pornography Use Motivations Scale (PUMS) and Its Short Form (PUMS-8).

Motivations for pornography use may vary across gender identities, sexual orientations, and geographical regions, warranting examination to promote individual and public health. The aims of this study were to validate the Pornography Use Motivations Scale (PUMS) in a diverse, multicultural sample, and develop a short form (PUMS-8) that can assess a wide range of pornography use motivations. Using data from 42 countries (N = 75,117; Mage = 32.07; SDage = 12.37), enabled us to thoroughly evaluate the dimensionality, validity, and reliability of the Pornography Use Motivations Scale (PUMS), leading to the development of the more concise PUMS-8 short scale. Additionally, language-, nationality-, gender-, and sexual-orientation-based measurement invariance tests were conducted to test the comparability across groups. Both the PUMS and the PUMS-8 assess eight pornography use motivations, and both demonstrated excellent psychometric properties. Sexual Pleasure emerged as the most frequent motivation for pornography use across countries, genders, and sexual orientations, while differences were observed concerning other motivations (e.g. self-exploration was more prevalent among gender-diverse individuals than men or women). The motivational background of pornography use showed high similarity in the examined countries. Both the PUMS and the PUMS-8 are reliable and valid measurement tools to assess different types of motivations for pornography use across countries, genders, and sexual orientations. Both scales are recommended for use in research and clinical settings.

The short version of the Sexual Distress Scale (SDS-3): Measurement invariance across countries, gender identities, and sexual orientations.

Background: The three-item Sexual Distress Scale (SDS-3) has been frequently used to assess distress related to sexuality in public health surveys and research on sexual wellbeing. However, its psychometric properties and measurement invariance across cultural, gender and sexual subgroups have not yet been examined. This multinational study aimed to validate the SDS-3 and test its psychometric properties, including measurement invariance across language, country, gender identity, and sexual orientation groups. Methods: We used global survey data from 82,243 individuals (Mean age=32.39 years; 40.3 % men, 57.0 % women, 2.8 % non-binary, and 0.6 % other genders) participating in the International Sexual Survey (ISS; https://internationalsexsurvey.org/) across 42 countries and 26 languages. Participants completed the SDS-3, as well as questions regarding sociodemographic characteristics, including gender identity and sexual orientation. Results: Confirmatory factor analysis (CFA) supported a unidimensional factor structure for the SDS-3, and multi-group CFA (MGCFA) suggested that this factor structure was invariant across countries, languages, gender identities, and sexual orientations. Cronbach's α for the unidimensional score was 0.83 (range between 0.76 and 0.89), and McDonald's ω was 0.84 (range between 0.76 and 0.90). Participants who did not experience sexual problems had significantly lower SDS-3 total scores (M = 2.99; SD=2.54) compared to those who reported sexual problems (M = 5.60; SD=3.00), with a large effect size (Cohen's d = 1.01 [95 % CI=-1.03, -0.98]; p < 0.001). Conclusion: The SDS-3 has a unidimensional factor structure and appears to be valid and reliable for measuring sexual distress among individuals from different countries, gender identities, and sexual orientations.

Cross-cultural validation and measurement invariance of anxiety and depression symptoms: A study of the Brief Symptom Inventory (BSI) in 42 countries.

BACKGROUND: Depression and anxiety are among the most prevalent mental health issues experienced worldwide. However, whereas cross-cultural studies utilize psychometrically valid and reliable scales, fewer can meaningfully compare these conditions across different groups. To address this gap, the current study aimed to psychometrically assess the Brief Symptomatology Index (BSI) in 42 countries. METHODS: Using data from the International Sex Survey (N = 82,243; Mage = 32.39; SDage = 12.52; women: n = 46,874; 57 %), we examined the reliability of depression and anxiety symptom scores of the BSI-18, as well as evaluated evidence of construct, invariance, and criterion-related validity in predicting clinically relevant variables across countries, languages, genders, and sexual orientations. RESULTS: Results corroborated an invariant, two-factor structure across all groups tested, exhibiting excellent reliability estimates for both subscales. The 'caseness' criterion effectively discriminated among those at low and high risk of depression and anxiety, yielding differential effects on the clinical criteria examined. LIMITATIONS: The predictive validation was not made against a clinical diagnosis, and the full BSI-18 scale was not examined (excluding the somatization sub-dimension), limiting the validation scope of the BSI-18. Finally, the study was conducted online, mainly by advertisements through social media, ultimately skewing our sample towards women, younger, and highly educated populations. CONCLUSIONS: The results support that the BSI-12 is a valid and reliable assessment tool for assessing depression and anxiety symptoms across countries, languages, genders, and sexual orientations. Further, its caseness criterion can discriminate well between participants at high and low risk of depression and anxiety.

Culture as an influence on the perceived risk of HIV infection: a differential analysis comparing young people from Mexico and Spain.

This study analyzes risk behaviors and attitudes related to HIV-AIDS transmission between young people from two Hispanic/Latino culture and origin (Mexico and Spain). For this purpose, 840 participants filled out the AIDS Prevention Questionnaire (Ballester et al., El "Cuestionario de Prevención del Sida (CPS)": Análisis de la fiabilidad y validez. Sociedad Española Interdisciplinaria del Sida, San Sebastián, 2007). From the Theory of reasoned action, our results revealed differences between the risk behaviour profiles of young people depending on their origin or gender, in terms of attitudes and behaviours. For example, Mexican participants have exhibited more levels of perceived risk or severity of HIV while for Spaniards, the fear of HIV was higher. Regarding the perception of condom use, loss of pleasure seems to be an important barrier for both groups of Mexican and Spanish young although others, such as lack of information would be reported only for Mexican women. Regarding self-efficacy, there are no significant differences in general but, in specific cases, we found them: Spanish participants seem to be more comfortable with putting on a condom while Mexican participants are more confident when it comes to buying it. However, these Spanish young people have reported more behavioural intention and present condom use in all sexual practices. In general, predictors of condom use are different depending on gender and origin. Thus, in order to develop effective strategies in AIDS prevention, cultural differences for HIV transmission should be considered even inside the group of Hispanic/Latino young people.

Virtual reality for enhancing the cognitive behavioral treatment of obesity with binge eating disorder: randomized controlled study with one-year follow-up.

BACKGROUND: Recent research identifies unhealthful weight-control behaviors (fasting, vomiting, or laxative abuse) induced by a negative experience of the body, as the common antecedents of both obesity and eating disorders. In particular, according to the allocentric lock hypothesis, individuals with obesity may be locked to an allocentric (observer view) negative memory of the body that is no longer updated by contrasting egocentric representations driven by perception. In other words, these patients may be locked to an allocentric negative representation of their body that their sensory inputs are no longer able to update even after a demanding diet and a significant weight loss. OBJECTIVE: To test the brief and long-term clinical efficacy of an enhanced cognitive-behavioral therapy including a virtual reality protocol aimed at unlocking the negative memory of the body (ECT) in morbidly obese patients with binge eating disorders (BED) compared with standard cognitive behavior therapy (CBT) and an inpatient multimodal treatment (IP) on weight loss, weight loss maintenance, BED remission, and body satisfaction improvement, including psychonutritional groups, a low-calorie diet (1200 kcal/day), and physical training. METHODS: 90 obese (BMI>40) female patients with BED upon referral to an obesity rehabilitation center were randomly assigned to conditions (31 to ECT, 30 to CBT, and 29 to IP). Before treatment completion, 24 patients discharged themselves from hospital (4 in ECT, 10 in CBT, and 10 in IP). The remaining 66 inpatients received either 15 sessions of ECT, 15 sessions of CBT, or no additional treatment over a 5-week usual care inpatient regimen (IP). ECT and CBT treatments were administered by 3 licensed psychotherapists, and patients were blinded to conditions. At start, upon completion of the inpatient treatment, and at 1-year follow-up, patients' weight, number of binge eating episodes during the previous month, and body satisfaction were assessed by self-report questionnaires and compared across conditions. 22 patients who received all sessions did not provide follow-up data (9 in ECT, 6 in CBT, and 7 in IP). RESULTS: Only ECT was effective at improving weight loss at 1-year follow-up. Conversely, control participants regained on average most of the weight they had lost during the inpatient program. Binge eating episodes decreased to zero during the inpatient program but were reported again in all the three groups at 1-year follow-up. However, a substantial regain was observed only in the group who received the inpatient program alone, while both ECT and CBT were successful in maintaining a low rate of monthly binge eating episodes. CONCLUSIONS: Despite study limitations, findings support the hypothesis that the integration of a VR-based treatment, aimed at both unlocking the negative memory of the body and at modifying its behavioral and emotional correlates, may improve the long-term outcome of a treatment for obese BED patients. As expected, the VR-based treatment, in comparison with the standard CBT approach, was able to better prevent weight regain but not to better manage binge eating episodes.

The eleven-item Alcohol, Smoking and Substance Involvement Screening Test (ASSIST-11): Cross-cultural psychometric evaluation across 42 countries.

The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) is an instrument to screen substance-use-related health risks. However, little is known whether the ASSIST could be further shortened while remaining psychometrically sound across different countries, languages, gender identities, and sexual-orientation-based groups. The study aimed to validate a shortened 11-item ASSIST (ASSIST-11). Using the International Sex Survey data, 82,243 participants (M age = 32.39 years) across 42 countries and 26 languages completed questions from the ASSIST-11 regarding gender identity, sexual orientation, and other information. Confirmatory factor analysis (CFA) and multigroup CFA (MGCFA) evaluated the ASSIST-11's structure and tested measurement invariance across groups. Cronbach's α and McDonald's ω were used to examine the internal consistency. Cohen's d and independent t-tests were used to examine known-group validity. The ASSIST-11 was unidimensional across countries, languages, age groups, gender identities (i.e., men, women, and gender-diverse individuals), and sexual orientations (i.e., heterosexual and sexual minority individuals). Cronbach's α was 0.63 and McDonald's ω was 0.68 for the ASSIST-11. Known-group validity was supported by Cohen's d (range between 0.23 and 0.40) with significant differences (p-values<0.001). The ASSIST-11 is a modified instrument with a unidimensional factor structure across different languages, age groups, countries, gender identities, and sexual orientations. The low internal consistency of the ASSIST-11 might be acceptable as it assesses a broad concept (i.e., use of several different substances). Healthcare providers and researchers may use the ASSIST-11 to quickly assess substance-use information from general populations and evaluate the need to follow up with more detailed questions about substance use.

Compulsive sexual behavior disorder in 42 countries: Insights from the International Sex Survey and introduction of standardized assessment tools.

Background and aims: Despite its inclusion in the 11th revision of the International Classification of Diseases, there is a virtual paucity of high-quality scientific evidence about compulsive sexual behavior disorder (CSBD), especially in underrepresented and underserved populations. Therefore, we comprehensively examined CSBD across 42 countries, genders, and sexual orientations, and validated the original (CSBD-19) and short (CSBD-7) versions of the Compulsive Sexual Behavior Disorder Scale to provide standardized, state-of-the-art screening tools for research and clinical practice. Method: Using data from the International Sex Survey (N = 82,243; Mage = 32.39 years, SD = 12.52), we evaluated the psychometric properties of the CSBD-19 and CSBD-7 and compared CSBD across 42 countries, three genders, eight sexual orientations, and individuals with low vs. high risk of experiencing CSBD. Results: A total of 4.8% of the participants were at high risk of experiencing CSBD. Country- and gender-based differences were observed, while no sexual-orientation-based differences were present in CSBD levels. Only 14% of individuals with CSBD have ever sought treatment for this disorder, with an additional 33% not having sought treatment because of various reasons. Both versions of the scale demonstrated excellent validity and reliability. Discussion and conclusions: This study contributes to a better understanding of CSBD in underrepresented and underserved populations and facilitates its identification in diverse populations by providing freely accessible ICD-11-based screening tools in 26 languages. The findings may also serve as a crucial building block to stimulate research into evidence-based, culturally sensitive prevention and intervention strategies for CSBD that are currently missing from the literature.

The use of VR distraction to decrease pain after laparoscopic bariatric surgery: a case study.

One of the advantages of laparoscopic bariatric surgery is the reduced level of postoperative pain. In some cases, however, the pain level may be high. This is a challenge for specialists. This case study explores the use of VR distraction in an 18 year-old patient who had undergone laparoscopic bariatric surgery and who reported pain during the postoperative period. The study was conducted in a Level III Private Hospital in Mexico City where the patient was hospitalized. The patient was administered standard analgesic during VR distraction, which lasted a total of 40 minutes divided into two sessions. The scores of three visual analogue scales and catastrophism were the dependent variables of this study. The scales were administered before and after the VR distraction intervention. The patient reported lower pain levels after VR distraction and reductions in some components of catastrophism. This study proves that VR distraction can be effective not only in reducing the physical component of pain (a notion that is already well established) but also the cognitive/affective component. More controlled studies of the issue are required.

Virtual reality in the treatment of body image disturbances after bariatric surgery: a clinical case.

Bariatric surgery is an operation on the stomach and/or intestines that helps patients with extreme obesity to lose weight. Even if bariatric surgery, compared with traditional obesity treatment, is more effective in reducing BMI, this approach does not achieve equal results in every patient. More, following bariatric surgery common problems are body image dissatisfaction and body disparagement: there is a significant difference between the weight loss clinicians consider successful (50% of excess weight) and the weight loss potential patients expect to achieve (at least 67% of the excess weight). The paper discusses the possible role of virtual reality (VR) in addressing this problem within an integrated treatment approach. More, the clinical case of a female bariatric patient who experienced body dissatisfaction even after a 30% body weight loss and a 62% excess body weight loss, is presented and discussed.

Efficacy of an Early Cognitive-Behavioral Intervention for Acute Stress Disorder in Mexican Earthquake Victims.

Acute stress disorder (ASD) refers to the symptoms associated with posttraumatic stress disorder (PTSD) within the first four weeks following the traumatic event. Recent theoretical models suggest that early detection of ASD provides an opportunity to implement early interventions to prevent the development of PTSD or ameliorate its symptomatology. The aim of the present study was the evaluation of the efficacy of an ASD treatment for earthquake victims, which would serve as an early intervention for PTSD. A single-case (n = 1) quasi-experimental design was used, with pre and post-assessments, as well as one, three and six-month follow-ups, with direct treatment replications. Fourteen participants completed the treatment and the follow-up measurements. The results obtained using a single-case analysis showed significant clinical improvement and clinically significant change when employing a clinical significance analysis and the reliable index of change. Statistical analyses of the dataset displayed statistically significant differences between the pre and post-assessments and the follow-up measures, as well as large effect sizes in all clinical measures. These results suggest that the treatment was an efficacious early intervention for PTSD during the months following the traumatic event, although some relevant study limitations are discussed in the text.

Virtual Reality-Enhanced Cognitive-Behavioral Therapy for Morbid Obesity: A Randomized Controlled Study with 1 Year Follow-Up.

It is well known that obesity has a multifactorial etiology, including biological, environmental, and psychological causes. For this reason, obesity treatment requires a more integrated approach than the standard behavioral treatment based on dietary and physical activity only. To test the long-term efficacy of an enhanced cognitive-behavioral therapy (CBT) of obesity, including a virtual reality (VR) module aimed at both unlocking the negative memory of the body and to modify its behavioral and emotional correlates, 163 female morbidly obese inpatients (body mass index >40) were randomly assigned to three conditions: a standard behavioral inpatient program (SBP), SBP plus standard CBT, and SBP plus VR-enhanced CBT. Patients' weight, eating behavior, and body dissatisfaction were measured at the start and upon completion of the inpatient program. Weight was assessed also at 1 year follow-up. All measures improved significantly at discharge from the inpatient program, and no significant difference was found among the conditions. However, odds ratios showed that patients in the VR condition had a greater probability of maintaining or improving weight loss at 1 year follow-up than SBP patients had (48% vs. 11%, p = 0.004) and, to a lesser extent, than CBT patients had (48% vs. 29%, p = 0.08). Indeed, only the VR-enhanced CBT was effective in further improving weight loss at 1 year follow-up. On the contrary, participants who received only the inpatient program regained back, on average, most of the weight they had lost. Findings support the hypothesis that a VR module addressing the locked negative memory of the body may enhance the long-term efficacy of standard CBT.

Adaptación de la Lista Checable de Trastorno por Estrés Postraumático para DSM-5 en Población Mexicana / Adaptation of the Posttraumatic Stress Disorder Checklist for DSM-5 in Mexican Population

Resumen La Lista Checable de Trastorno por Estrés Postraumático (PCL) ha sido una de las escalas más aplicadas en el ámbito clínico, misma que ha sido adaptada recientemente a los criterios del DSM-5 (PCL-5). Considerando la problemática que representa el TEPT en la población y los cambios recientes propuestos en el DSM-5, resulta importante contar con escalas validadas en México con base a los nuevos criterios diagnósticos descritos. El presente trabajo describe las propiedades psicométricas para la validación en población mexicana de la PCL-5, donde se contó con 204 estudiantes universitarios del sistema abierto de la UNAM, de 18 a 59 años, reclutados a través de una plataforma virtual. Los resultados mostraron una adecuada consistencia interna (.97), así como una validez convergente apropiada (rs = .58 a .88). A su vez, se realizaron distintos análisis factoriales exploratorios y confirmatorios donde se obtuvieron ajustes adecuados a los modelos planteados en el DSM-5 y estudios previos de la escala original. Se concluye que la escala es válida y confiable en población mexicana, lo que la convierte en el único instrumento adaptado al DSM-5 para la evaluación del TEPT en dicho contexto. Sin embargo, se recomiendan estudios adicionales con un mayor control sobre distintos tipos de trauma para mejor descripción del constructo.

Abstract The Posttraumatic Stress Disorder Checklist (PCL) has been one of the most applied scales in the clinical field, which has been recently adapted to the DSM-5 criteria (PCL-5). Considering the problems posed by PTSD in the population and the recent changes proposed in the DSM-5, it is important to have validated scales in Mexican population based on the new diagnostic criteria described. The present work describes the psychometric properties for the validation in Mexican population of the PCL-5, where 204 students from open and distance learning university between 18 and 59 years old participated, recruited through a virtual platform. The results showed an adequate internal consistency (.97), as well as an appropriate convergent validity (rs=.58 to .88). At the same time, different exploratory and confirmatory factor analyses were conducted, where appropriate adjustments to the models proposed in the DSM-5 and previous studies of the original scale were obtained. We conclude that the scale is valid and reliable in the Mexican population, which makes it the only instrument adapted to the DSM-5 for the evaluation of PTSD in this context. However, additional studies with greater control over different types of trauma are recommended for a better description of the construct.

Virtual reality for improving body image disorders and weight loss after gastric band surgery: a case series.

Laparoscopic Adjustable Gastric Banding (LAGB) is a common surgery method used to help obese patients to lose weight. However, even if LAGB is able to produce a durable and relevant weight loss, it is less effective in improving body image: as demonstrated by a recent study, obese patients with a body image disorder in the pre-operative stage continue to show this even 13 months after the operation. In this presentation we will discuss the possible role of virtual reality (VR) in addressing this problem within an integrated cognitive behavioral approach. To test this approach, a case series of three LAGB patient who experienced body dissatisfaction even after a >30/40% excess body weight loss, is presented and discussed. At the end of the 6-week protocol the patients experienced a 15%-20% further reduction of their weight. This reduction was also matched by a general improvement of the psychological state. Both the weight loss and the level of well-being were further improved after a three-month follow-up.

Evaluación de la depresión en pacientes con cáncer terminal y su aplicación en el contexto mexicano: Una revisión / Assessment of depression in patients with terminal cancer and its aplication in the Mexican context: A review

La depresión es uno de los problemas emocionales más frecuentes en pacientes con cáncer terminal. Debido a la evolución de la enfermedad, varios síntomas físicos presentes en los pacientes se pueden yuxtaponer y confundir con los síntomas que permiten identificar de manera taxonómica la depresión, lo cual dificulta la evaluación del problema. El objetivo de este artículo es realizar una revisión de los principales instrumentos utilizados para evaluar la depresión en pacientes con cáncer terminal, junto con sus implicaciones en el contexto mexicano. Con base en la información recabada se puede decir que es más pertinente realizar una evaluación de la depresión enfocada en los aspectos emocionales que en los somáticos. Actualmente existe una gran cantidad de instrumentos para evaluar la depresión que dan mayor énfasis a los aspectos de la anhedonia y las emociones que a los aspectos somáticos de la depresión. En México existe un enorme rezago en el desarrollo de instrumentos que permitan identificar estos síntomas. Se concluye señalando instrumentos alternativos para evaluar la depresión en pacientes con cáncer terminal, estos instrumentos podrían ser evaluados y considerados en un futuro en el contexto de la medicina paliativa.

Depression is one of the most common emotional problems in palliative patients. Due to the advanced nature of the disease, several physical symptoms presented by patients overlap with symptoms of depression, making it difficult to evaluate and diagnose the problem. The aim of this paper was to conduct a narrative review of the main instruments used to assess depression when it is present in palliative patients, with a special consideration of the Mexican context. Based on the available data and the scholarly literature, it is more appropriate to conduct an assessment of depression focused on emotional aspects than somatics aspects in palliative patients. Internationally, a number of depression assessments place greater emphasis on anhedonia and emotions, such as hopelessness, than on somatic aspects of depression. In Mexico, a considerable gap remains in the development of instruments to identify depression in the palliative setting. Finally, we describe alternative assessments of depression, which could be evaluated and considered in the future in the palliative care setting.