Determinantes sociales asociados con ideación suicida durante la pandemia por Covid-19 en México.

OBJETIVO: Estimar la prevalencia de la ideación suicida (IS) y su asociación con los determinantes sociales (DS) en la pobla-ción mexicana durante la pandemia de Covid-19. Material y métodos. Datos de la encuesta de Atención Psicológica a Distancia para la Salud Mental debido a la Contingencia por Covid-19 obtenidos durante 2020. La muestra fue de 79 665. Se realizaron modelos de regresión logística obteniendo razones de momios (RM) con intervalos de confianza del 95% (IC95%). RESULTADOS: La prevalencia de IS fue de 17.1% (mujeres:18.8% y hombres: 14.4%). Principales DS asociados fueron: ser mujer (RM=1.11; IC95% 1.06,1.13), mujeres jóvenes (RM=1.30; IC95% 1.09,1.54), escolaridad (RM=1.89; IC95% 1.14,3.12), soltera(o) (RM= 1.31; IC95% 1.24,1.38), desempleo (RM= 2.33; IC95% 2.21,2.45), distanciamiento social (RM 1.81; IC95%1.68,1.96), vivir solo (RM 1.18; IC95% 1.10,1.27), pérdida de familiar por Covid-19 (RM= 1.41; IC95%1.30,1.54), tener un diagnóstico de depresión (RM= 5.72; IC95% 5.41,6.05), ser víctima de violencia física (RM=2.71; IC95% 2.49,2.95), consumo excesivo de alcohol (RM=1.68; IC95%1.58,1.79) y drogas (RM= 3.13; IC95% 2.88,3.41), y sospecha o diagnóstico de Covid-19 (RM=1.79; IC95% 1.67,1.89). CONCLUSIONES: La prevalencia de IS durante la pandemia por Covid-19 fue elevada; se discute la relevancia de los DS estructurales e intermedios que influyen en la IS.

Eventos de vida estresantes y su efecto en la conducta suicida en mujeres durante la pandemia por Covid-19 en México.

OBJETIVO: Analizar la estructura factorial, la validez convergente y divergente de la Escala Columbia de Severidad Suicida (CSSRS) y el Cuestionario de Eventos de Vida Estresantes (EVE) y medir la asociación entre EVE y conducta suicida (CS) en mujeres mexicanas durante la pandemia por Covid-19. Material y métodos. Se usaron datos de 2 398 mujeres que participaron en un estudio multicéntrico, realizado en México entre mayo y octubre de 2021. La información se recolectó mediante un cuestionario en línea que incluyó la CSSRS y el EVE. Se hizo un análisis factorial confirmatorio para valorar el ajuste de los modelos. RESULTADOS: El modelo final mostró asociación entre los EVE y la CS, y tuvo a la violencia como variable central. Dicho modelo presentó un ajuste adecuado (CFI = 0.950, IFI = 0.950, MFI = 0.975, RMSEA = 0.031, CI RMSEA = 0.026-0.036). CONCLUSIONES: La pandemia por Covid-19 evidenció la necesidad de crear e implementar estrategias que promuevan el cuidado de la salud mental, reduzcan la exposición a la violencia y faciliten los procesos de duelo para prevenir la CS en mujeres mexicanas.

Estudio de la calidad de vida en cuidadores familiares de personas con discapacidad intelectual.

OBJETIVO: Explorar las experiencias y percepciones de la calidad de vida (CV) en cuidadores familiares (CF) de personas con discapacidad intelectual (PDI) en Morelos y Sinaloa, México. Material y métodos. Estudio cualitativo. Se realizaron 18 entrevistas semiestructuradas a CF de PDI que asistían a escuelas básicas públicas en Huitzilac, Morelos y Culiacán, Sinaloa, México. Se realizó análisis de contenido con apoyo del programa ATLAS.ti.8.0. RESULTADOS: Los CF experimentaron un deterioro en distintas dimensiones: bienestar emocional, físico y material, desarrollo personal, autodeterminación y relaciones interpersonales, deterioro que afecta negativamente su CV. Los lazos de empatía, acompañamiento y motivación con otros CF son beneficiosos y los libera de actividades por lapsos breves, disminuyendo así la carga del cuidado de una PDI. CONCLUSIONES: Cuidar a una PDI puede afectar negativamente la CV de las y los CF. Se sugiere el desarrollo de intervenciones para atención, apoyo y orientación integral; asimismo, crear y fortalecer grupos de ayuda mutua con otros cuidadores.

Factores asociados con el consumo excesivo de alcohol: Encuesta Nacional de Salud y Nutrición 2020 sobre Covid-19.

Objetivo. Conocer la magnitud del consumo excesivo de alcohol (CEA) y su asociación con los factores individuales, familiares y sociales entre agosto y noviembre de 2020 en México. Material y métodos. Con base en los datos de la Encuesta Nacional de Salud y Nutrición 2020 sobre Covid-19, se analizaron 8 595 adultos mayores de 20 años. Se estimaron modelos de regresión logística estratificados por sexo y se obtuvieron razones de momios (RM) con intervalos de confianza al 95% (IC95%). Resultados. El CEA fue de 40.43%; hombres 56.49% y mujeres 25.70%. Los principales factores asociados fueron ser hombre (RM=3.66; IC95%: 3.22,4.12), edad de 20 a 29 años (RM=3.65; IC95%: 2.89,4.63), salir a trabajar durante la pandemia (RM=1.56; IC95%: 1.33,1.81) y tener dos o más escolares en el hogar (RM=1.20; IC95%: 1.03,1.39). Conclusiones. En México, el patrón de CEA es prevalente; por su naturaleza de riesgo y su amplia distribución poblacional, es prioritario implementar intervenciones preventivas individuales y de salud pública.

Encodat 2016: Violencia de pareja y uso de tabaco, alcohol y drogas. Nuevos retos para la salud mental.

Objetivo. Estimar la prevalencia de violencia de pareja por sexo y su asociación con el uso de tabaco, alcohol y drogas en México. Material y métodos. Estudio transversal de la Encuesta Nacional de Consumo de Drogas, Alcohol y Tabaco 2016, que incluyó a 34 861 personas de 12 a 65 años. Se esti-maron modelos de regresión logística para obtener razones de momios (RM) e intervalos de confianza al 95% (IC95%). Resultados. La prevalencia de violencia de pareja fue de 15.14%; 18.16% en mujeres y 11.89% en hombres. Factores asociados: consumo excesivo de alcohol (RM: 1.64; IC95% 1.38-1.96), consumo de tabaco (RM:1.71;IC95% 1.42-2.07), consumo de medicamentos psicotrópicos sin receta (RM: 3.72; IC95% 1.76-7.88) y consumo de marihuana (RM: 3.06; IC95%: 1.58-5.91). Conclusiones. Los resultados apoyan la necesidad de implementar intervenciones multisectoriales, fortalecer competencias psicosociales para lograr la mejora de la calidad y acceso a los servicios de salud mental y adic-ciones en México.

[Prevalence and psychological factors associated withsuicidal behavior in adolescents. Ensanut 2018-19]. / Prevalencia y factores psicológicos asociados con conducta suicida en adolescentes. Ensanut 2018-19.

OBJECTIVE: To estimate the prevalence of suicidal behavior and its association with psychological factors in Mexican adolescents. MATERIALS AND METHODS: Cross-sectional study based on the National Survey of Health and Nutrition (Ensanut 2018-19), with a sample of 17 995 adolescents (10-19 years). Adjusted logistic regression models were estimated, obtaining Odds Ratio (OR) and 95% confidence intervals (95%CI). RESULTS: Prevalence of suicidal ideation and suicide attempt in Mexico were 5.1 and 3.9%, respectively; the high-est prevalence was in Guanajuato (ideation: 9.0%, attempt: 7.8%). Associated factors. Suicidal ideation: tobacco (OR= 2.26; 95%CI: 1.62-3.16), alcohol (OR= 2.12; 95%CI: 1.65-2.73), depressive symptoms (OR= 6.04; 95%CI: 4.71-7.73), sexual abuse (OR= 6.57; 95%CI: 4.57-9.45). Suicidal attempt: tobacco (OR= 2.17; 95%CI: 1.49-3.15), alcohol (OR= 2.32; 95%CI:1.77-3.03), depressive symptoms (OR= 6.47; 95% CI: 4.91-8.51), sexual abuse (OR= 6.76; 95%CI: 4.60-9.96). CONCLUSIONS: By increasing suicidal behavior in Mexican adolescents, it is necessary to implement preventive public policies that articulate mental health, addiction and violence programs.

OBJETIVO: Estimar la prevalencia de conducta suicida y su asociación con factores psicológicos en adolescentes mexi-canos. MATERIAL Y MÉTODOS: Estudio transversal prove-niente de la Encuesta Nacional de Salud y Nutrición (Ensanut 2018-19). Se estimaron modelos de regresión logística, con lo que se obtuvieron razones de momios (RM) con intervalos de confianza al 95% (IC95%). RESULTADOS: nacional de ideación e intento de suicidio fue de 5.1 y 3.9%, respectivamente; fue más alta en Guanajuato (ideación: 9.0%, intento: 7.8%). Factores asociados. Ideación suicida: tabaco (RM= 2.26; IC95%: 1.62-3.16), alcohol (RM= 2.12; IC95%: 1.65-2.73), sintomatología depresiva (RM= 6.04; IC95%: 4.71-7.73), abuso sexual (RM= 6.57; IC95%: 4.57-9.45). Intento de suicidio: tabaco (RM= 2.17; IC95%: 1.49-3.15), alcohol (RM= 2.32; IC95%: 1.77-3.03), sintomatología depresiva (RM= 6.47; IC95%: 4.91-8.51), abuso sexual (RM= 6.76; IC95%: 4.60-9.96). CONCLUSIONES: Debido al incremento de la conducta suicida en adolescentes mexicanos, es necesario implementar políticas públicas pre-ventivas que articulen programas de salud mental, adicciones y violencia.

[Social factors associated with tobacco and alcohol consumption in Mexican adolescents from populations under 100 000 inhabitants.] / Factores sociales asociados con el consumo de tabaco y alcohol en adolescentes mexicanos de poblaciones menores a 100 000 habitantes.

OBJECTIVE: To evaluate the social factors associated with tobacco and alcohol consumption in Mexican adolescents from populations under 100 000 inhabitants. MATERIALS AND METHODS: Cross-sectional study based on the National Health and Nutrition Survey (Ensanut100k). It included adolescents between 10-19 years. Adjusted logistic regression models were estimated, obtaining Odds Ratio (OR) and confidence intervals 95% (CI95%). RESULTS: Prevalence of tobacco consumption in the last month was 5.5% (10-14 years= 1.0%, 15-19 years= 11.2%); alcohol consumption 9.3%, and excessive alcohol consumption, 2.8%. Associated factors: smoking, sex (male, OR=6.00, CI95%: 2.89-12.46), age (OR=1.73, CI95%: 1.46-2.04), remunerated work (OR=2.87, CI95%: 1.12-7.34), affiliation to health services (OR=0.26, CI95%: 0.08-0.82); alcohol consumption, (male, OR=5.11, CI95%: 2.38-11.00), age (OR=1.70, CI95%: 1.51-1.92), remunerated work (OR=2.51, CI95%: 1.01-6.24). CONCLUSIONS: To reduce the consumption of alcohol and tobacco in adolescents, comprehensive prevention strategies must be implemented that consider the individual and social context.

OBJETIVO: Evaluar los factores sociales asociados con el consumo de tabaco y alcohol en adolescentes mexicanos de poblaciones menores a 100 000 habitantes. MATERIAL Y MÉTODOS: Estudio transversal a partir de resultados de la Encuesta Nacional de Salud y Nutrición (Ensanut 100k) que se enfocó en adolescentes de entre 10 y 19 años. Se estimaron modelos de regresión logística ajustados y se obtuvieron razones de momios (RM) e intervalos de confianza al 95% (IC95%). RESULTADOS: La prevalencia de consumo de tabaco en el último mes fue de 5.5% (10-14 años=1.0%, 15-19 años= 11.2%); de consumo de alcohol, 9.3%, y de consumo excesivo de alcohol, 2.8%. Factores asociados: consumo de tabaco, sexo (hombre, RM= 6.00; IC95%: 2.89-12.46), edad (RM=1.73; IC95%: 1.46-2.04), trabajo remunerado (RM= 2.87; IC95%: 1.12-7.34) y afiliación a servicios de salud (RM= 0.26; IC95%: 0.08-0.82); consumo de alcohol, (hombre, RM= 5.11; IC95%: 2.38-11.0), edad (RM= 1.70; IC95%: 1.51-1.92) y trabajo remunerado (RM= 2.51; IC95%: 1.01-6.24). CONCLUSIONES: Para reducir el consumo de alcohol y tabaco en adolescentes deben implementarse estrategias de prevención integrales que tomen en cuenta el contexto individual y social.

Prevention and control of neoplasms associated with HPV in high-risk groups in Mexico City: The Condesa Study.

OBJECTIVE: To evaluate the effectiveness of a combined strategy of human papillomavirus virus (HPV) vaccination and high-risk HPV screening to reduce the occurrence of anogenital and oropharyngeal neoplasms among men who have sex with men, people with HIV, homeless people, transgender women, female sex workers and rape victims. MATERIALS AND METHODS: This mixed methods study evaluates the effectiveness of a combined vaccination-screening strategy to reduce HPV prevalence/incidence and occurrence of cervical intraepithelial neoplasms grade 2+ and/or anal intraepithelial neoplasms grade 2+, using Kaplan-Meier. The time-to-event method will evaluate time from positive results for specific anogenital HPV to incidence of anogenital lesions containing that HPV type. RESULTS: People vaccinated against HPV and screened for HPV as a primary test will have lower prevalence and incidence of HPV infection and consequently lower frequency of HPV-related anogenital and oropharyngeal lesions. CONCLUSIONS: Thisstudy will generate scientific evidence on effectiveness of a combined vaccination-screening strategy to reduce the burden of HPV-associated neoplasms.

OBJETIVO: Evaluar la efectividad de una estrategia combinada de vacunación contra el virus de papiloma humano (VPH) y tamizaje de VPH de alto riesgo para reducir neoplasias anogenitales y orofaringeas entre hombres que tienen sexo con hombres, personas con VIH, personas en situación de calle, mujeres transgénero, trabajadoras sexuales y víctimas de violación. MATERIAL Y MÉTODOS: Este estudio evaluará la efectividad de una estrategia combinada de vacunación y tamizaje para reducir la ocurrencia de neoplasias intraepiteliales cervicales grado 2+ o neoplasias intraepiteliales anales grado NIA2+ utilizando Kaplan-Meier. Se evaluará tiempo de resultados positivos para tipos específicos deVPH anogenital a incidencia de lesiones anogenitales con ese tipo de VPH. RESULTADOS: Las personas vacunadas contra VPH y con tamizaje de VPH tendrán menor prevalencia e incidencia de infecciones por VPH y por ende menor frecuencia de lesiones anogenitales y orofaringeas relacionadas con VPH. CONCLUSIONES: Este estudio generará evidencia científica sobre la efectividad de una estrategia combinada de vacunación y tamizaje para reducir la carga de neoplasias asociadas al VPH.

Validity and reliability of the Mexican resilience measurement scale in families of children with chronic conditions.

BACKGROUND: The resilience to face disease is a process of positive adaptation despite the loss of health. It involves developing vitality and skills to overcome the negative effects of adversity, risks, and vulnerability caused by disease. In Mexico, the Mexican Resilience Measurement Scale (RESI-M) has been validated with a general population and has a five-factor structure. However, this scale does not allow evaluation of resilience in specific subpopulations, such as caregivers. METHOD: This study investigated the psychometric properties of RESI-M in 446 family caregivers of children with chronic diseases. A confirmatory factor analysis (CFA) was performed, internal consistency values were calculated using Cronbach's alpha coefficient, and mean comparisons were determined using t-tests. RESULTS: The expected five-factor model showed an adequate fit with the data based on a maximum likelihood test. The internal consistency for each factor ranged from .76 to .93, and the global internal consistency was .95. No average difference in RESI-M and its factors was found between women and men. CONCLUSION: The RESI-M showed internal consistency and its model of five correlated factors was valid among family caregivers of children with chronic diseases.

Provider report of the existence of detection and care of perinatal depression: quantitative evidence from public obstetric units in Mexico.

OBJECTIVE: To provide evidence on perinatal mental healthcare in Mexico. MATERIALS AND METHODS: Descriptive and bivariate analyses of data from a cross-sectional probabilistic survey of 211 public obstetric units. RESULTS: Over half (64.0%) of units offer mental healthcare; fewer offer perinatal depression (PND) detection (37.1%) and care (40.3%). More units had protocols/guidelines for PND detection and for care, respectively, in Mexico City-Mexico state (76.7%; 78.1%) than in Southern (26.5%; 36.4%), Northern (27.3%; 28.1%) and Central Mexico (50.0%; 52.7%). CONCLUSION: Protocols and provider training in PND, implementation of brief screening tools and psychosocial interventions delivered by non-clinical personnel are needed.

[Individual and family factors associated with depressive symptomatology in adolescents from public schools of Mexico]. / Factores individuales y familiares asociados con sintomatología depresiva en adolescentes de escuelas públicas de México.

OBJECTIVE: To estimate the prevalence of depressive symptoms (DS) and to explore associated individual and family factors in high-school students from public schools of Mexico. MATERIALS AND METHODS: Cross-sectional study of a representative sample of 9 982 students aged between 14 and 19 years. Logistic regression models were used to estimate odds ratio (OR) with 95% confidence interval (CI95%). RESULTS: 27% of students presented DS, with higher proportion among women (34%) than among men (18%). Factors associated with DS were being female (OR=2.25 CI95% 1.86-2.71); low self-esteem (OR=2.77 CI95% 2.41 -3.19); consuming alcohol (OR= 1.72 CI95% 1.46-2.02), consuming tobacco (OR= 1.57 CI95% 1.31-1.88), consuming illegal drugs (OR=1.63 CI95% 1.29-2.05), domestic violence (OR=2.05 CI95% 1.77-2.39), and low communication between parents and their children (OR=1.78 CI95% 1.59-2.00). CONCLUSIONS: Depressive symptomatology among high-school students in Mexico is a public health issue.There is a need for intervention programs aimed at tackling the associated risk factors.

A Cross-Sectional Analysis of Parental Behavior and Adolescent Mental Health in Mexico: Insights into Excessive Alcohol Intake, Tobacco Use, Suicidal Behavior, and Depressive Symptomatology.

Depression, suicidal behavior, excessive alcohol intake, and tobacco use are the main mental health problems in adolescents. To address these problems, it is necessary to understand the many factors associated with them, including parental factors. The aim of this study was to assess the associations between parental behavior and mental health problems in adolescents in Mexico. Data from the National Health and Nutrition Survey (ENSANUT) 2018-2019, representative for Mexico, were used. Households in which a parent-adolescent child pairing was identified (regardless of family type) were selected; n = 8758 households. The four outcomes of interest that were measured in the adolescents were: excessive alcohol intake, tobacco use, suicidal behavior, and depressive symptomatology. Logistic regression models using the adjusted odds ratio (AOR) and 95% confidence interval (95% CI) were estimated. Adolescents whose parents used alcohol or tobacco and reported depressive symptoms and suicidal behavior were more likely to present these behaviors themselves (AOR = 1.47, 95% CI: 1.17-1.85; AOR = 2.26, 95% CI: 1.51-3.39; AOR = 2.61, 95% CI: 1.88-3.61; AOR = 1.74, 95% CI: 1.16-2.61, respectively). Child sexual abuse was also strongly associated with the four outcomes of interest in adolescents (AOR = 1.89, 95% CI: 1.06-3.36 for excessive alcohol intake; AOR = 2.97, 95% CI: 1.49-5.91 for tobacco use; AOR = 5.15, 95% CI: 3.27-8.09 for depressive symptoms; AOR = 6.71, 95% CI: 4.25-10.59 for suicidal behavior). The family constitutes the central nucleus of care for children and adolescents; therefore, any effort to promote adolescent mental health must necessarily involve their parents and family.

[Gender role orientation and tobacco and alcohol use among youth in Morelos, Mexico]. / Orientación al rol de género y uso de tabaco y alcohol en jóvenes de Morelos, México.

OBJECTIVE: To quantify the association between gender role orientation and tobacco and alcohol use among young people of the State of Morelos. MATERIALS AND METHODS: Study conducted in 2004-2005, students aged 14 to 24 years (n = 1 730). Sociodemographic variables (area of residence, socioeconomic status), family (parental education and violence), psycho-sociological (gender role, self-esteem, depression, alcohol consumption, tobacco, locus of control, sexual abuse). Logistic regression analysis. RESULTS: Factors associated with use of tobacco: In women, being androgynous undesirable, masculine role, attempted sexual abuse and urban areas. For men, depression and submission. Factors associated with alcohol use: In women, masculine gender role; and in men to be older than 20 years, living in semi-urban and urban area, and internal locus. CONCLUSIONS: The machismo is one of the gender role orientations with greater association with the use of tobacco primarily in girls in Mexico, and the masculine or instrumental role with alcohol.

[Interpersonal violence in Mexican young people and prevention opportunities]. / Violencia interpersonal en jóvenes mexicanos y oportunidades de prevención.

OBJECTIVE: To estimate the prevalence of health damage due to interpersonal violence in teenagers and young adults. MATERIALS AND METHODS: The consequences of violence in Mexico are presented in this analysis, with data from the National Health and Nutrition Survey 2012 conducted between October 2011 and May 2012. Statistical analysis consisted in calculating general and specific prevalences and intervals obtained at 95% confidence for the group of adolescents and young people. RESULTS: Four of each hundred youngsters have presented health damage due to interpersonal violence. The prevalence of interpersonal violence is higher among men (5.0% men, 3.3% women), the most vulnerable age group is that of men 20 to 29 years old; one of four women reported domestic violence (24.5%). CONCLUSIONS: It is necessary to implement comprehensive measures for young people, designed to prevent this problem from growing in frequency as well as in its variety of forms and spaces.

[Sociodemographic and reproductive characteristics associated with the increase of cesarean section practice in Mexico]. / Características sociodemográficas y reproductivas asociadas con el aumento de cesáreas en México.

OBJECTIVE: To describe the trend of cesarean section practice in Mexico, and its association with women's sociodemographic and reproductive characteristics. MATERIALS AND METHODS: Based on the 2000, 2006 and 2012 National Health Surveys, information on c-section was analyzed. A multivariate logistic regression model was used in 2012. RESULTS: A 50.3% increase in the use of c-section was observed nationally from 2000 to 2012. Women more likely to undergo a c-section include those whose delivery care takes place in the private sector (OR=2.84, 95%CI:2.15-3.74). When associating women's age and parity, the greatest risks are observed among primiparous women between 12 and 19 years of age, and those aged 35 years and more (OR=6.02, 95%CI:1.24-29.26 and OR=5.20, 95%CI:2.41-11.21, respectively). CONCLUSIONS: Some recommendations to revert the increase of this clinical practice, especially when there is no full justification for its realization, are proposed.

Positive Mental Health Scale (PMHS) in Parents of Children with Cancer: A Psychometric Evaluation Using Item Response Theory.

Mental health is currently a public health issue worldwide. However, evidence is lacking regarding the validity of the instruments used to measure and assess positive mental health in specific populations. The objective of this study was to evaluate the psychometric properties of the PMHS using IRT. A cross-sectional retrospective study with non-probabilistic convenience sampling was conducted with 623 parents of children undergoing cancer treatment at the National Institute of Health in Mexico City. The participants responded to a battery of tests, including a sociodemographic questionnaire, the PMHS, Measurement Scale of Resilience, Beck Depression Inventory, Inventory of Quality of Life, Beck Anxiety Inventory, an interview regarding caregiver burden, and the World Health Organization Well-Being Index. PMHS responses were analyzed using Samejima's graded response model. The PMHS findings indicated that the IRT-based graded response model validated the single latent trait model. The scale scores were independent of depression, anxiety, well-being, caregiver burden, quality of life, and resilience. The PMHS scores were associated with low subjective well-being. The PMHS findings reveal that from an IRT-based perspective, this scale is unidimensional and is a valid, reliable, and culturally relevant instrument for assessing positive mental health in parents of children with chronic diseases.

The Columbia-suicide severity rating scale: validity and psychometric properties of an online Spanish-language version in a Mexican population sample.

The aim of this study was to evaluate the validity and psychometric properties in a Mexican sample of a Spanish-language online version of the Columbia-Suicide Severity Rating Scale (C-SSRS). Data were collected between May and October 2021 from 3,645 participants aged 18 years and over, who agreed to complete the questionnaire. Reliability analysis, confirmatory factor analysis (CFA), and psychometric properties were calculated using a two-parameter model. The results showed a reasonable level of reliability with a Cronbach's alpha of 0.814, and evidence of unidimensionality, and construct validity for suicide risk at three risk levels: low, medium, and high. Analysis of the items suggests that they are consistent with the proposed theoretical model. Our results also demonstrate that the parameters are stable and able to efficiently discriminate individuals at high risk of suicide. We propose the use of this version of the C-SSRS in the Spanish-speaking population, since it is a multifactorial assessment of suicide risk and the inclusion of other clinical and risk factor assessments for a more comprehensive evaluation.

Psychological distress, intimate partner violence and substance use in a representative sample from Mexico: A structural equation model.

Introduction: Intimate Partner Violence (IPV) is a public health concern associated with multiple adverse health outcomes, including psychological distress (PD). Objective: To assess the association of IPV and psychological distress, and the mediation of tobacco and alcohol consumption in a national representative sample from Mexico. Material and methods: Data from the Encuesta Nacional de Consumo de Drogas, Tabaco y Alcohol (ENCODAT) were analyzed. The sample included 34,864 people between the ages of 12 and 65 with a partner. Using Structural Equation Modeling (SEM), the association between IPV, use alcohol, tobacco and psychological distress was measured. Results: The population was composed of women (51.9%) and men (48.1%); 15.1% (women = 18.2% and men = 11.9%) reported IPV in the last year. The prevalence of psychological distress in the last year was 3.3%, being 3.8% in women, and 2.7% in men. Results from the SEM in women indicated a direct positive effect of the IPV construct on psychological distress (ß = 0.298, p < 0.01); these findings confirmed that IPV tended to systematically increase psychological distress. Likewise, the presence of IPV increased the consumption of tobacco (ß = 0.077, p < 0.01) and alcohol (ß = 0.072, p < 0.01). The SEM results in men showed that alcohol and tobacco consumption tended to increase in the presence of IPV (ß = 0.121, p < 0.01, and ß = 0.086, p < 0.01, respectively), and in turn, alcohol consumption and tobacco tended to increase psychological distress (ß = 0.024, p < 0.01, and ß = 0.025, p < 0.01, respectively). Conclusion: This study indicated that in women, IPV had a direct effect on psychological distress and on alcohol and tobacco consumption. Meanwhile in men, alcohol and tobacco consumption had a mediating effect between IPV and psychological distress. The empirical findings of this study will contribute toward the design of public health policies for the prevention and attention of IPV, alcohol and tobacco consumption, and consequently address the mental health consequences derived from these problems.

Violence against Women during the COVID-19 Pandemic in Mexico.

This study measured the prevalence of cases of domestic violence against women and some associated factors during the COVID-19 pandemic in Mexico. Data were collected through a remote survey during 2020. The sample included 47,819 women aged 15 years and older. Jointpoint regression and logistic regression models were used. The prevalence of violence was 11.5%, which decreased in July and subsequently increased. The associated factors were being unemployed (OR = 2.01; 95%CI 1.89-2.16); being partially and totally quarantined (OR = 1.58; 95%CI 1.43-1.75 and OR = 1.47; 95%CI 1.32-1.63); being a caregiver of children; being a caregiver of elderly and/or suffering from a chronic illness (OR = 1.27; 95%CI 1.19-1.36; OR = 1.42; 95%CI 1.33-1.53; OR = 1.59; 95%CI 1.47-1.73); losing a family member to COVID-19 (OR = 1.26; 95%CI 1.13-1.41); and binge drinking (OR = 1.94; 95%CI 1.78-2.12). The confinement measures increased gender inequalities, economic problems and workload which further evidenced violence against women.

Latent Class Analysis of Polysubstance Use and Sexual Risk Behaviors among Men Who Have Sex with Men Attending Sexual Health Clinics in Mexico City.

Men who have sex with men (MSM) are more likely to use drugs and other substances compared to their heterosexual peers. No studies have evaluated patterns of substance use among MSM adults in Mexico. We used latent class analysis (LCA) to identify MSM subgroups with specific substance use patterns and their associations with sexual behaviors. METHODS: Data from 1850 adult MSM were collected at HIV clinics in Mexico City between September 2018 and December 2019. The structural equation modeling approach was used to estimate a LC model to identify patterns of substance use by self-report of substance use (i.e., cigarette smoking, alcohol, and drugs). To evaluate LC membership, we included HIV status, condomless anal sex (CAS), and serosorting, while controlling for demographic variables. RESULTS: 30.3% were under the age of 22. Alcohol use in last 30 days (76.2%), binge drinking (29.2%), marijuana (29.4%), sex-drugs (23.9%), stimulants (13.7%), and depressants (6.3%). MSM reported engaging in CAS (55.9%) and serosorting (13.5%) behaviors, and 40% reported being HIV positive. LCA indicated three general categories of MSM substance users: Class 1 (49.0%), Class 2 (29.8%), and Class 3 (20.4%). Members of Class 3 were younger: 23-28 age years (aOR = 1.86) and 29-33 age years (aOR = 1.86), more educated: completed graduate studies (aOR = 1.60), had a high probability of polysubstance use and were more likely to engage in CAS and serosorting. CONCLUSIONS: Attempts to detect alcohol and problematic use of substances are needed for MSM followed by culturally competent approaches that address alcohol and drug use disorders.