Impact of Depression on Anxiety, Well-being, and Suicidality in Mexican Adolescent and Young Adult Students From Mexico City: A Mental Health Screening Using Smartphones.

Background: Depression, anxiety, well-being, and suicidality are highly associated during adolescence and greatly predict mental health outcomes during adulthood. This study explored relationships between these variables among students from Mexico City.Methods: This representative cross-sectional study was carried out in education centers in Mexico City during the 2019-2020 academic year. Using a smartphone app, we implemented validated questionnaires for depression (Patient Health Questionnaire-9), anxiety (Generalized Anxiety Disorder-7), well-being (World Health Organization 5 Well-Being Index), and risk of suicide (Columbia-Suicide Severity Rating Scale). Partial least squares structural equation modeling was performed for the entire sample and after stratifying by gender.Results: Out of 3,042 students, 1,686 were females; mean age of the sample was 17.3 years. Compared to males, females had higher levels of anxiety, depressive symptoms, and suicidal ideation and lower levels of self-perceived well-being. Structural equation models indicated that depression was the main predictor of the rest of the outcomes in the overall sample. The role of anxiety was heterogeneous across genders and not clearly correlated to suicidal behavior or well-being.Conclusions: Large-scale mental health screening using an online tool proved feasible, with high response rates. Depression was the most important factor influencing anxiety, suicidal behavior, and well-being in Mexican high school students. The roles of depression and anxiety were heterogeneous across genders.Trial Registration: ClinicalTrials.gov Identifier: NCT04067076.

Tratamiento de la esquizofrenia en México: recomendaciones de un panel de expertos.

La esquizofrenia es una enfermedad compleja que actualmente no tiene cura. Existen, sin embargo, numerosas terapias que, solas o en combinación, son eficaces para tratar los síntomas de la enfermedad y mantenerla bajo control. La elección del tratamiento debe ser siempre individualizada, y basarse en la presentación clínica de la enfermedad, el estado general del paciente y la eficacia del fármaco, si bien hay que considerar también el costo y el acceso a servicios y al fármaco, que en México tiene algunas limitaciones. Un panel de 12 expertos mexicanos se reunió de forma virtual para revisar los últimos datos publicados y establecer unas recomendaciones de tratamiento en México, basadas en la evidencia, que garanticen una atención médica integral, homogénea, eficiente y con calidad.Schizophrenia is a complex illness that currently has no cure. There are, however, numerous therapies that, alone or in combination, are effective in treating the symptoms of the disease and keeping it under control. The choice of treatment must always be individualized, and based on the clinical presentation of the disease, the general condition of the patient and the efficacy of the drug, although the cost and access to services and to the drug must also be considered, as in Mexico it has some limitations. A panel of 12 Mexican experts met virtually to review the latest published data and establish evidence-based treatment recommendations in Mexico that guarantee comprehensive, homogeneous, efficient, and quality medical care.

Tratamiento de la esquizofrenia en México: recomendaciones de un panel de expertos / Treatment of schizophrenia in Mexico: recommendations from an expert panel

Resumen La esquizofrenia es una enfermedad compleja que actualmente no tiene cura. Existen, sin embargo, numerosas terapias que, solas o en combinación, son eficaces para tratar los síntomas de la enfermedad y mantenerla bajo control. La elección del tratamiento debe ser siempre individualizada, y basarse en la presentación clínica de la enfermedad, el estado general del paciente y la eficacia del fármaco, si bien hay que considerar también el costo y el acceso a servicios y al fármaco, que en México tiene algunas limitaciones. Un panel de 12 expertos mexicanos se reunió de forma virtual para revisar los últimos datos publicados y establecer unas recomendaciones de tratamiento en México, basadas en la evidencia, que garanticen una atención médica integral, homogénea, eficiente y con calidad.

Abstract Schizophrenia is a complex illness that currently has no cure. There are, however, numerous therapies that, alone or in combination, are effective in treating the symptoms of the disease and keeping it under control. The choice of treatment must always be individualized, and based on the clinical presentation of the disease, the general condition of the patient and the efficacy of the drug, although the cost and access to services and to the drug must also be considered, as in Mexico it has some limitations. A panel of 12 Mexican experts met virtually to review the latest published data and establish evidence-based treatment recommendations in Mexico that guarantee comprehensive, homogeneous, efficient, and quality medical care.

Universal mental health screening with a focus on suicidal behaviour using smartphones in a Mexican rural community: protocol for the SMART-SCREEN population-based survey.

INTRODUCTION: Mental disorders represent the second cause of years lived with disability worldwide. Suicide mortality has been targeted as a key public health concern by the WHO. Smartphone technology provides a huge potential to develop massive and fast surveys. Given the vast cultural diversity of Mexico and its abrupt orography, smartphone-based resources are invaluable in order to adequately manage resources, services and preventive measures in the population. The objective of this study is to conduct a universal suicide risk screening in a rural area of Mexico, measuring also other mental health outcomes such as depression, anxiety and alcohol and substance use disorders. METHODS AND ANALYSIS: A population-based cross-sectional study with a temporary sampling space of 9 months will be performed between September 2019 and June 2020. We expect to recruit a large percentage of the target population (at least 70%) in a short-term survey of Milpa Alta Delegation, which accounts for 137 927 inhabitants in a territorial extension of 288 km2.They will be recruited via an institutional call and a massive public campaign to fill in an online questionnaire through mobile-assisted or computer-assisted web app. This questionnaire will include data on general health, validated questionnaires including Well-being Index 5, Patient Health Questionnaire-9, Generalized Anxiety Disorder Scale 2, Alcohol Use Disorders Identification Test, selected questions of the Drug Abuse Screening Test and Columbia-Suicide Severity Rating Scales and Diagnostic and statistical manual of mental disorders (DSM-5) questions about self-harm.We will take into account information regarding time to mobile app response and geo-spatial location, and aggregated data on social, demographical and environmental variables. Traditional regression modelling, multilevel mixed methods and data-driven machine learning approaches will be used to test hypotheses regarding suicide risk factors at the individual and the population level. ETHICS AND DISSEMINATION: Ethical approval (002/2019) was granted by the Ethics Review Board of the Hospital Psiquiátrico Yucatán, Yucatán (Mexico). This protocol has been registered in ClinicalTrials.gov. The starting date of the study is 3 September 2019. Results will serve for the planning and healthcare of groups with greater mental health needs and will be disseminated via publications in peer-reviewed journal and presented at relevant mental health conferences. TRIAL REGISTRATION NUMBER: NCT04067063.

Epidemiological description of suicide mortality in the state of Yucatan between 2013 and 2016 / Descripción epidemiológica de la mortalidad por suicidio en el estado de Yucatán entre 2013 y 2016

Abstract Introduction Every region in the world has an epidemiological trend of death by suicide that is particular and dependent on its sociodemographic and cultural aspects. Knowing the epidemiological characteristics of people who have died by suicide in the state of Yucatan is important for understanding the phenomenon and planning future preventive strategies. Objective To describe the epidemiological characteristics of suicide mortality between 2013 and 2016. Method Observational, descriptive study, retrospective longitudinal section, in which the epidemiological trends of mortality are analyzed. Results In the period studied, Yucatan was among the states with the highest mortality rate due to suicide. Hanging was the most frequent method, followed by the use of agrochemicals. Together, these methods were employed by nearly 95% of those who died. Agrochemical use was associated with a greater likelihood of receiving medical care before death compared with other methods, particularly hanging (24.5 to 1.00). Discussion and conclusion In this study, sociodemographic differences and factors associated with suicide were observed. Suicide methods are consistent with those observed nationwide and in countries with poverty and agricultural societies. Preventive measures to address this problem in the state could incorporate the epidemiological characteristics of the population with suicidal tendencies in Yucatan. Suicide in the state of Yucatan is an ongoing public health problem, which showed an annual increase in the period studied and a significant predominance in the month of May.

Resumen Introducción Se considera que en cada región del mundo existe una tendencia epidemiológica de mortalidad por suicidio que es particular y dependiente de los aspectos sociodemográficos y culturales de la región. Conocer las características epidemiológicas de las personas que han muerto por suicidio en el estado de Yucatán es importante para entender y planear futuras estrategias preventivas. Objetivo Describir las características epidemiológicas de la mortalidad por suicidio entre 2013 y 2016. Método Estudio observacional, descriptivo, de corte longitudinal retrospectivo, en el cual se analizan las tendencias epidemiológicas de mortalidad. Resultados En el período estudiado, Yucatán se encontró entre los estados con mayor tasa de mortalidad por suicidio. El ahorcamiento fue el método más frecuente, seguido del uso de agroquímicos. La suma de ambos métodos constituyó casi el 95% de fallecidos. El uso de agroquímicos se asoció con mayor probabilidad de recibir atención médica antes del fallecimiento al compararse con los otros métodos, principalmente el ahorcamiento (24.5 a 1.00). Discusión y conclusión En este estudio se observaron diferencias sociodemográficas y factores asociados al suicidio; los métodos de suicidio son congruentes con los observados en el resto del país y en países con pobreza y sociedades agrícolas. Las medidas preventivas para abordar este problema en el estado podrían incorporar las características epidemiológicas de la población con tendencias suicidas en Yucatán. El suicidio en el estado de Yucatán es un problema de salud pública vigente, que mostró un incremento anual en el periodo estudiado y un predominio significativo en el mes de mayo.

Predictors of short-term course in Mexican first-episode psychosis patients / Predictores de curso temprano en pacientes mexicanos con primer episodio psicótico

Background and objectives The identification of prognostic factors in patients with schizophrenia and related psychotic disorders should enhance our understanding of the aetiology of these disorders and improve their treatment. The first years following an initial episode of psychosis are a <

Antecedentes y objetivos La identificación de factores pronósticos en pacientes con esquizofrenia y otros trastornos psicóticos relacionados podría facilitar la comprensión de la etiología de estos trastornos así como mejorar los tratamientos existentes. Los primeros años a partir del primer episodio psicótico son un <

[Syndrome premenstrual dysphoric 185 preschool teachers in Mérida Yucatán]. / Síndrome disfórico premenstrual de docentes preescolares en Mérida, Yucatán.

BACKGROUND: Premenstrual dysphoric syndrome affects 3 to 8% of women. It is a disabling health problem, family and socio-economic impact. This syndrome increases the risk of: major depressive disorder, postpartum depression and other serotonin spectrum pictures. In Yucatan, there are no specific reports on the frequency of dysphoric premenstrual syndrome. OBJECTIVE: To determine the prevalence and the most common symptoms of premenstrual dysphoric syndrome in a group of preschool teachers in Merida, Yucatan. MATERIALS AND METHODS: a descriptive study conducted from October 2006 to January 2007 with a probability sample of 77 teachers. A questionnaire was applied and provided a table with data related to premenstrual dysphoric syndrome, which was completed daily during two menstrual cycles. Data was analyzed with descriptive statistics in Epi Info V6. RESULTS: Forty-six women (59.7%) had regular menstrual cycles and 30 (39%) suffered from a previously diagnosed disease (premenstrual syndrome, endometriosis, acute anemia, migraine, hypothyroidism). Of the 77 women, 27.3% (21/77) had positive result for premenstrual dysphoric syndrome. The most frequent symptoms were physical, that require that patients seek the help of a professional or self-medication, this did not happen when the symptoms were kind of emotional or behavioral disability occurred although, even for everyday activities. CONCLUSIONS: The percentage of patients with premenstrual dysphoric syndrome was higher than that reported in the literature. The daily monitoring of symptoms caused by the menstrual cycle and enables doctors to identify women premenstrual dysphoric syndrome and avoid its consequences.

[Latin America: clinical responses to the antipsychotic drugs]. / América Latina: respuesta a los antipsicóticos.

OBJECTIVE: To compare the effectiveness of a 12 months antipsychotic monotherapy treatment with Olanzapine, risperidone and an atypical antipsychotic drug in Latin American patients with schizophrenia. METHOD: The outcomes of effectiveness and tolerability were evaluated in outpatients with schizophrenia belonging to a large sample (N=7658) in a prospective, international trial carried out in 27 countries. The results for the population of Latin America were presented. RESULTS: The probabilities of response were higher for Olanzapine than Risperidone and the atypical antipsychotic drugs. (p < or = 0.05) and for risperidone compared with the atypical antipsychotic drugs. (p < or = 0.05). Olanzapine was better tolerated as regarding the extrapiramidals symptoms and the sexual disfunction, although it was associated to a higher weight gain, as compared to the other groups of the trial. CONCLUSION: the trial indicated that in the Latin American patients with schizophrenia, it is likely that Olanzapine induces clinical responses and has lower incidences on side effects, when compared with risperidone or atypical antipsychotic drugs.

América Latina: respuesta a los antipsicóticos / [Latin America: clinical responses to the antipsychotic drugs]

OBJECTIVE: To compare the effectiveness of a 12 months antipsychotic monotherapy treatment with Olanzapine, risperidone and an atypical antipsychotic drug in Latin American patients with schizophrenia. METHOD: The outcomes of effectiveness and tolerability were evaluated in outpatients with schizophrenia belonging to a large sample (N=7658) in a prospective, international trial carried out in 27 countries. The results for the population of Latin America were presented. RESULTS: The probabilities of response were higher for Olanzapine than Risperidone and the atypical antipsychotic drugs. (p < or = 0.05) and for risperidone compared with the atypical antipsychotic drugs. (p < or = 0.05). Olanzapine was better tolerated as regarding the extrapiramidals symptoms and the sexual disfunction, although it was associated to a higher weight gain, as compared to the other groups of the trial. CONCLUSION: the trial indicated that in the Latin American patients with schizophrenia, it is likely that Olanzapine induces clinical responses and has lower incidences on side effects, when compared with risperidone or atypical antipsychotic drugs.

América Latina: respuesta a los antipsicóticos. / [Latin America: clinical responses to the antipsychotic drugs]

OBJECTIVE: To compare the effectiveness of a 12 months antipsychotic monotherapy treatment with Olanzapine, risperidone and an atypical antipsychotic drug in Latin American patients with schizophrenia. METHOD: The outcomes of effectiveness and tolerability were evaluated in outpatients with schizophrenia belonging to a large sample (N=7658) in a prospective, international trial carried out in 27 countries. The results for the population of Latin America were presented. RESULTS: The probabilities of response were higher for Olanzapine than Risperidone and the atypical antipsychotic drugs. (p < or = 0.05) and for risperidone compared with the atypical antipsychotic drugs. (p < or = 0.05). Olanzapine was better tolerated as regarding the extrapiramidals symptoms and the sexual disfunction, although it was associated to a higher weight gain, as compared to the other groups of the trial. CONCLUSION: the trial indicated that in the Latin American patients with schizophrenia, it is likely that Olanzapine induces clinical responses and has lower incidences on side effects, when compared with risperidone or atypical antipsychotic drugs.