Mental health data available in representative surveys conducted in Latin America and the Caribbean countries: a scoping review.

BACKGROUND: Mental health data from Latin America and the Caribbean countries (LACC) national and international surveys are essential for public health surveillance. This review aimed to identify and describe available mental health survey data in LACC, providing access details for researchers. METHODS: Our study was a scoping review. The search for available mental health survey data was conducted in PubMed and through grey literature searches, and the search dates were between 26 August 2021 and 15 October 2021. Included survey data were/had (1) nationally representative, (2) the latest version available from 2012 onward, (3) collected in at least one LACC and (4) at least one mental health variable or related factor. We accepted all written languages, including Spanish and English. RESULTS: A total of 56 national and 13 international surveys were included, with data available on 95 mental health variables classified into 10 categories. Most national surveys were performed in upper-middle-income countries. Variables categorised as 'Substance use' and 'Violence' were the most frequent. Mexico and Colombia had the highest production in both the national and international surveys. The main target population was the adult population. However, there are several mental health topics and LACC yet unsurveyed. CONCLUSION: We identified a total of 69 representative surveys from LACCs since 2012. We categorised the available data on mental health variables into 10 categories, and provided technical details to facilitate the future selection and use of these surveys.

Sensitivity and specificity of the Patient Health Questionnaire (PHQ-9, PHQ-8, PHQ-2) and General Anxiety Disorder scale (GAD-7, GAD-2) for depression and anxiety diagnosis: a cross-sectional study in a Peruvian hospital population.

OBJECTIVES: The Patient Health Questionnaire (PHQ) and Generalised Anxiety Disorder Scale (GAD) are widely used screening tools, but their sensitivity and specificity in low-income and middle-income countries are lower than in high-income countries. We conducted a study to determine the sensitivity and specificity of different versions of these scales in a Peruvian hospital population. DESIGN: Our study has a cross-sectional design. SETTING: Our participants are hospitalised patients in a Peruvian hospital. The gold standard was a clinical psychiatric interview following ICD-10 criteria for depression (F32.0, F32.1, F32.2 and F32.3) and anxiety (F41.0 and F41.1). PARTICIPANTS: The sample included 1347 participants. A total of 334 participants (24.8%) were diagnosed with depression, and 28 participants (2.1%) were diagnosed with anxiety. RESULTS: The PHQ-9's≥7 cut-off point showed the highest simultaneous sensitivity and specificity when contrasted against a psychiatric diagnosis of depression. For a similar contrast against the gold standard, the other optimal cut-off points were: ≥7 for the PHQ-8 and ≥2 for the PHQ-2. In particular, the cut-off point ≥8 had good performance for GAD-7 with sensitivity and specificity, and cut-off point ≥10 had lower levels of sensitivity, but higher levels of specificity, compared with the cut-off point of ≥8. Also, we present the sensitivity and specificity values of each cut-off point in PHQ-9, PHQ-8, PHQ-2, GAD-7 and GAD-2. We confirmed the adequacy of a one-dimensional model for the PHQ-9, PHQ-8 and GAD-7, while all PHQ and GAD scales showed good reliability. CONCLUSIONS: The PHQ and GAD have adequate measurement properties in their different versions. We present specific cut-offs for each version.

Estimated impact of the COVID-19 pandemic on the prevalence and treatment of depressive symptoms in Peru: an interrupted time series analysis in 2014-2021.

PURPOSE: The COVID-19 pandemic increased the burden of mental disorders worldwide. Peru has been one of the countries most affected by COVID-19, however, studies evaluating the medium and long-term consequences of the pandemic on Peruvians' mental health are recent and represent a new field of study in proliferation. We aimed to estimate the impact of the COVID-19 pandemic on the prevalence and treatment of depressive symptoms using nationally representative surveys in Peru. METHODS: Our study is an analysis of secondary data. We carried out a time series cross-sectional analysis based on the National Demographic and Health Survey of Peru, collected using a complex sampling design. The Patient Health Questionnaire-9 was used to measure mild (5-9 points), moderate (10-14 points), and severe (15 points or more) depressive symptoms. The participants were men and women aged 15 years and older, living in urban and rural areas of all regions of Peru. The main statistical analysis used segmented regression with Newey-West standard errors, taking into account that each year of the evaluation was divided into four measures (quarter measure). RESULTS: We included 259,516 participants. An average quarterly increase of 0.17% (95% CI 0.03-0.32%) in the prevalence of moderate depressive symptoms was identified after the onset of the COVID-19 pandemic (approximately an increase of 1583 new cases of moderate depressive symptoms by each quarter). The percentage of cases treated for mild depressive symptoms increased quarterly by an average of 0.46% (95% CI 0.20-0.71%) after the onset of the COVID-19 pandemic (approximately an increase of 1242 new cases treated for mild depressive symptoms by each quarter). CONCLUSION: In Peru, increases in the prevalence of moderate depressive symptoms and the proportion of cases treated with mild depressive symptoms were found after the COVID-19 pandemic. Therefore, this study is a precedent for future research assessing the prevalence of depressive symptoms and the proportion of cases receiving treatment during the pandemic and post-pandemic years.

Home-Based Respiratory Physiotherapy and Telephone-Based Psychological Support for COVID-19 Survivors in Peru: Protocol for a Randomized Controlled Trial.

BACKGROUND: Both pulmonary and mental health are affected following hospitalization for COVID-19 pneumonia. Pulmonary rehabilitation therapy has demonstrated benefits in improving mental health, but no validated combined programs that include mental health have been proposed. OBJECTIVE: This article presents the design of a trial that aimed to assess whether the participation in a combined rehabilitation program that includes home-based respiratory physiotherapy and telephone-based psychological support is associated with a greater improvement of pulmonary and mental health outcomes 7-12 weeks after COVID-19 hospitalization discharge compared with posthospital usual care provided by a public Peruvian hospital. METHODS: WAYRA (the word for air in the Quechua language) was an open-label, unblinded, two-arm randomized controlled trial. We recruited 108 participants aged 18-75 years who were discharged from the hospital after COVID-19 pneumonia that required >6 liters/minute of supplemental oxygen during treatment. Participants were randomly assigned at a 1:1 ratio to receive the combined rehabilitation program or usual posthospital care provided by a public Peruvian hospital. The intervention consisted of 12 at-home respiratory rehabilitation sessions and 6 telephone-based psychological sessions. The primary outcome was the 6-minute walk distance. Secondary outcomes included lung function, mental health status (depression, anxiety, and trauma), and quality of life. Outcomes were assessed at baseline (before randomization) and at 7 and 12 weeks after hospital discharge to assess the difference between arms. RESULTS: This study was funded by the Peruvian National Council of Science Technology and Technology Innovation in July 2020. Ethics approval was obtained on September 2, 2020. Recruitment and data collection occurred between October 2020 and June 2021. Results are expected to be published by the end of 2022. CONCLUSIONS: WAYRA was the first randomized controlled trial evaluating combined pulmonary-mental health rehabilitation for hospitalized COVID-19 survivors in resource-limited settings, potentially providing a foundation for the cost-effective scale-up of similar multidisciplinary rehabilitation programs. TRIAL REGISTRATION: ClinicalTrials.gov NCT04649736; https://clinicaltrials.gov/ct2/show/NCT04649736. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR1-10.2196/36001.

Spanish version of Jenkins Sleep Scale in physicians and nurses: psychometric properties from a Peruvian nationally representative sample.

OBJECTIVE: To evaluate the psychometric properties of the Spanish version of Jenkins Sleep Scale with 4 items (JSS-4) of the Peruvian health system's (PHS) nurses and physicians. METHODS: We carried out a psychometric study based on secondary analysis in a sample from a nationally representative survey that used acomplex sampling design. The participants were physicians and nurses aged 18-65 years, working in PHS private and public facilities, who have fulfilled all JSS-4 items. We performed a confirmatory factor analysis. Reliability was evaluated via two estimates - classic alpha (α) and categorical omega (ω) coefficients. Also, we tested the invariance across groups of variables. The convergent validity was evaluated based on the relation between JSS-4 and PHQ-2 using Pearson's correlation coefficient and effect size (Cohen's d). Also, we designed normative values based on percentiles. RESULTS: We included 2100 physicians and 2826 nurses in the analysis. We observed that the unidimensional model has adequate goodness-of-fit indices and values of α and ω coefficients. No measurement invariance was found between the groups of professionals and age groups; however, invariance was achieved between sex, monthly income, work-related illness, and chronic illness groups. Regarding the relation with other variables, the JSS-4 has a small correlation with PHQ-2. Also, profession and age-specific normative values were proposed. CONCLUSION: JSS-4 Spanish version has adequate psychometric properties in PHS nurses and physicians.