RESUMO
OBJECTIVE: Limited research exists on the impact of type and number of traumatic events on the incidence of suicide ideation and attempts (suicidality) among adolescents in low/middle income countries where violence is common. METHOD: We estimated prospective associations of 7 types of events on the new occurrence of suicidality from a follow-up conducted in 2013 (n = 1071; ages 19-26) of the original Mexican Adolescent Mental Health Survey conducted in 2005 (ages 12-17), by using Hazard Ratios (HR) estimates. RESULTS: For new onset of suicide ideation, those reporting "Ever raped or sexually assaulted" had the highest adjusted HR (3.8), followed by "Ever other traumatic event" (HR = 1.9), "Ever committed or witnessed violence" (HR = 1.7) and "Beaten as a child or witnessed physical fights at home" (HR = 1.5). For suicide attempt, those reporting "Ever beaten up by spouse, partner, someone else, mugged with a weapon, or stalked" (HR = 3.8) and "Ever other traumatic event" (HR = 2.0) had the higher hazards. Compared to those without a traumatic event, increased hazards of ideation and attempt were found for those reporting a greater number of types of events. CONCLUSIONS: Our sample is representative of the largest metropolitan area in Mexico but does not include other cities or age groups that may differ in risk factors. Traumatic events that happened in the eight years between waves are not considered. Traumatic events increased the risk of suicidality, independent of common mental disorders. Identifying and addressing these events in clinical settings may therefore be important for preventing suicide in this population.
Assuntos
Suicídio , Adolescente , Adulto , Criança , Inquéritos Epidemiológicos , Humanos , México/epidemiologia , Fatores de Risco , Ideação Suicida , Tentativa de Suicídio , Inquéritos e Questionários , Adulto JovemRESUMO
Suicide is a major public health problem in Mexico and around the world. Genetic predisposition for major depressive disorder (MDD) has been associated with increased risk for suicidal behaviors (SB) in populations of European ancestry (EA). Here, we examine whether MDD polygenic risk scores (MDD PRS), derived from a genome-wide association study involving EA individuals, predict SB, including ideation, planning, and attempt, among Mexican youth using a longitudinal design. At baseline, participants (N = 1,128, 12-17 years, 55% women) were interviewed and genotyped as part of a general population survey on adolescent mental health. Eight years later, they were recontacted for a follow up visit (N = 437, 20-25 years, 63% women). At both assessments, individuals reported on their engagement in SB within the past year. MDD PRS were significantly positively associated with SB, particularly suicide ideation and planning during adolescence, accounting for ~4-5% of the variance in these outcomes. In contrast, associations between MDD PRS and SB during young adulthood did not reach statistical significance. Our results suggest that increased genetic liability for depression increased risk for SB, particularly during adolescence, expanding our knowledge of the genetic underpinnings of SB.
Assuntos
Transtorno Depressivo Maior , Ideação Suicida , Adolescente , Adulto , Depressão/genética , Transtorno Depressivo Maior/genética , Feminino , Estudo de Associação Genômica Ampla , Humanos , Masculino , México , Fatores de Risco , Adulto JovemRESUMO
PURPOSE: Mental health disparities have been documented among sexual minority college students, but there is a dearth of evidence from developing countries. The aim is to estimate the prevalence of 12-month mental and substance use disorders across a range of sexual identities among first-year college students in Mexican universities, and test whether there is an association between sexual identity and disorders and whether the association is moderated by gender. METHOD: The University Project for Healthy Students, a web-based survey conducted as part of the World Health Organization's World Mental Health International College Student initiative, recruited 7874 students from nine Mexican universities in 2016 and 2017. Logistic regressions estimated the association of sexual identity with 12-month major depressive episode, generalized anxiety disorder, panic disorder, alcohol abuse/dependence, and drug abuse/dependence, with interaction terms for gender. RESULTS: Compared to heterosexual students reporting no same-sex attraction (SSA), heterosexual students with SSA (AORs range 1.77-3.67) and lesbian/gay and bisexual students (AORs range 2.22-5.32) were at a higher risk for several disorders. Asexual students were at higher risk for drug abuse/dependence (AOR = 3.64). Students unsure of their sexual identity were at a higher risk for major depressive episode, panic disorder, and drug abuse/dependence (AORs range 2.25-3.82). Gender differences varied across sexual identity and disorder. CONCLUSION: These findings are the first empirical report of sexual minority psychiatric disparities among a college student population from a developing nation and underscore the importance of clinical interventions that address mental health needs among sexual minority college students.
Assuntos
Transtorno Depressivo Maior , Transtornos Mentais , Minorias Sexuais e de Gênero , Transtornos Relacionados ao Uso de Substâncias , Transtorno Depressivo Maior/epidemiologia , Feminino , Humanos , Transtornos Mentais/epidemiologia , México/epidemiologia , Prevalência , Estudantes , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , UniversidadesRESUMO
BACKGROUND: Sexual minority college students are at a higher risk for suicidal thoughts and self-injurious behaviors compared to heterosexual students. Minority stress theory proposes sexual minority individuals experience higher stress due to stigma. Using a sample of Mexican college students, this study tested perceived life stress as a mediator of suicide and self-injury outcomes across various sexual orientation groups. METHODS: The sample of college students (N=7882) was recruited from nine Mexican universities as part of the WHO World Mental Health International College Student (WMH-ICS) initiative. Participants completed an online survey including demographic questions, measure of perceived life stress, suicide outcomes, and non-suicidal self-injury (NSSI) in the past 12 months. RESULTS: Logistic regression analyses revealed identifying as a sexual minority significantly predicted a higher likelihood of suicide ideation (ORs 2.05-3.00), suicide attempts (ORs 2.48-8.73), and NSSI (ORs 2.92-4.18) compared to heterosexual students reporting no same-gender attraction. Significant indirect effects from mediation path analyses showed perceived life stress mediated the relationship between a sexual minority identity and suicide ideation (range of proportion mediated 10.48-31.48%), attempts (10.48-31.48%), and NSSI (7.69-20.09%) across each group except among asexual students. LIMITATIONS: The cross-sectional nature of the survey design precludes drawing causal inferences. CONCLUSION: Findings from this study contribute to minority stress theory by elucidating the role of perceived life stress as a mediator of suicide ideation and attempts and NSSI among sexual minority college students. Clinical interventions may benefit in focusing on experiences of stress across various life areas when supporting sexual minority college students.
Assuntos
Comportamento Autodestrutivo , Minorias Sexuais e de Gênero , Estudos Transversais , Feminino , Humanos , Masculino , México/epidemiologia , Comportamento Autodestrutivo/epidemiologia , Estresse Psicológico/epidemiologia , Estudantes , Ideação Suicida , UniversidadesRESUMO
BACKGROUND: Depression is a leading cause of disease burden around the globe, often develops during adolescence and is recurrent. Thus, disentangling risk factors for incidence from those of recurrence during adolescence is relevant and might suggest different strategies for prevention of onset than for relapse. The aim was to evaluate the relative risk of socio-demographic and clinical factors and traumatic events associated to incidence and recurrence of depression in youth from Mexico City. METHODS: This is a prospective longitudinal general population survey in which 1071 respondents from the Mexican Adolescent Mental Health Survey were interviewed between the ages of 12 and 17 and again eight years later when they were between 19 and 26 years of age. The World Mental Health Composite International Diagnostic Interview evaluated incidence and persistence of major depression and risk factors. RESULTS: Eight-year incidence was 12.9% while recurrence was 46.1%. Risk factors for incidence (female sex, any incident trauma, and specifically sexual abuse and an other/private event) differed from the risk factors for recurrence (childhood onset and domestic violence) with the exception of having a parent with depression, which was associated to increased risk for both. LIMITATIONS: The follow-up response rate was limited by inability to locate participants at wave II. Statistical power was limited for persistence due to low rate of depression at wave I. CONCLUSIONS: Intervening with both depressed and non-depressed children of parents with depression may have beneficial effects on both the development of depression as well as recurrence.
Assuntos
Depressão , Adolescente , Adulto , Criança , Depressão/epidemiologia , Feminino , Seguimentos , Inquéritos Epidemiológicos , Humanos , Incidência , Estudos Longitudinais , México/epidemiologia , Estudos Prospectivos , Recidiva , Fatores de Risco , Inquéritos e QuestionáriosRESUMO
BACKGROUND AND AIMS: DSM-5 includes Internet gaming disorder (IGD) as a condition for further study. While online and offline gaming may produce undesired negative effects on players, we know little about the nosology of IGD and its prevalence, especially in countries with emerging economies. METHODS: A self-administered survey has been employed to estimate prevalence of DSM-5 IGD and study the structure and performance of an instrument in Spanish to measure DSM-5 IGD among 7,022 first-year students in 5 Mexican universities that participated in the University Project for Healthy Students (PUERTAS), part of the World Health Organization's World Mental Health International College Student Initiative. RESULTS: The scale for IGD showed unidimensionality with factor loadings between 0.694 and 0.838 and a Cronbach's α = .816. Items derived from gaming and from substance disorders symptoms mixed together. We found a 12-month prevalence of IGD of 5.2% in the total sample; prevalence was different for males (10.2%) and females (1.2%), but similar for ages 18-19 years (5.0%) and age 20+ (5.8%) years. Among gamers, the prevalence was 8.6%. Students with IGD were more likely to report lifetime psychological or medical treatment [OR = 1.8 (1.4-2.4)] and any severe role impairment [OR = 2.4 (1.7-3.3)]. Adding any severe role impairment to the diagnostic criteria decreased the 12-month prevalence of IGD to 0.7%. DISCUSSION AND CONCLUSIONS: Prevalence of DSM-5 IGD and the performance of diagnostic criteria in this Mexican sample were within the bounds of what is reported elsewhere. Importantly, about one in every seven students with IGD showed levels of impairment that would qualify them for treatment under DSM-5.
Assuntos
Comportamento Aditivo/epidemiologia , Internet , Estudantes/estatística & dados numéricos , Universidades/estatística & dados numéricos , Jogos de Vídeo , Adolescente , Adulto , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Masculino , México/epidemiologia , Prevalência , Adulto JovemRESUMO
BACKGROUND: Specific phobia is one of the most common psychiatric disorders in the general population, begins at a younger age, and has high comorbidity. However, it receives less treatment than other disorders, perhaps because it is circumscribed to a specific object or situation that can be avoided or is difficult to differentiate from developmentally adaptive fear. Longitudinal studies are needed to clarify its clinical significance, risk factors, and course. This study was designed to determine the persistence of specific phobia in participants during an 8-year period from adolescence to young adulthood and its predictors in a Mexican cohort. METHODS: 1,071 respondents from a representative 2-wave panel sample participated in the Mexican Adolescent Mental Health Survey in 2005 and in the follow-up survey in 2013. DSM-IV disorders were evaluated with the World Mental Health Composite International Diagnostic Interview. RESULTS: Of adolescents with specific phobia at baseline, 17.46% persisted into adulthood. Persistence of specific phobia was predicted by an age of onset of disorder in adolescence (risk ratio [RR] = 2.83, 95% CI, 1.30-6.13), parental neglect (RR = 2.76, 95% CI, 1.35-5.65), a first-degree relative with specific phobia (RR = 2.69, 95% CI, 1.34-5.39) and economic adversities (RR = 2.06, 95% CI, 1.21-3.53). Noncomorbid specific phobia in adolescence predicted incidence of other anxiety and substance use disorders in early adulthood (RR = 1.98; 95% CI, 1.11-3.54 and RR = 1.35; 95% CI, 1.07-1.69, respectively). CONCLUSIONS: While many adolescents with specific phobia remit in adulthood, there are early adult consequences of adolescent phobia and identifiable risk factors for persistence that suggest a group of adolescents that might benefit from early intervention.
Assuntos
Transtornos Fóbicos/diagnóstico , Transtornos Fóbicos/epidemiologia , Adolescente , Idade de Início , Estudos Transversais , Feminino , Seguimentos , Predisposição Genética para Doença/genética , Inquéritos Epidemiológicos , Humanos , Estudos Longitudinais , Masculino , México , Transtornos Fóbicos/genética , Transtornos Fóbicos/psicologia , Fatores de Risco , Adulto JovemRESUMO
BACKGROUND: Non-suicidal self-injury (NSSI) may lead to scarring, infection, accidental death and psychological distress. Little is known about NSSI in the general population of young adults in developing countries like Mexico. The current study examined the prevalence of any NSSI and each type of NSSI, the prevalence of meeting DSM-5 proposed criteria, and finally the association of NSSI with socio-demographic variables, suicidal behavior and psychiatric disorders. METHODS: This study was conducted in a community sample of 1071 young adults between 19 and 26 years of age residents of Mexico City. RESULTS: The lifetime prevalence of NSSI was 18.56% with females having 87% greater odds. The 12-month prevalence was 3.19%. Only 0.22% of the total sample and 6.96% of those that self-injured in the past 12 months met full criteria proposed by DSM-5, in part due to the lack of reported impairment; 39.99% of those that self-injured reported impairment. Suicidal behavior commonly co-occurred with NSSI. All lifetime anxiety, mood, disruptive behavior and substance use disorders were associated with greater risk for lifetime NSSI whereas only 12-month depression and substance use disorder was associated with greater risk of 12-month NSSI. LIMITATIONS: The cross-sectional nature of the study precludes conclusions of causality and directionality and the study excluded institutionalized and homeless young adults. CONCLUSIONS: NSSI is a concerning problem in young adults from Mexico City due to the important associations with all types of psychiatric disorders and suicidal behavior. Because many who self-injure do not perceive impairment, they are unlikely to seek treatment.
Assuntos
Transtornos Mentais/complicações , Comportamento Autodestrutivo/epidemiologia , Ideação Suicida , Adulto , Ansiedade/complicações , Estudos Transversais , Depressão/complicações , Países em Desenvolvimento , Feminino , Humanos , Masculino , México/epidemiologia , Prevalência , Fatores de Risco , Comportamento Autodestrutivo/psicologia , Fatores Sexuais , Transtornos Relacionados ao Uso de Substâncias/complicações , Tentativa de Suicídio/estatística & dados numéricos , Adulto JovemRESUMO
The normative process of autonomy development in adolescence involves changes in adolescents' information management typically characterized by decreasing disclosure and increasing concealment. These changes may have an important impact on the early detection and timely treatment of mental health conditions and risky behavior. Therefore, the objective was to extend our understanding of how these developmental changes in adolescent disclosure might impact adolescent mental health interviews. Specifically, we estimated the effects of third party presence and type of third party presence (adult, child, or both) on adolescents' reports of psychiatric symptoms, substance use, suicidal behavior, and childhood adversity. In this representative sample of 3005 adolescents from Mexico City (52.1 % female), administered the World Mental Health Composite International Diagnostic Interview (WMH-CIDI-A), adult presence influenced reporting the most; in their presence, adolescents reported more ADHD, parental mental illness and economic adversity, but less panic disorder, PTSD, drug use and disorder, and suicidal behavior. The presence of children was associated with increased odds of reporting conduct disorder, opportunity for drug use, parental criminal behavior, neglect, and the death of a parent. While adolescent information management strategies are normative and even desirable as a means of gaining emotional autonomy, they may also interfere with timely detection and treatment or intervention for mental health conditions and risky behaviors. Research and practical implications of these findings are discussed.
Assuntos
Comportamento do Adolescente/psicologia , Revelação , Entrevista Psicológica/métodos , Saúde Mental/estatística & dados numéricos , Psicologia do Adolescente , Adolescente , Adulto , Feminino , Humanos , Masculino , México , Pais , Assunção de RiscosRESUMO
Half of mental disorders have their first onset before adulthood when the presence of a disorder may be particularly disruptive to developmental milestones. Retrospective prevalence estimates have been shown to underestimate the burden of mental illness and scarce data are available on the incidence of disorders throughout the adolescent period, especially in developing countries. Thus, the objective was to determine the incidence of mental disorders in an 8-year period from adolescence to young adulthood, onset of service use and their predictors in a Mexican cohort. 1071 respondents from a representative two-wave panel sample participated in the Mexican Adolescent Mental Health Survey in 2005 and in the follow-up survey in 2013. Disorders were evaluated with the World Mental Health Composite International Diagnostic Interview. 37.9% experienced the onset of a psychiatric disorder and 28.4% sought services for the first time. Substance use disorders had the greatest incidence, followed by mood and behavior disorders, anxiety disorders and lastly eating disorders. Sex, age, school dropout, childhood adversities and prior mental disorders predicted the onset of new disorders. Being female, having more educated parents and most classes of disorder predicted first time service use. These findings contribute to a paradigm shift in conceptions of mental disorder similar to how we think of common physical afflictions as near universal experiences across the life course, but less frequent at any given moment. Adolescents are particularly vulnerable. Therefore, public health policy should focus on early universal promotion of positive mental health and structural determinants of mental health.
Assuntos
Serviços de Saúde do Adolescente/estatística & dados numéricos , Transtornos Mentais/epidemiologia , Transtornos Mentais/terapia , Serviços de Saúde Mental/estatística & dados numéricos , Psicopatologia/métodos , Adolescente , Adulto , Transtornos de Ansiedade/diagnóstico , Feminino , Seguimentos , Inquéritos Epidemiológicos , Humanos , Incidência , Estudos Longitudinais , Masculino , Transtornos Mentais/diagnóstico , Transtornos Mentais/psicologia , Saúde Mental , México/epidemiologia , Prevalência , Escalas de Graduação Psiquiátrica , Estudos Retrospectivos , Índice de Gravidade de Doença , Fatores Socioeconômicos , Transtornos Relacionados ao Uso de Substâncias/psicologia , Inquéritos e Questionários , Adulto JovemRESUMO
OBJECTIVE: To estimate the prevalence, sex, age distribution, and socio-demographic correlates of any alcohol use, consumption patterns, and any alcohol use disorder in a representative sample of Mexican adolescents. METHODS: 3005 youth (52.1% female) aged 12-17 from a stratified multistage area probability sample were representative of adolescents residing in the Mexico City Metropolitan Area. Alcohol use and disorder and their socio-demographic correlates were evaluated with the World Mental Health adolescent version of the Composite International Diagnostic Interview. Data were post-stratified to the total Mexico City adolescent population. RESULTS: 59% has used alcohol, this proportion increasing significantly with age. By age 17, 82.5% has used alcohol. Consumption patterns are mostly of low/moderate quantity or infrequent high quantity. Lifetime DSM-IV alcohol use disorder criteria are met by 3.8%, reaching 8.1% for 16-17 years-olds. While males have greater frequency and quantity of drinking, there are no gender differences for alcohol use disorders. Non-school attending youth have twice the odds of a lifetime (OR=2.0, 95% CI=1.13-3.53) and 12-month disorder (OR=2.1, 95% CI=1.10-4.15). Low parental monitoring is associated with 1.72 times the odds of a lifetime disorder (95% CI=1.10-2.68). CONCLUSIONS: Over a third of 12 year-olds had ever drunk an alcoholic beverage in their lifetime suggesting that the prevention of alcohol use and disorders must begin in late childhood. Initiatives to foment parental monitoring and to prevent, identify, and treat alcohol use problems in non-school attending youth in particular should be a priority for the wellbeing of Mexico City adolescents.
Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Alcoolismo/epidemiologia , Adolescente , Fatores Etários , Idade de Início , Criança , Interpretação Estatística de Dados , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Inquéritos Epidemiológicos , Humanos , Modelos Logísticos , Masculino , Saúde Mental , México/epidemiologia , Prevalência , Fatores Sexuais , Fatores Socioeconômicos , População UrbanaRESUMO
BACKGROUND: Studies have shown that those who experience chronic childhood adversity have a greater likelihood of substance abuse and dependence. However, substance use disorders are first preceded by substance use, and substance use is preceded by substance use opportunities. This study aims to estimate the association of chronic adversity with different stages of substance involvement: opportunities, use given the opportunity and abuse or dependence given use. METHODS: 3005 adolescents aged 12-17 were interviewed in a stratified multistage general population probability survey of Mexico City, Mexico. Substance involvement and chronic childhood adversities were assessed with the World Mental Health Composite International Diagnostic Interview Adolescent Version (WMH-CIDI-A). Discrete-time survival models were performed; their survival coefficients and standard errors were exponentiated, and reported as odds-ratios (ORs). RESULTS: Childhood adversities were associated with alcohol opportunity, alcohol use and alcohol abuse/dependence with significant ORs for individual adversities ranging from 1.4 to 4.1. Childhood adversities were also associated with illicit drug opportunity, drug use and drug abuse/dependence with significant ORs for individual adversities ranging from 1.6 to 17.3. Having more adversities was associated with greater incremental odds of substance involvement, particularly drug use given the opportunity. CONCLUSIONS: While adversities are mostly related to transitioning into use and disorder, a few are related to substance opportunities, particularly those which were likely to make substances available through parents. Attending to the needs of youth living in adversity, particularly adversities related to parental dysfunction and child abuse should be integral to addiction prevention efforts.
Assuntos
Comportamento do Adolescente/psicologia , Maus-Tratos Infantis/psicologia , Acontecimentos que Mudam a Vida , Relações Pais-Filho , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adolescente , Criança , Maus-Tratos Infantis/etnologia , Estudos Transversais , Feminino , Humanos , Masculino , México/etnologia , Relações Pais-Filho/etnologia , Estudos Retrospectivos , Fatores de Risco , Fatores Socioeconômicos , Transtornos Relacionados ao Uso de Substâncias/etnologiaRESUMO
Objetives The objective of this article is to estimate the prevalence of DSM-IV anorexia nervosa, bulimia nervosa and binge-eating disorder in the general adolescent population of the Mexico City Metropolitan Area. A further objective is to describe socio-demographic and clinical characteristics of youth who meet criteria for these disorders, the proportion with impairment, psychiatric comorbidity and suicidal behavior, as well as to estimate service utilization. Methods The data come from the Mexican Adolescent Mental Health Survey, a probablistic multi-stage survey representative of adolescents between 12 and 17 years of age, residents of the Mexico City Metropolitan Area. Trained interviewers administered face-to-face the World Mental Health computerized adolescent version of the Composite International Diagnostic Interview (WMH-CIDI-A) to 3005 adolescents in their homes. The response rate was 71%. Results The lifetime prevalence of anorexia, bulimia and binge-eating disorder in the Mexico City adolescent population is 0.5%, 1.0% and 1.4%, respectively. Between 83% and 100% report any impairment and all of those with anorexia and almost half of those with bulimia and binge-eating disorder report serious impairment. However, only 14% to 24% of those with a 12-month eating disorder have sought treatment despite the associated impairment. There is greater prevalence of comorbid psychiatric disorders, suicidal behavior and psychosocial adversities in those with an eating disorder than in those without such a disorder. Conclusions These results clearly demonstrate a treatment gap for these disorders in our adolescent population. They highlight the importance of programs for the prevention of risky eating behaviors, early detection focusing on vulnerable groups such as those who have suffered adversity like sexual abuse, and the reduction of treatment seeking and utilization barriers.
Objetivos El presente trabajo tiene el objetivo de estimar la prevalencia de anorexia nervosa, bulimia nervosa y el trastorno por atracones en la población general de adolescentes del Distrito Federal. Asimismo se pretende proporcionar una descripción de las características socio-demográficas y clínicas de los jóvenes que cumplen criterios diagnósticos según el DSM-IV para estos trastornos, la proporción de discapacidad, comorbilidad psiquiátrica y conducta suicida para cada trastorno y estimar la utilización de servicios. Material y métodos Los datos provienen de la Encuesta Mexicana de Salud Mental Adolescente, una encuesta con diseño probabilístico y multietápico representativa de adolescentes entre los 12 y 17 años, residentes del Distrito Federal y área conurbada. Se entrevistó a 3005 adolescentes en sus hogares utilizando como instrumento diagnóstico la Entrevista Internacional Diagnóstica Compuesta (WMH-CIDI-A), aplicada cara a cara, por medio de una computadora portátil, por encuestadores capacitados. La tasa de respuesta fue de 71%. Resultados La prevalencia alguna vez de anorexia, bulimia y el trastorno por atracones se estima en 0.5%, 1.0% y 1.4%, respectivamente. Entre 83 y 100% reportan discapacidad y todos aquellos con anorexia y casi la mitad de aquellos con bulimia y atracones reportan discapacidad grave. Sin embargo, ni una cuarta parte con uno de estos trastornos ha recibido tratamiento a pesar de la discapacidad que generan. Hay mayor prevalencia de trastornos comórbidos, conducta suicida y adversidades psicosociales en jóvenes con trastornos alimentarios que en aquellos sin ellos. Conclusiones Los hallazgos muestran una brecha entre las necesidades de atención y el tratamiento para estos trastornos en nuestra población adolescente. Señalan la importancia de programas para la prevención de conductas alimentarias riesgosas, la detección temprana con un enfoque en grupos vulnerables (por ejemplo quienes han sufrido alguna adversidad como abuso sexual), y la reducción de barreras para la búsqueda y utilización de servicios.
RESUMO
OBJECTIVE: Limited educational and job opportunities for youth has led to a phenomenon termed NEET (not in education, employment or training). The objective is to estimate the prevalence of psychiatric disorders, substance use and suicidal behavior in youth classified as NEET and to compare with those who study only, work only or do both. MATERIAL AND METHODS: 3 005 12-to-17 year-olds in Mexico City were evaluated in 2005 with the Composite International Diagnostic Interview. Descriptive and logistic regression analyses considered the multistage weighted sample design. RESULTS: NEET youth as well as those who work only or study and work simultaneously have greater odds of psychiatric disorder, substance use and suicidal behavior compared to those who study exclusively even after controlling for social disadvantage. CONCLUSION: Vulnerability is not circumscribed to NEET adolescents, but to all teens who are not exclusive students. Supporting youth to continue studying exclusively may buffer negative mental health outcomes.
OBJETIVO: Oportunidades educativas y laborales limitadas para los jóvenes han dado lugar al fenómeno de adolescentes que no estudian ni trabajan (NINIs). El objetivo es estimar la prevalencia de trastornos psiquiátricos, consumo de sustancias y conducta suicida en adolescentes NINIs y compararlos con adolescentes que estudian exclusivamente, trabajan exclusivamente y quienes estudian y trabajan. MATERIAL Y MÉTODOS: 3 005 adolescentes entre 12 y 17 años de edad fueron evaluados en 2005 con la Entrevista Internacional Psiquiátrica Compuesta en una encuesta multietápica, estraficada y representativa del Distrito Federal y municipios conurbados. RESULTADOS: Los NINIs, quienes trabajan, y quienes estudian y trabajan tienen mayor riesgo de trastornos psiquiátricos, consumo de sustancias y conducta suicida en comparación con aquellos que estudian exclusivamente. CONCLUSIÓN: La vulnerabilidad no se circunscribe a los NINIs sino a todos los que no son estudiantes exclusivamente. Apoyar a los jóvenes para que estudien podría beneficiar su salud mental.
Assuntos
Adolescente , Criança , Humanos , Comportamento do Adolescente , Psicologia do Adolescente , Transtornos Mentais/epidemiologia , Evasão Escolar/estatística & dados numéricos , Desemprego/estatística & dados numéricos , Escolaridade , Inquéritos Epidemiológicos , Entrevista Psicológica , México/epidemiologia , Prevalência , Fatores de Risco , Estudos de Amostragem , Fatores Socioeconômicos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Suicídio/estatística & dados numéricos , População Urbana/estatística & dados numéricosRESUMO
OBJECTIVE: Limited educational and job opportunities for youth has led to a phenomenon termed NEET (not in education, employment or training). The objective is to estimate the prevalence of psychiatric disorders, substance use and suicidal behavior in youth classified as NEET and to compare with those who study only, work only or do both. MATERIAL AND METHODS: 3 005 12-to-17 year-olds in Mexico City were evaluated in 2005 with the Composite International Diagnostic Interview. Descriptive and logistic regression analyses considered the multistage weighted sample design. RESULTS: NEET youth as well as those who work only or study and work simultaneously have greater odds of psychiatric disorder, substance use and suicidal behavior compared to those who study exclusively even after controlling for social disadvantage. CONCLUSION: Vulnerability is not circumscribed to NEET adolescents, but to all teens who are not exclusive students. Supporting youth to continue studying exclusively may buffer negative mental health outcomes.
Assuntos
Comportamento do Adolescente , Transtornos Mentais/epidemiologia , Psicologia do Adolescente , Evasão Escolar/estatística & dados numéricos , Desemprego/estatística & dados numéricos , Adolescente , Criança , Escolaridade , Inquéritos Epidemiológicos , Humanos , Entrevista Psicológica , México/epidemiologia , Prevalência , Fatores de Risco , Estudos de Amostragem , Fatores Socioeconômicos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Suicídio/estatística & dados numéricos , População Urbana/estatística & dados numéricosRESUMO
Systemic autoimmune diseases are conditions of unknown etiology, characterized by the simultaneous or successive involvement of most organs and systems, as well as the presence of autoantibodies as biological markers. Venous thromboembolic disease has a higher incidence in this population when compared to healthy individuals. This responds to the increase in congenital and acquired risk factors in this group. One of the main risk factors is linked to the presence of antiphospholipid antibodies, whose prevalence is increased among patients with such conditions.
Assuntos
Doenças Autoimunes/complicações , Tromboembolia Venosa/complicações , Anticorpos Antifosfolipídeos/imunologia , Doenças Autoimunes/imunologia , Humanos , Fatores de Risco , Tromboembolia Venosa/imunologiaRESUMO
BACKGROUND: Specific phobia is among the most common disorders in the general adolescent population, but also among the least studied. The objectives of this study were to estimate the prevalence of specific fears among adolescents, the proportion of those with fears who meet criteria for specific phobia, and the proportion who recognize their fears as excessive and to identify comorbidity with other disorders and factors associated with severity and treatment. METHOD: 3,005 youth aged 12 to 17 years participated in the Mexican Adolescent Mental Health Survey, a stratified multistage probability sample representative of adolescents living in Mexico City in 2005. Fears, specific phobia, and 20 other DSM-IV psychiatric disorders were evaluated with the adolescent computerized version of the World Mental Health Composite International Diagnostic Interview, administered by trained lay interviewers in the participants' homes. Descriptive, logistic regression, and discrete-time survival analyses were employed. RESULTS: Most adolescents reported at least 1 fear (76.5%); 36.5% of those met lifetime criteria for specific phobia, and 27.3% met criteria in the prior 12 months. Blood-injection-injury and animal fears were the most common types. Females were more likely to report any fear, to have more fear types, and to meet diagnostic criteria. Increased numbers of fears were associated with increased odds of meeting specific phobia criteria and with increased impairment. Among teens with specific phobia, 71.3% recognized their fear as excessive, 9.7% to 12.3% reported severe impairment, and only 6.5% had received treatment. Severity of impairment and comorbid disorders were associated with treatment seeking. CONCLUSIONS: The large percentage of adolescents meeting diagnostic criteria coupled with the low proportion with serious impairment suggests that current diagnostic thresholds may be too low or not developmentally sensitive. Future research should address the nature of impairment for adolescents with specific phobia. Early detection and timely treatment are important given that specific phobia is persistent and highly comorbid and that few individuals seek treatment.
Assuntos
Comportamento do Adolescente/psicologia , Medo/psicologia , Transtornos Fóbicos/epidemiologia , Transtornos Fóbicos/psicologia , Adolescente , Criança , Comorbidade , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , México/epidemiologia , PrevalênciaRESUMO
Introducción: el Síndrome de Guillaín-Barré (SGB) es una enfermedad autoinmune autolimitada considerándose la neuropatía aguda más frecuente. Objetivo: describir las características clínicas, analíticas y epidemiológicas de diez pacientesadultos con diagnóstico de Sindrome de Guillaín-Barré. Material y método: se incluyeron pacientes con diagnóstico de SGB. Se revisó retrospectivamente la historia clínica extrayéndose datos epidemiológicos, clínicos, paraclínicos y modalidad terapéutica utilizada.Resultados: siete pacientes eran de sexo masculino. La edad al diagnóstico fue 43,3 ± 17,3 años. El tiempo entre inicio de los síntomas y diagnóstico fue 13,6 ± 7,8 días. En la mitad se encontró un potencial desencadenante. La totalidad presentó compromiso espinal y cuatrocompromiso craneal. En ocho pacientes se objetivó disociación albúmino-citológica y pacientes sometidos a estudio de neuroconducción (ENC) mostraron alteraciones predominando el patrón desmielinizante sobre el axonal. Un subgrupo de pacientes presentópositividad para anticuerpos antigangliósido y anticerebrósido sin vincularse éstos a la presentación clínica, severidad, evolución ni patrón del ENC. El tratamiento se realizó enbase a recambio plasmático, inmunoglobulina intravenosa o combinación de ambos. No se halló correlación entre el tipo de tratamiento instituído y la evolución clínica al egreso. Al alta mostraron recuperación 9/10. Conclusiones: las características clínicas, analíticas y epidemiológicas son similares a las presentadas en otras series. Fueron frecuentes las infecciones como eventos desencadenantes. El tiempo entre inicio de los síntomas y diagnóstico fue prolongado. Las manifestaciones clínicas y el ENC fueron herramientas diagnósticas útiles, no así la búsqueda de autoanticuerpos. No hubo diferencias en los resultados en función del tratamiento instituido.
Introduction: Guillain-Barré syndrome (GBS) is a self-limited autoimmune disorder and it is regarded as the mostfrequent neuropathy. Objective: the present study aimed to describe theclinical presentation, as well as the analytical and epidemiologicalcharacteristics in ten adult patients diagnosed with Guillain-Barré syndrome.Method: 10 patients with diagnose of GBS were included in the study. We retrospectively revised epidemiological,clinical and para-clinical data, as well as the therapeutic modality used. Results: seven patients were men. Age at diagnosis was 43.3 ± 17.3 years old. Time between the onset of symptomsand initiation of treatment was 13.6 ± 7.8 days. In all cases there was spine compromise and in four of them there was cranial compromise. Eight patients showed albumin-cytologic dissociation and patients who underwent nerve conduction studies (NCS) evidenced alterations mainly presenting demyelinating patterns on the axon.A sub-group was found positive for antiganglioside and anti-cerebroside antibodies without their being connectedto clinical presentation, severity, evolution or pattern in the NCS. Treatment was based on plasma replacement, intravenous immunoglobulin or both. No correlation was found between the treatment applied and the clinical evolution upon being discharged. Upon leaving the hospital, 9/10 appeared to be recovered. Conclusions: clinical, analytical and epidemiologicalcharacteristics are similar to those in other groups. Infectious triggers were frequent. Time between the onset of symptoms and diagnose was long. Unlike antibodies search, clinical manifestations and NCS were usefuldiagnostic techniques. No differences were found in terms of the treatment applied.
A síndrome de Guillaín-Barré (SGB) é uma doença autoimune autolimitada e é considerada como a neuropatia aguda mais freqüente. Objetivo: descrever as características clínicas, analíticas e epidemiológicas de dez pacientes adultos com diagnóstico de síndrome de Guillaín-Barré. atendidos em forma consecutiva no período 2005 a 2009 em uma instituição de saúde. Material e métodos: foram estudados pacientes com diagnóstico de SGB. Fez-se uma revisão retrospectiva dos prontuários dos pacientes para obtenção dos dados epidemiológicos, clínicos, exames auxiliares e tratamento recibido. Resultados: sete pacientes eram do sexo masculino; a idade media no momento do diagnóstico era 43,3 ± 17,3 anos e o tempo entre o inicio dos sintomas e o diagnóstico foi de 13,6 ± 7,8 dias. Em 50 por cento dos casos uma infecção foi o provável desencadeante. Todos os pacientes apresentaram compromisso espinal: motor 10/10, sensitivo 8/10 e neurovegetativo 1/10; quatro apresentaram compromisso craniano. Em oito pacientes se observoudissociação albumino-citológica no líquido cefalorraquidiano e os oito pacientes submetidos a estudo de neurocondução (ENC) mostraram alterações com predominância do padrão desmielinizante (6/8) sobre o axonal (2/8). Um subgrupo de pacientes foi positivo para anticorposantigangliosideo e anticerebrosideo sem relação com a apresentação clínica, gravidade, evolução ou padrão doENC. O tratamento foi realizado utilizando troca plasmática, imunoglobulina intravenosa ou a combinação de ambas. Não se observou correlação entre o tipo de tratamentousado e a evolução clínica na alta. Nove dos dez pacientes estavam recuperados no momento da alta hospitalar.Conclusões: as características clínicas, analíticas e epidemiológicas são similares as descritas em outras séries.Foram freqüentes os casos em que as infecções desencadearam a SGB. O tempo passado entre o inicio dos sintomas e o diagnóstico foi prolongado. As manifestações clínicas e o ENC foram ferramentas úteis...