RESUMO
AIMS: To provide cross-national data for selected countries of the Americas on service utilization for psychiatric and substance use disorders, the distribution of these services among treatment sectors, treatment adequacy and factors associated with mental health treatment and adequacy of treatment. METHODS: Data come from data collected from 6710 adults with 12 month mental disorder surveys across seven surveys in six countries in North (USA), Central (Mexico) and South (Argentina, Brazil, Colombia, Peru) America who were interviewed 2001-2015 as part of the World Health Organization (WHO) World Mental Health (WMH) Surveys. DSM-IV diagnoses were made with the WHO Composite International Diagnostic Interview (CIDI). Interviews also assessed service utilization by the treatment sector, adequacy of treatment received and socio-demographic correlates of treatment. RESULTS: Little over one in four of respondents with any 12 month DSM-IV/CIDI disorder received any treatment. Although the vast majority (87.1%) of this treatment was minimally adequate, only 35.3% of cases received treatment that met acceptable quality guidelines. Indicators of social-advantage (high education and income) were associated with higher rates of service use and adequacy, but a number of other correlates varied across survey sites. CONCLUSIONS: These results shed light on an enormous public health problem involving under-treatment of common mental disorders, although the problem is most extreme among people with social disadvantage. Promoting services that are more accessible, especially for those with few resources, is urgently needed.
Assuntos
Transtornos Mentais/terapia , Serviços de Saúde Mental/estatística & dados numéricos , Adolescente , Adulto , Idoso , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/terapia , Argentina/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/terapia , Transtorno Bipolar/epidemiologia , Transtorno Bipolar/terapia , Brasil/epidemiologia , Colômbia/epidemiologia , Transtornos Disruptivos, de Controle do Impulso e da Conduta/epidemiologia , Transtornos Disruptivos, de Controle do Impulso e da Conduta/terapia , Escolaridade , Utilização de Instalações e Serviços , Feminino , Acessibilidade aos Serviços de Saúde , Humanos , Renda , Masculino , Transtornos Mentais/epidemiologia , México/epidemiologia , Pessoa de Meia-Idade , Transtornos do Humor/epidemiologia , Transtornos do Humor/terapia , Peru/epidemiologia , Guias de Prática Clínica como Assunto , Qualidade da Assistência à Saúde , Índice de Gravidade de Doença , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/terapia , Estados Unidos/epidemiologia , Adulto JovemRESUMO
AIMS: Low and middle income countries share a heavy burden of suicide with about three in every four suicides occurring in these countries. Mexico has witnessed a growing trend in suicide deaths; if this trend is not simply a reflection of better reporting of suicide on death certificates, then this increase should logically be accompanied by an increasing trend in suicide ideation, plan and attempts, but we lack information on the trends for suicide ideation, plan and attempt for this period. We therefore aim to report changes for suicidal behaviour for the period 2001-2013 in the Mexico City Metropolitan Area. METHOD: Using two cross-sectional surveys conducted in Mexico in 2001 and 2013, we report the lifetime and 12-month prevalence of suicide ideation, plan and attempt and changes in treatment for these problems among respondents aged 19-26 living in the Mexico City Metropolitan Area 12 years apart. To estimate the changes in prevalence for each outcome, we used generalised linear models to calculate prevalence ratios (PR; the prevalence rate in the exposed (year 2013) divided by the prevalence rate in the unexposed (year 2001-2002), adjusting for sociodemographic variables. RESULTS: While increases in the prevalence are noted everywhere, statistical comparisons only found differences for lifetime ideation (PR = 3.1; 95% CI = 1.7-5.8) and a borderline difference for suicide attempt (PR = 2.2; 95% CI = 1.0-4.9). No attempt within the last 12-months was reported in 2001, but the prevalence in 2013 reached 1.5% (18 cases). While PRs for 12-month prevalence were all above the null, none reached statistically significant differences. During this 12-year period, the distribution of mental disorders and the use of services for mental disorders among suicide ideators, planners and attempters did not change in any noticeable way. CONCLUSIONS: The limitations of our data are the small number of participants in the 2001 survey, the low follow-up rate for the survey in 2013 and that while representative from one city it does not represent the whole country. These findings suggest that suicide ideation and attempt may have increased during this 12-year period in the Mexico City metropolitan area, but this increase did not lead to more use of mental health care services. This information, coupled with the long-term trend of increasing suicide death rates in the country, draw a worrisome and neglected scenario for our youth in this region. Urgent measures, following the recent WHO guidelines for suicide prevention, must not be postponed.
Assuntos
Transtornos Mentais/psicologia , Ideação Suicida , Tentativa de Suicídio/estatística & dados numéricos , Suicídio/estatística & dados numéricos , Adulto , Causas de Morte/tendências , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Transtornos Mentais/epidemiologia , México/epidemiologia , Suicídio/psicologia , Suicídio/tendências , Tentativa de Suicídio/psicologia , Tentativa de Suicídio/tendências , Adulto JovemRESUMO
BACKGROUND: Considerable research has documented that exposure to traumatic events has negative effects on physical and mental health. Much less research has examined the predictors of traumatic event exposure. Increased understanding of risk factors for exposure to traumatic events could be of considerable value in targeting preventive interventions and anticipating service needs. METHOD: General population surveys in 24 countries with a combined sample of 68 894 adult respondents across six continents assessed exposure to 29 traumatic event types. Differences in prevalence were examined with cross-tabulations. Exploratory factor analysis was conducted to determine whether traumatic event types clustered into interpretable factors. Survival analysis was carried out to examine associations of sociodemographic characteristics and prior traumatic events with subsequent exposure. RESULTS: Over 70% of respondents reported a traumatic event; 30.5% were exposed to four or more. Five types - witnessing death or serious injury, the unexpected death of a loved one, being mugged, being in a life-threatening automobile accident, and experiencing a life-threatening illness or injury - accounted for over half of all exposures. Exposure varied by country, sociodemographics and history of prior traumatic events. Being married was the most consistent protective factor. Exposure to interpersonal violence had the strongest associations with subsequent traumatic events. CONCLUSIONS: Given the near ubiquity of exposure, limited resources may best be dedicated to those that are more likely to be further exposed such as victims of interpersonal violence. Identifying mechanisms that account for the associations of prior interpersonal violence with subsequent trauma is critical to develop interventions to prevent revictimization.
Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Vítimas de Crime/estatística & dados numéricos , Estado Terminal/epidemiologia , Estado Civil/estatística & dados numéricos , Trauma Psicológico/epidemiologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Adulto , Idoso , Análise Fatorial , Feminino , Humanos , Cooperação Internacional , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Proteção , Fatores de Risco , Inquéritos e Questionários , Adulto JovemRESUMO
AIMS: To examine whether the association between prevalence measures of suicidality and substance abuse/dependence among adolescents (1) is attenuated when temporal priority of exposure and outcome are taken into account, (2) extends to substance use (i.e. without disorder), (3) applies to tobacco use and dependence independent of illicit drugs and alcohol use/disorder, and (4) is confounded by comorbid mental illness. DESIGN: Discrete-time survival models were applied to retrospectively reported age of onset of first suicidal ideation, plan and attempt and age of onset of first substance use and disorder. PARTICIPANTS: 3005 adolescents aged 12-17 residing in the Mexico City Metropolitan Area in 2005. MEASUREMENTS: The World Mental Health computer-assisted adolescent version of the Composite International Diagnostic Interview was used to assess suicidal outcomes and psychiatric disorders including substance dependence/abuse. FINDINGS: Use of and dependence on tobacco is as strong a predictor of subsequent suicidality as is use of and dependence with abuse of alcohol and drugs. The association between substance use and subsequent suicidality is not fully accounted for by comorbid mental illness. CONCLUSION: Efforts to reduce the use as well as the abuse of alcohol, drugs and tobacco may help reduce the risk of subsequent suicidal behaviors among adolescents in Mexico.
Assuntos
Comportamento do Adolescente/efeitos dos fármacos , Consumo de Bebidas Alcoólicas/efeitos adversos , Diagnóstico Duplo (Psiquiatria)/efeitos adversos , Usuários de Drogas/psicologia , Inquéritos Epidemiológicos/métodos , Nicotiana/efeitos adversos , Suicídio/estatística & dados numéricos , Adolescente , Idade de Início , Criança , Feminino , Humanos , Masculino , Transtornos Mentais/complicações , México , Transtornos Relacionados ao Uso de Substâncias/complicaçõesRESUMO
BACKGROUND: While an association between cigarette smoking and depression has been established in Anglo populations, replication of tobacco-depression associations in countries where smoking is growing may provide important new insights. The objectives of this study were to estimate the association of depressive symptomatology with tobacco smoking, number of cigarettes smoked daily, and smoking cessation in a representative sample of the Mexican population. METHOD: The data come from the Third National Addictions Survey (1998) conducted by the Mexican Ministry of Health, representative of Mexico's civilian population residing in cities and towns with 2500+ inhabitants, aged 18-64. Part of a multi-stage, stratified, probability sample, 1935 men and women answered a version of the survey that also included the CES-D depression scale. Analyses addressed the survey's complex design and controlled for income and educational evel. RESULTS: Among women only, current smokers had twice the odds of elevated depressive symptomatology than never smokers (OR 2.1, 95% CI 1.3-3.5, p = 0.002). For men, only those smoking a pack or more a day had greater odds of depressive symptomatology (OR 5.9, 95% CI 1.6-21.9, p = 0.008). Overall, former smokers who ceased smoking within 6 months had lower odds of depressive symptomatology than current smokers (OR 0.4, 95% CI 0.1-1.0, p = 0.042). CONCLUSIONS: These findings add to the accumulating evidence for the association between smoking and depression in different cultures and populations.
Assuntos
Depressão/etnologia , Inquéritos e Questionários , Tabagismo/etnologia , Adolescente , Adulto , Depressão/diagnóstico , Depressão/epidemiologia , Escolaridade , Feminino , Humanos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Prevalência , Abandono do Hábito de Fumar/métodos , Fatores Socioeconômicos , Tabagismo/diagnóstico , Tabagismo/epidemiologiaRESUMO
OBJECTIVE: The aim of this study was to obtain epidemiological measures of the association between alcohol consumption and emergency room (ER) attendance due to violence, compared to the general population in the city of Pachuca, Mexico, during October-November, 1996 and June-July, 1997. METHOD: The study was a population-based case-control design. INTERVENTION AND MEASUREMENTS: Data consisted of an interviewer-administered questionnaire, collected on a 24-h basis, during the entire week. SETTING AND PARTICIPANTS: Cases were 127 patients (78% male) admitted to the ER because of an injury that was the result of violence (being in a fight or being attacked by someone). A sample of residents from Pachuca (n = 920) was the comparison group. RESULTS: Patients reporting drinking within 6h compared to nondrinkers were more likely to suffer a violence-related injury [34.0 (17.5-66.2)] and alcohol dependent patients were more likely to be involved in a violence-related injury [7.4 (3.5-15.6)] compared to noncurrent drinkers. When both alcohol prior and alcohol dependence were considered simultaneously in multiple models among current drinkers, patients with violence-related injuries were more likely to report alcohol prior but not to be positive for alcohol dependence. Depressive symptoms, but not conduct problem behavior, were also associated with violent injury in simultaneous regressions that included alcohol variables. CONCLUSIONS: In the city of Pachuca, Mexico, a large relationship between drinking prior to the event and violence-related injury, regardless of alcohol dependence, was found. Depression was also related to violence, suggesting the need for more comprehensive intervention with these patients.
Assuntos
Alcoolismo/complicações , Transtorno da Personalidade Antissocial/complicações , Depressão/complicações , Serviço Hospitalar de Emergência/estatística & dados numéricos , Violência/estatística & dados numéricos , Ferimentos e Lesões/terapia , Adolescente , Adulto , Idoso , Estudos de Casos e Controles , Feminino , Pesquisa sobre Serviços de Saúde , Humanos , Masculino , México , Pessoa de Meia-Idade , Inquéritos e Questionários , Ferimentos e Lesões/etiologiaRESUMO
The authors compared high school students in Baja California Norte (BCN), Mexico (n = 775), with Mexican American students in Los Angeles (LA), California (n = 516). The students' use of cigarettes, alcohol, marijuana, cocaine, inhalants, and other illicit drugs were compared, because these vary by gender, country, and their age of first drug use and are influenced by demographic variables, individual characteristics, and environmental influences. More BCN students than LA students had used alcohol, but more LA than BCN students had used illicit drugs and initiated drug use earlier. When demographic variables were influential, they were most powerful and increased the risk for drug use more than environmental factors or individual characteristics. Environmental factors were most influential for boys' drug use, whereas environmental and demographic variables were most influential for girls' drug use.
Assuntos
Comportamento do Adolescente/psicologia , Americanos Mexicanos/psicologia , Autoimagem , Meio Social , Transtornos Relacionados ao Uso de Substâncias/etnologia , Adolescente , Adulto , California/epidemiologia , Área Programática de Saúde , Feminino , Humanos , Masculino , Americanos Mexicanos/estatística & dados numéricos , Prevalência , Estados Unidos/epidemiologiaRESUMO
OBJECTIVE: This article describes the demographic characteristics and psychological differences in a sample of female heavy and non-heavy drinkers who attended three emergency services of the Mexican city of Pachuca, Hidalgo. MATERIAL AND METHODS: A sample of patients seen at emergency services (ES) patients over the age of 18 was selected using ES admission forms. Twenty-five-minute, face-to-face interviews were conducted by a group of trained interviewers. Patients answered various questionnaires and scales to measure alcohol consumption and to provide information on variables that have proved to be related to female drinking. RESULTS: Thirty-six women (5.2%) out of 717 of the total number of women were found to be heavy drinkers according to the TWEAK scale. This group of women had 2.3 times the risk of becoming depressed, 2.87 times the risk of taking other drugs, 1.95 times the likelihood of having been sexually abused and 1.57 times the risk of displaying suicidal ideation. CONCLUSIONS: Data from this small analysis confirm international findings that problem drinking among females throughout the life cycle is linked to depression. As regards the screening instruments employed, it is necessary to conduct more in-depth research to enrich their contents and increase their reliability and validity when used among female populations. In this study, the TWEAK proved to be extremely useful for studies in emergency services.
Assuntos
Consumo de Bebidas Alcoólicas , Alcoolismo , Mulheres , Adolescente , Adulto , Idoso , Consumo de Bebidas Alcoólicas/psicologia , Alcoolismo/complicações , Alcoolismo/psicologia , Depressão/complicações , Depressão/etiologia , Serviço Hospitalar de Emergência , Feminino , Humanos , Entrevistas como Assunto , México , Pessoa de Meia-Idade , Fatores de Risco , Delitos Sexuais , Transtornos Relacionados ao Uso de Substâncias/complicações , Suicídio , Inquéritos e QuestionáriosRESUMO
Alcohol abuse is an endemic problem in the country, by itself is responsible of 9% of the global burden of disease due to premature death and disability associated with cirrhosis, accidents, homicides and dependence. Use of other drugs is increasing with an important participation of cocaine and with out breaks of heroin use in the northern border. With the increase of drugs with higher potential of development of addiction, new are required to treat dependence and sequels derived from chronic use. The aim of this paper is to provide an overview of the available alternatives to be instrumented within the health system.
Assuntos
Transtornos Relacionados ao Uso de Substâncias/terapia , Humanos , Transtornos Relacionados ao Uso de Substâncias/diagnósticoRESUMO
The paper addresses the experiences of measuring and monitoring patterns of alcohol consumption and consequences in Mexico, provides an overview of alcohol use and problems, describes local cultural values that influence patterns of drinking, and discusses measurement implications.
Assuntos
Consumo de Bebidas Alcoólicas/efeitos adversos , Transtornos Relacionados ao Uso de Álcool/epidemiologia , Países em Desenvolvimento , Inquéritos Epidemiológicos , Adolescente , Adulto , Idoso , Consumo de Bebidas Alcoólicas/epidemiologia , Estudos Transversais , Características Culturais , Feminino , Humanos , Incidência , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Valores SociaisRESUMO
AIMS: To examine the symptom profile and factorial structure of DSM-IV alcohol dependence. DESIGN: Subjects were interviewed in program facilities by trained interviewers using a standardized questionnaire. The response rate was 95% in Mexico and 90% in the United States. SETTING: Two publicly funded inpatient facilities in Mexico and five in the United States. In Mexico the programs were located in Mexico City. In the United States the programs were located in Santa Clara County, California. PARTICIPANTS: Three hundred and ninety-one Mexican and 212 Mexican American men in treatment for alcohol problems in Mexico and the United States. MEASUREMENT: Dependence criteria were assessed with the Composite Diagnostic Interview-Substance Abuse Module (CIDI-SAM). FINDINGS: The unidimensional structure of alcohol dependence fits the Mexican American data but not the Mexican data. However, when Mexican clients were divided according to place of interview (treatment program), the unidimensional structure fits one of the groups but not the other. CONCLUSIONS: The test of unidimensionality must be seen as inconclusive with regard to the Mexican data. These results highlight the potential influence that client selection methods may have on study results, especially in cross-cultural projects.
Assuntos
Alcoolismo/diagnóstico , Adulto , California , Indicadores Básicos de Saúde , Humanos , Masculino , Americanos Mexicanos , México/etnologia , Índice de Gravidade de Doença , Inquéritos e QuestionáriosAssuntos
Abuso Sexual na Infância , Fatores Etários , Alcoolismo/complicações , Criança , Abuso Sexual na Infância/diagnóstico , Abuso Sexual na Infância/etnologia , Abuso Sexual na Infância/prevenção & controle , Abuso Sexual na Infância/estatística & dados numéricos , Violência Doméstica/etnologia , Violência Doméstica/estatística & dados numéricos , Feminino , Guias como Assunto , Educação em Saúde , Humanos , Incesto/estatística & dados numéricos , Indígenas Norte-Americanos , Masculino , México/epidemiologia , México/etnologia , Fatores SexuaisRESUMO
OBJECTIVE: Prevalence of alcohol consumption and abuse among patients with medical emergencies, accidents and violence, attending an emergency room in one of three public health hospitals in Pachuca, Hidalgo, was studied. MATERIAL AND METHODS: Patients answered a questionnaire and their blood alcohol was measured on their first visit to the emergency room. The questionnaire gathered socio-demographic data, patterns of alcohol consumption and included scales for heavy and dependent drinkers, such as the CAGE and the alcohol use disorders identification test (AUDIT). Injured and non-injured patients were compared with the chi 2 statistics. RESULTS: A total of 1,511 patients were evaluated. Alcohol consumption was higher in those attending for accidents or violence than in medical patients. Positive blood alcohol levels were found in 17.7% of injured patients and 15.8% reported alcohol consumption 6 hours prior to the accident. According to the CAGE, 9.2% of the patients were alcohol-dependent, and 10.9% were heavy drinkers according to the AUDIT. CONCLUSIONS: Alcohol consumption, especially among emergency room patients attending for accidents or injuries is high. Preventive measures are indispensable to diminish social and individual costs of alcohol abuse in this population.
Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , População Urbana , Adolescente , Adulto , Idoso , Distribuição de Qui-Quadrado , Feminino , Hospitais Gerais/estatística & dados numéricos , Humanos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Prevalência , Fatores Socioeconômicos , População Urbana/estatística & dados numéricosRESUMO
OBJECTIVE: To determine the prevalence of sexual abuse among high school (secondary and preparatory) students, male and female, throughout Mexico, and its relationship with drug abuse. MATERIAL AND METHODS: Data were obtained from the National Survey of Drug Use in Schools applied in November and December, 1991. A total of 61,779 students, 51.8% men and 47.1% women, with a mean age of 14.4 years completed the self-applied questionnaire. Sexual abuse was explored from the perspective of the abusers and of the victims. RESULTS: The prevalence of sexual abuse in adolescent victims was 4.3% and no statistically significant differences were found between sexes. The prevalence of sexual aggressors was 2.5%. Men coerced someone else in a higher proportion than women. Adolescent women experienced sexual abuse at a younger age than men and they also reported a higher percentage of intrafamily abuse. Men reported friends as the most frequent aggressors. Victims and aggressors of both sexes reported a significantly higher drug consumption than students without these antecedents. CONCLUSIONS: The differences in the experience of sexual abuse between men and women are described. In particular, the fact that sexual abuse in men mainly occurs outside the family sphere, while in women it is mainly within the family and at a younger age than in men. Additionally, the need for further research focusing on the consequences on mental health of infantile and adolescent sexual abuse and drug consumption is emphasized, considering the characteristics of each gender.
Assuntos
Delitos Sexuais/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Distribuição por Idade , Criança , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , México/epidemiologia , Prevalência , Distribuição por SexoRESUMO
OBJECTIVE: This study surveyed high school student drug users in urban areas of Mexico to describe use patterns and drug-related behaviors among adolescents and to develop predictor models of pathways to underage drug use. SUBJECT/DESIGN: A National School Survey was conducted among high school students where data are provided by the State. Only urban sites were considered for this study (n = 40,521). Stratified two-stage cluster sampling was used; schools and groups within the schools were the sampling units. CONCLUSIONS: Male adolescents who have worked the previous year, have high exposure within the family and are affiliated with drug using peers are at increased risk of becoming drug users and subject to depression and suicidal ideation as well as drug-related social problems.
Assuntos
Comportamento do Adolescente , Estudantes/psicologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adolescente , Análise de Variância , Criança , Feminino , Humanos , Relações Interpessoais , Masculino , México/epidemiologia , Motivação , Distribuição por Sexo , Percepção Social , Valores Sociais , Transtornos Relacionados ao Uso de Substâncias/epidemiologiaRESUMO
Our purpose was to obtain epidemiological measures of the association between habitual alcohol consumption, alcohol consumption before the event and alcohol abuse/dependence, and emergency room (ER) attendance compared to the general population in Pachuca-Hidalgo, a city located in the central area of Mexico. The study was a population based case-control design. Data consisted of breath samples to estimated blood alcohol concentration, as well as an interviewer-administered questionnaire, collected on a 24-hr basis, during the entire week, in each of the three main ERs of Pachuca. Cases were all patients who visited the three main hospitals ERs during the study period, classified according to their status as an injured or noninjured (medically ill) patient (n = 1511). The general population sample (n = 920) serves as a comparison group for both types of patients. Injured patients in the ER sample were significantly more likely to report high frequency/high quantity of drinking during the last 12 months than the general population [odds ratio and 95% confidence intervals = 5.55 (1.72-17.97)] and to report drinking within 6 hr before the injury. These relationships did not hold for noninjured patients. Both types of patients were more likely to report high frequency of drunkenness during the preceding 12 months, to be positive for alcohol dependence and to report drug use. We found in the city of Pachuca, a large relationship between habitual alcohol consumption and ER injuries. These findings support associations of alcohol consumption and admission to an emergency room found in ER and general population studies in other countries. Due to the increases in the risk found for abuse/dependent in both injured and noninjured patients, they both would benefit with a brief intervention strategy for reducing their alcohol consumption.
Assuntos
Transtornos Relacionados ao Uso de Álcool/epidemiologia , Intoxicação Alcoólica/epidemiologia , Alcoolismo/epidemiologia , Países em Desenvolvimento , Serviço Hospitalar de Emergência/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Adolescente , Adulto , Idoso , Estudos de Casos e Controles , Intervalos de Confiança , Feminino , Humanos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Razão de Chances , Detecção do Abuso de Substâncias/estatística & dados numéricos , Ferimentos e Lesões/epidemiologiaRESUMO
This paper documents some possible reasons of failure of programs for street children in Mexico, and provides background information on demographic and socioeconomic trends that underlay self-employment as well as a historical perspective of the social context of street children. It also describes the strategies used to survive in the streets, trends in drug use/misuse, the felt needs of children and the social responses to this problem. It documents how underlying failure there are unrealistic goals, a fragmented perception of the problem and consequently, a fragmented response to it. It also refers to the great pressure on institutions for results, lack of continuity of the programs and disregard of the perception and felt needs of working children who should benefit from these programs.
Assuntos
Proteção da Criança/tendências , Emprego , Jovens em Situação de Rua , Avaliação de Programas e Projetos de Saúde , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Adolescente , Criança , Emprego/economia , Emprego/psicologia , Feminino , Jovens em Situação de Rua/etnologia , Jovens em Situação de Rua/legislação & jurisprudência , Jovens em Situação de Rua/psicologia , Jovens em Situação de Rua/estatística & dados numéricos , Humanos , Masculino , México/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologiaRESUMO
OBJECTIVE: To validate the Report Questionnaire for children (RQC) in order to estimate the prevalence of childhood psychiatric disorders in Mexico. MATERIAL AND METHODS: The RQC was applied by random selection to parents of children in a specialized care service, in a general practice setting and in schools, during an urban household survey within the National Mental Health Survey (NMHS) conducted in 1988. The sample size of adults participating in the NMHS was 2,025. Fifty-two percent (1,068) reported having a child between 3 to 12 years old living in the household. The data collection instrument was applied to the oldest children in that range. The weighted mean was used for analysis and the unbiased prevalence was estimated using the formula proposed by Rogan and Gladen; predictive values were computed using a Bayesian expression. RESULTS: The estimated prevalence of mental health disorders for children aged 3 to 12 years old was between 16.4% and 20.7%. The Positive Predictive Value of the instrument ranged between 46.6% and 76.1%, depending of the cut-off points: one or more positive items in the questionnaire or two or more. The Negative Predictive Value (NPV) ranged between 91.6% and 99.2%. CONCLUSIONS: The estimates are very similar to those reported in different countries and the NPV supports the reliability of the estimates and the potential uses of the instrument for the early detection of childhood psychiatric disorders.
Assuntos
Transtornos Mentais/epidemiologia , Adulto , Fatores Etários , Teorema de Bayes , Criança , Pré-Escolar , Estudos Transversais , Feminino , Necessidades e Demandas de Serviços de Saúde , Inquéritos Epidemiológicos , Humanos , Masculino , México/epidemiologia , Fatores Sexuais , Inquéritos e QuestionáriosRESUMO
This article describes the results from a drug use survey conducted among high school students of the Federal District. The analysis suggested that being male and attending the last three years of high-school, differentiated significantly users from non users. These two variables, along with an older age, differentiated students that had used one substance from those that had used more than one. These variables had no effect on the decision of stopping the use after experimenting or continuing the use of substances. Significant variables were also perception of availability, having friends, parents or brothers that use substances, or to knowing drug users; peer approval and low perception of risk. Depression symptoms differentiated only users from non users but suicidal tendency grew with use; receiving information from friends influenced the decision of experimenting and of using more than one substance. Finally, the more severe patterns were related to the perception that there are no consequences for drug use in the school.