[Early onset depression: prevalence, course, and treatment seeking delay]

Factores del ambiente familiar predictores de depresión en adolescentes escolares: análisis por sexo

En este artículo se analiza la manera en que se ha querido establecer en el estudiante universitario las competencias iniciales de investigación. La atención se enfoca en las diferentes tendencias que se han seguido para enseñar tempranamente al estudiante a investigar. Para hacer lo anterior, en primer lugar, se aborda la función de la universidad en la iniciación temprana a la investigación y después se presentan las tendencias que se han seguido en el pregrado para impulsar la formación inicial de los estudiantes para la investigación. Dichas tendencias se engloban en cinco modelos instruccionales: 1) demostrativo; 2) procedimental; 3) transcriptivo; 4) computacional, y (5) integral. El artículo finaliza examinando de las bondades y limitaciones de cada uno de dichos modelos, y concluye que para impulsar de modo efectivo la iniciación temprana a la investigación es necesario diseñar espacios curriculares en los planes de estudio en el pregrado, considerando como punto de referencia un modelo instruccional integral que conjugue la reflexión teórica con el uso de metodologías variadas y se apliquen procedimientos cuantitativos y cualitativos para analizar la base empírica obtenida en el proceso de investigación.

Revista Digital Internacional de Psicología y Ciencia Social | Volumen 6 | Número 1 | Enero-Junio 2020 | Investigación y acción para el cambio social

El nombre del presente número es “La investigación para la acción y el cambio social”, decidimos titularlo de esa manera porque consideramos de fundamental interés destacar la importancia que ha adquirido el trabajo científico desarrollado por los profesionales de distintas disciplinas para favorecer a la población que atienden respectivamente, pues en los trabajos presentados se muestra una excelente articulación entre la teoría y la práctica, poniendo en evidencia que se parte de una concepción social y científica, holística, pluralista e igualitaria.

Depressive disorder and psychosocial indicators in high school and college students from Mexico City: data from two censuses

Introduction. Almost 5% of the Mexican general population (18-65 years old) has suffered depression once in their lives, and 2% of them more than once without receiving treatment. Objetive. To measure the prevalence of depressive disorder and to calculate its relationship with psychosocial indicators. Method. Data were collected through two censuses with high school and college students from a university in Mexico City (n = 116 214). Participants completed the CES-D and other scales. Multivariate logistic regression models were used. Results. The prevalence of depressive disorder was 16%. Predictors of depressive disorder were: having suffered psychological or sexual violence, having a family member who had been injured during an assault, history of depression in the family, poor quality in family and social relationships, among others. Discussion and conclusion. The prevalence of depressive disorder increases with age. As prevention and treatment at an early age are essential, intervention and monitoring strategies must be created and systematized taking gender and other elements into account, such as the relationship with the parents, violence, and a history of depression in the family.

Validity and Utility of the Patient Health Questionnaire (PHQ)-2 and PHQ-9 for Screening and Diagnosis of Depression in Rural Chiapas, Mexico: A Cross-Sectional Study

BACKGROUND

Depressive disorders are frequently under diagnosed in resource-limited settings because of lack of access to mental health care or the inability of healthcare providers to recognize them. The Patient Health Questionnaire (PHQ)-2 and the PHQ-9 have been widely used for screening and diagnosis of depression in primary care settings; however, the validity of their use in rural, Spanish-speaking populations is unknown.

METHOD

We used a cross-sectional design to assess the psychometric properties of the PHQ-9 for depression diagnosis and estimated the sensitivity and specificity of the PHQ-2 for depression screening. Data were collected from 223 adults in a rural community of Chiapas, Mexico, using the PHQ-2, the PHQ-9, and the World Health Organization Quality of Life BREF Scale (WHOQOL- BREF).

RESULTS

Confirmatory factor analysis suggested that the 1-factor structure fit reasonably well. The internal consistency of the PHQ-9 was good (Cronbach's alpha > = 0.8) overall and for subgroups defined by gender, literacy, and age. The PHQ-9 demonstrated good predictive validity: Participants with a PHQ-9 diagnosis of depression had lower quality of life scores on the overall WHOQOL-BREF Scale and each of its domains. Using the PHQ-9 results as a gold standard, the optimal PHQ-2 cutoff score for screening of depression was 3 (sensitivity 80.00%, specificity 86.88%, area under receiver operating characteristic curve = 0.89; 95% confidence interval [0.84, 0.94]).

CONCLUSION

The PHQ-2 and PHQ-9 demonstrated good psychometric properties, suggesting their potential benefit as tools for depression screening and diagnosis in rural, Spanish-speaking populations.

[Depression among adolescents. A hidden problem for public health and clinical practice]

Depression is an important public health problem that requires more and better attention. In the present work we review epidemiologic studies of depression among adolescents in Mexico and discuss strategies that may help in earlier identification and referral of potential cases for timely care. In summary, depressive symptoms are prevalent among adolescents and adults in Mexico as in many other countries, with a higher ratio of female cases. Young people experiencing the most challenging socio-urban situations have higher rates of depression. Even though depressive disorders are more prevalent among females, consequences may be even worse for males. The authors posit that, among males, stigma attached to depression might lead to attempts to hide depressive symptoms by masking them through high-risk behaviors (e.g., alcohol, drug use, and violence, among others). Women may have higher rates of suicide attempts, but the case-fatality rate of suicide attempts is higher among males. Despite of barriers and resource scarcity among healthcare and educational institutions, it is necessary to continue to develop alternatives that will lead to better attention of mental health issues among the youth, even when their mental health needs are not expressed directly or their chief complaints are in regard to "other" health issues.

Depression and Quality of Life for Women in Single-parent and Nuclear Families

This is a cross-sectional study which objectives are 1) to determine the predictors for perceived quality of life and 2) to analyze the differences between women from single-parent families and bi-parent families, about their quality of life, depression and familiar income. We worked with a non-probabilistic sample of 140 women from Monterrey, N.L, Mexico, 107 are from bi-parent families and 33 from single parent families. Some of the results show that women from single-parent families have lower quality of life (Z = −2.224, p = .026), lower income (Z = −2.727, p = .006) and greater depression (Z = −6.143, p = .001) than women from bi-parental families. The perceived quality of life's predictors, using a multiple regression model (n = 140) were depression, income and number of children, those variables explaining 25.4% of variance.

Depression, gender, and the treatment gap in Mexico

BACKGROUND

Gender is associated to lifetime risk of mood disorders, women having the highest lifetime and 12-month prevalence. In Mexico one out of five individuals with any mood disorder receives treatment during the first year. We evaluate the ages at which women and men are more vulnerable for the first onset of a major depressive episode, the longest duration and greatest number of episodes, the areas of daily functioning most affected, and which variables predict whether or not a person receives any kind of treatment.

METHODS

The Mexican National Comorbidity Survey, as part of the World Mental Health Surveys Initiative, is based on a stratified, multistage area probability Mexican urban household sample aged 18 to 65 (n=5782). Wald X(2) tests were performed to evaluate gender and cohort differences; logistic regression models were performed to evaluate gender and cohort as treatment predictors.

RESULTS

The most vulnerable group is the cohort of 45-54 year-old women. Once a first episode occurs, there are no sex differences in terms of number or length of episodes. There is a gap in service use, especially among 18-29 year-old women; the oldest women are the most impaired.

LIMITATIONS

Individuals from rural communities are not represented and there may have been recall bias due to the retrospective design.

CONCLUSIONS

Efforts should focus on factors related to the first onset episode and on early treatment programs to reduce the risk of subsequent episodes. Research and health resources should attend to the most vulnerable group, and the youngest women, who are in the reproductive age and have the largest treatment gap.

El consumo de drogas y su tratamiento desde la perspectiva de familiares y amigos de consumidores en Bogotá, Colombia

En este estudio, se presenta el análisis parcial de los resultados de un trabajo cuantitativo, relacionado con la perspectiva que tienen los familiares y amigos de consumidores frente al tratamiento para los problemas derivados del consumo de drogas ilícitas. Participaron 104 usuarios de los servicios de salud de Bogotá, El 58% considera el consumo como una enfermedad que necesita tratamiento. El 56% identifica el hospital general como la principal alternativa para el mismo y, 95% al Estado como el principal responsable de este. Las instituciones privadas son las más conocidas y dentro de estas, las comunidades terapéuticas y los grupos religiosos aparecen como los que más se comprometen con la problemática. Para el 73% los servicios existentes no son suficientes y el acceso a la utilización de los mismos es difícil. El estigma es la principal barrera para solicitar la atención, solo el 50% considera que los tratamientos son útiles. Es necesaria una mayor difusión de los recursos existentes, para aumentar su demanda y utilización.

Psychiatric disorders in Mexico: lifetime prevalence in a nationally representative sample

BACKGROUND

No national data on lifetime prevalence and risk factors for DSM-IV psychiatric disorders are available in Mexico.

AIMS

To present data on lifetime prevalence and projected lifetime risk, age at onset and demographic correlates of DSM-IV psychiatric disorders assessed in the Mexican National Comorbidity Survey.

METHOD

The survey was based on a multistage area probability sample of non-institutionalised people aged 18-65 years in urban Mexico. The World Mental Health Survey version of the Composite International Diagnostic Interview was administered by lay interviewers.

RESULTS

Of those surveyed, 26.1% had experienced at least one psychiatric disorder in their life and 36.4% of Mexicans will eventually experience one of these disorders. Half of the population who present with a psychiatric disorder do so by the age of 21 and younger cohorts are at greater risk for most disorders.

CONCLUSIONS

Our results suggest an urgent need to re-evaluate the resources allocated for the detection and treatment of psychiatric illnesses in Mexico.