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Introduction: Major depressive disorder (MDD) is highly prevalent in the general population and among medical students (MS). Risk factors of depression in MS are important to clarify. Objectives: To determine the prevalence of depressive symptoms and its changes during 5 years of medical school. Which are the factors associated with depressive symptomatology and how these factors change over time. Methods: A prospective, longitudinal observational study was conducted at the Medical School of the National University of Mexico, between 2012-2018. We included students who maintained their participation annually, completing the patient health questionnaire (PHQ-9) and the survey on socio-demographic variables in order to evaluate potential predictors, personal and academic characteristics and perceived academic difficulties. Results: The response rate was between 78-89%. 245 MS were evaluated longitudinally, 60.9% were women, 97.2% single, 96.5% lived with their family or partner and 71% received sufficient financial resources for living costs. For depression the prevalence ranged from 10.5-16.2% according to the academic year. The multiple logistic regression analysis per year showed that the history of emotional abuse in childhood (OR=1.89-3.11, p<0.05), anxiety levels (OR=1.85-2.97, p<0.05), poor financial resources (OR=3.11-4.54, p<0.05) and being female (OR=1.83-2.02, p<0.05) increase the risk of depressive symptoms. Conclusions: Our findings suggest that personal factors (female, poor financial resources, anxiety and history of child abuse) are relevant for persistence of high score of PHQ-9. Medical schools need to identity students who have depressive symptoms and offer them, as early as possible, particularly when depression has been present over time. [ABSTRACT FROM AUTHOR]

Introduction: Pediatricians in training are a population at risk for anxiety and depression: they face long working hours, they are confronted with the suffering and death of a vulnerable population and may have personal characteristics that put them in danger. Nonetheless, few studies have looked at their prevalence and associated factors. We aimed to compare demographic, professional activities, adversities and perfectionism personality features between a group of pediatricians in training with depression and/or anxiety and a group of pediatricians in training without depression nor anxiety and, to identify the variables that increase the probabilities of depression and/or anxiety in pediatricians in training., Methods: Pediatric residents who voluntarily answered an online survey distributed via personal and institutional social media channels from October 2019 to April 2021, as part of a cross-sectional study with medical specialists and residents from Mexico were included. Demographic information, professional activities and adversities, perfectionism personality features (Multidimensional Perfectionism Scale), depression and anxiety (ICD-11 PHC) were evaluated. For comparison purposes Chi-square tests (χ 2 ) and independent sample t -tests were used. A logistic regression analysis was used to identify those variables that increase the probabilities of depression and/or anxiety., Results: 934 pediatric residents answered the survey. 11.6% reported having depression and 20% anxiety. Being single, a history of anxious or depressive episodes, being the resident in charge of a patient who died, aggressions from colleagues and a high concern for errors were associated with current depression and/or anxiety., Discussion: Screening for depressive and anxious symptoms should be routinely performed from entry to the residency to favor early intervention. A shift from promoting perfectionism to a more compassionate training could serve a population facing so many adversities., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Yoldi-Negrete, Guízar-Sánchez, Robles-García, Tovilla-Zárate, Saracco-Álvarez, Navarro-Castellanos, Hill-de-Titto and Fresán.)

Objective: Examining orthopedic residents in Mexico, researchers explore the relationship between the presence of depressive or anxious symptoms and the degree of perfectionism, perceived work-related distress, and involvement in the care of patient(s) who died., Methods: This was a cross-sectional online survey of 642 orthopedic residents from October 2019 to April 2021., Results: Of orthopedic residents contacted, 50.6% responded rate (70.9% male, average age 29.8 years). A total of 12.5% reported significant depressive symptoms and 18.4% reported significant anxious symptoms. On a scale from 0-100, the mean score of perceived work-related distress was 51.9. One-third (33.6%) reported being involved in the care of patient(s) who had died. Higher levels of work-related distress and higher scores on perfectionism were associated with depressive and anxiety symptoms. In particular, being involved in the care of patient(s) who had died was associated with anxious symptoms (OR = 1.79; 95%CI = 1.18-2.72)., Conclusions: These results highlight the need for systematic monitoring of the mental health of orthopedic residents in Mexico, particularly those who report a high level of work-related distress or perfectionism or who have recently experienced the death of a patient., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: In cerebral palsy (CP), spasticity is the dominant symptom and hip pain is one of the most common secondary conditions. Aetiology is not clear. Musculoskeletal ultrasound (MSUS) is a low-cost, non-invasive imaging technique that allows assessment of structural status, dynamic imaging, and quick contralateral comparison., Objective: A retrospective case-matched-control study. To investigate associated factors with painful spastic hip and to compare ultrasound findings (focusing on muscle thickness) in children with CP vs. typically developing (TD) peers., Setting: Paediatric Rehabilitation Hospital in Mexico City, from August to November 2018., Participants: 21 children (13 male, 7 + 4.26 years) with CP, in Gross Motor Function Classification System (GMFCS) levels IV to V, with spastic hip diagnosis (cases) and 21 children age- and sex-matched (7 + 4.28 years) TD peers (controls)., Characteristically Data: Sociodemographic data, CP topography, degree of spasticity, mobility arch, contractures, Visual Analog Scale (VAS), GMFCS, measurements of the volumes of eight major muscles of the hip joint and MSUS findings of both hips., Results: All children with CP group reported chronic hip pain. Associated factors for hip pain (high VAS hip pain score) were degree of hip displacement (percentage of migration), Ashworth Level, GMFCS level V. No synovitis, bursitis or tendinopathy was found. Significant differences (p < 0.05) were found in muscle volumes in all hip muscles (right and left) except in the right and left adductor longus., Conclusion: Though possibly the most important issue with diminished muscle growth in CP children is the influence on their long-term function, it is likely that training routines that build muscle size may also increase muscle strength and improve function in this population. To improve the choice of treatments in this group and maintain muscle mass, longitudinal investigations of the natural history of muscular deficits in CP as well as the impact of intervention are needed., (© 2023. The Author(s).)

Background: Physicians in training face a variety of stressors throughout their professional development and according to their gender. Among them, surgical trainees appear to be especially at risk for mental health problems., Objective: The aim of the present study was to compare demographic features, professional activities and adversities, depression, anxiety, and distress among men and women trainees of surgical and nonsurgical medical specialties., Design and Participants: A cross-sectional, retrospective, comparative study was conducted on a total of 12,424 trainees (68.7% nonsurgical and 31.3% surgical) from Mexico through an online survey. Demographic features, variables related to professional activities and adversities, depression, anxiety, and distress were evaluated through self-administered measures. Comparative analyses using the Cochran-Mantel-Haenszel test for categorical variables and multivariate analysis of variance including medical residency program and gender as fixed factors to test their interaction effect for continuous variables were used., Results: An important interaction between medical specialty and gender was found. Women trainees from surgical specialties report more frequent psychological and physical aggressions. Women from both specialties had higher distress, significant anxiety, and depression than men. Men from surgical specialties worked more hours per day., Conclusions: Gender differences are evident in trainees for medical specialties, with a larger impact in surgical fields. Mistreatment of students is a pervasive behavior that affects society as a whole, and actions to improve learning and working environments in all medical specialties, but mostly in surgical fields, are urgently needed., (Copyright © 2023 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)

Background: Psychiatrists are at high risk of developing burnout and mental health problems mainly due to their emotionally demanding jobs, difficult working conditions, long working hours, and poor work-life balance. As leisure activities are associated with better physical and mental health, engaging in these activities has been recommended as a measure to improve the wellbeing of healthcare workers. However, it is unclear the extent of which psychiatrists and trainees are involved in leisure activities, what type of activities they prefer, or how these impact their self-perceived health, stress, confidence in stress management, and satisfaction with their social support., Objective: The aim of this study was to identify differences in self-perceived health, perceived stress, confidence in stress management, and satisfaction with social support, between psychiatrists and trainees who engage in different leisure activities, compared with those who do not., Methods: This was a cross-sectional study, including Mexican psychiatrists ( n = 355) and trainees ( n = 330) who agreed to participate through an online survey., Results: 73.1% of participants engaged in some leisure activity, being solitary-passive activities the most reported. Those who have a leisure activity reported lower stress, greater confidence in stress management, and more satisfaction with their social support. Passive-solitary activities were associated with less perceived stress and better confidence in stress management, while active-solitary and social activities were associated with better satisfaction with social support., Conclusion: Psychiatrists' and trainees' wellbeing benefits from engagement in leisure activities, which should be part of their daily schedules to reduce stress, and potentially improve their mental health., Competing Interests: All authors declare that the research was conducted in the absence of any commercial or financial relationship that could be construed as a potential conflict of interest., (Copyright © 2022 Lagunes-Córdoba, Yoldi-Negrete, Hewson, Guízar-Sánchez, Robles-García, Tovilla-Zárate, Tracy, Saracco-Alvarez and Fresán.)

Introduction: The present study aims to examine sex differences in demographic variables, professional activities and adversities, self-reported mental health problems, and perceived discrimination in a sample of family doctors and family medicine residents in Mexico. METHODS: From a larger sample of medical specialists, an analytic, cross-sectional study was conducted with 566 participants, including 317 (56%) family medicine residents and 249 (44%) family doctors in Mexico through an online survey. Demographic features, professional activities and adversities, mental health, and perceived discrimination were examined. Descriptive and comparative analyses were performed. Cramer's V for chi-square tests and Hedge's g for t test were conducted to determine effect sizes. RESULTS: Both sexes displayed similar percentages of professional adversities (such as attending patients with suicidal behavior or who died not by suicide under their care), and a higher number of women reported seeking specialized support to cope with these deaths (Fisher = 0.04). Men perceived greater discrimination ( P =  .01), worked more hours per day ( P <  .001) and were more verbally assaulted ( P =  .04), whereas women reported mental health problems more frequently ( P <  .001) particularly depression, anxiety, burnout and sleeping problems. Women also reported worse health status ( P <  .001) when compared with men. CONCLUSION: Family medicine specialists constitute a vulnerable group for mental health problems and perceived discrimination. Particular attention should be paid to how men and women cope with professional adversities to determine whether additional support is required. Interventions should encourage self-care and promote the well-being of health personnel., Competing Interests: Conflicts of interest: None., (© Copyright by the American Board of Family Medicine.)

The number of immigrants seeking entry into the U.S. through asylum requests or through irregular means is increasing, and most come from the Northern Triangle of El Salvador, Guatemala, and Honduras. Immigrants come fleeing extreme poverty, violence, health and social inequities, and drastic climate changes. Most had limited access to healthcare at home, and even more limited care along the journey. Those that are allowed entry into the U.S., are confronted with feeling unwelcome in many communities, having to navigate an array of local, state, and federal laws that regulate access to healthcare. We need immigration policies that preserve the health, dignity with a multinational policy for provision of healthcare through a human rights lens from point of origin to point of destination., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Venturi, Guízar-Sánchez, Ramos-Tovar, Torres, Avellaneda, Torres-Hostos and Matuk-Villazon.)

Objective: The objective was to determine and compare demographic features, professional activities and adversities, physical health conditions, and self-care behaviors related to the most frequently self-reported mental health problems among psychiatrists and psychiatry trainees., Methods: A cross-sectional, retrospective, comparative study was conducted on a total of 330 (48.2%) psychiatry trainees and 355 (51.8%) psychiatrists from Mexico through an online survey. Demographic features, professional activities and adversities, physical and mental health problems, self-care behaviors, and social support were examined. Comparative analyses and multiple logistic regression models were performed., Results: Major depression, anxiety, and burnout were the most common mental health problems reported with a higher frequency of anxiety disorders in psychiatry trainees. Being a woman, having a physical health problem, and lack of restful sleep were the main risk factors in both groups. Consultation in the government sector and having patients with severe suicidal ideation affected more psychiatry trainees. Perceived discrimination and inadequate eating schedules were risk factors for mental health problems for psychiatrists., Conclusion: Psychiatry trainees constitute a vulnerable group for anxiety disorders. Particular attention should be paid to how students cope with the training experience to determine whether additional support is required. These professionals face major stressors leading to a high prevalence of depression, burnout, and anxiety. Encouraging psychiatrists to have better health habits is a step in the right direction, which must be accompanied by tangible organizational avenues to do so and creating a culture that truly promotes self-care., (© 2021. Academic Psychiatry.)