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Background: We examined Mexican migrants' perceived barriers to entering substance abuse treatment and potential differences by gender. Methods: This study analyzed a subset of household data collected in Mexico in 2011 via the Encuesta Nacional de Adicciones (National Survey of Addictions). A sample of 1,143 individuals who reported using illicit drugs was analyzed using multivariate negative binomial models to determine direct and moderated relationships of gender, migrant status, and drug dependence with perceived barriers to accessing treatment. Results: Significant findings included disparities in drug dependence by migrant status. Compared with non-migrant men, women who have traveled to the United States was associated with fewer (1.3) barriers to access treatment. Fewer barriers to access care were associated with individuals residing in other regions of the country, compared to those living in Mexico City. Conclusions: Drug dependence, gender, migration status and regional location are factors associated with access to needed treatment. Implications for health care policy to develop treatment services infrastructure and for future research are discussed in the context of ongoing drug policy reform in Mexico.

BACKGROUND: The relationship between mental and physical disorders is well established, but there is less consensus as to the nature of their joint association with disability, in part because additive and interactive models of co-morbidity have not always been clearly differentiated in prior research. METHOD: Eighteen general population surveys were carried out among adults as part of the World Mental Health (WMH) Survey Initiative (n=42 697). DSM-IV disorders were assessed using face-to-face interviews with the Composite International Diagnostic Interview (CIDI 3.0). Chronic physical conditions (arthritis, heart disease, respiratory disease, chronic back/neck pain, chronic headache, and diabetes) were ascertained using a standard checklist. Severe disability was defined as on or above the 90th percentile of the WMH version of the World Health Organization Disability Assessment Schedule (WHODAS-II). RESULTS: The odds of severe disability among those with both mental disorder and each of the physical conditions (with the exception of heart disease) were significantly greater than the sum of the odds of the single conditions. The evidence for synergy was model dependent: it was observed in the additive interaction models but not in models assessing multiplicative interactions. Mental disorders were more likely to be associated with severe disability than were the chronic physical conditions. CONCLUSIONS: This first cross-national study of the joint effect of mental and physical conditions on the probability of severe disability finds that co-morbidity exerts modest synergistic effects. Clinicians need to accord both mental and physical conditions equal priority, in order for co-morbidity to be adequately managed and disability reduced. [ABSTRACT FROM AUTHOR]

BACKGROUND: Physical morbidity is a potent risk factor for depression onset and clearly increases with age, yet prior research has often found depressive disorders to decrease with age. This study tests the possibility that the relationship between age and mental disorders differs as a function of physical co-morbidity. METHOD: Eighteen general population surveys were carried out among household-residing adults as part of the World Mental Health (WMH) surveys initiative (n=42 697). DSM-IV disorders were assessed using face-to-face interviews with the Composite International Diagnostic Interview (CIDI 3.0). The effect of age was estimated for 12-month depressive and/or anxiety disorders with and without physical or pain co-morbidity, and for physical and/or pain conditions without mental co-morbidity. RESULTS: Depressive and anxiety disorders decreased with age, a result that cannot be explained by organic exclusion criteria. No significant difference was found in the relationship between mental disorders and age as a function of physical/pain co-morbidity. The majority of older persons have chronic physical or pain conditions without co-morbid mental disorders; by contrast, the majority of those with mental disorders have physical/pain co-morbidity, particularly among the older age groups. CONCLUSIONS: CIDI-diagnosed depressive and anxiety disorders in the general population decrease with age, despite greatly increasing physical morbidity with age. Physical morbidity among persons with mental disorder is the norm, particularly in older populations. Health professionals, including mental health professionals, need to address barriers to the management of physical co-morbidity among those with mental disorders. [ABSTRACT FROM AUTHOR]

Anonymous surveys have been widely used worldwide to describe adolescent substance use yet cannot elucidate causal drug abuse predictors. Studies in the U.S. have generally found that anonymous and confidential surveys yield comparable levels of self-reported substance use, yet the effect of survey format on youth self-report has not been evaluated in other countries. The present study compared data from the confidential International Longitudinal Survey of Adolescent Health with anonymously collected survey data on alcohol and marijuana use among school-based youth in Mexico, Puerto Rico, and the U.S. The findings suggest that confidential surveys yield valid self-reports of adolescent substance use. [ABSTRACT FROM AUTHOR]

The authors show associations between immigration and alcohol disorders using data from the 1995 and 2000 U.S. National Alcohol Surveys and the 1998 Mexico National Household Survey on Addictions. The prevalence of alcohol dependence was 4.8% for the Mexicans, 4.2% for the Mexico-born immigrants, and 6.6% for the U.S.-born Mexican Americans. They found a general lack of significance for the immigration variables with few consistent dose-response findings for alcohol use disorders. High acculturation was associated with higher risks for women; however, unexpectedly, high acculturation was associated with lower risks for males. Among Mexican Americans, the impact of immigration to the United States on the prevalence of alcohol use disorders differs by gender. Male and female differences and possible sources of immigrant selection are important issues for future research. [ABSTRACT FROM AUTHOR]

OBJECTIVE: This study described the rate and adequacy of mental health service use among participants in the Mexico National Comorbidity Survey and the correlates of any 12-month treatment and of adequate treatment. METHOD: The authors conducted face-to-face household surveys of a probability sample of individuals ages 18 to 65 years in the noninstitutionalized population living in urban areas of Mexico from 2001 to 2002. The use of mental health services and 12-month DSM-IV disorders was assessed with the World Mental Health version of the World Health Organization Composite International Diagnostic Interview. The rates and correlates of any service use and the adequacy of treatment were identified in logistic regression analyses, taking into account the complex sample design and weighting process. RESULTS: The data reported here were based on 2,362 interviews. Fewer than one in five respondents with any psychiatric disorder during the last 12 months used any service during the prior year. The rates of service use by those with mood disorders were somewhat higher. About one in every two respondents who used services received minimally adequate care. CONCLUSIONS: The authors found large unmet needs for mental health services among those with psychiatric disorders. Those with mental illness and those who deliver or seek to improve mental health care in Mexico face enormous challenges. [ABSTRACT FROM AUTHOR]

Background. This paper describes the 12-month prevalence, severity and demographic correlates of 16 DSM-IV psychiatric disorders and service utilization in the Mexican urban population aged 18-65 years of age. This is representative of 75% of the national adult population.Method. The sample design was a strict probability selection scheme. The response rate was 76·6%. The World Mental Health Survey version of the Composite International Diagnostic Interview was installed on laptops and administered by lay interviewers. An international WHO task force carried out its translation into Spanish.Results. The 12-month prevalence of any disorder was 12·1%. The most common disorders were specific phobia (4·0%), major depressive disorder (3·7%) and alcohol abuse or dependence (2·2%). The 12-month prevalence of very severe disorders was 3·7% of which only 24% used any services. Age was the only variable associated with any 12-month disorder, with the younger more likely to report any disorder. Income was associated with severity, with low and low-average incomes more likely to report a 12-month disorder. Females were more likely to report a mood and anxiety disorder, but less likely to report a substance disorder. The group of separated/widowed/divorced was more likely to report a mood and an impulse-control disorder.Conclusions. The results show that while psychiatric disorders are common in the Mexican population, very severe mental disorders are less common and there is extreme under-utilization of mental health services. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Introduction: Very little research has heen done in Mexico to estimate drug-related treatment needs or service utilization. There is also scarce epidemiological research on the influence of parents on drug-related service utilization by adolescents in Mexico. In this paper, we use advanced epidemiologic strategies to provide population-based estimates of the association between parental involvement and treatment needs and service utilization, by level of drug use, with and without adjustment for sociodemographic characteristics. Methods: We used data from the latest survey on drug use, representative of all middle and high school students in the Federal District of Mexico (Mexico City). A standardized, self-administered questionnaire was given to 10,173 students aged 12-22 (mean = 1-1.6, SE=0.08), especially designed to assess use of several drugs and risk/protective factors, including a sub-scale on parental involvement. All analyses used procedures that account for the complex sample design. Results: Students with lower parental involvement (lowest quartile) were found to be more likely to have used drugs in their lifetime, in the past year, as well as in the past month. Moreover, students with the lowest quartile of parental involvement were more likely to have used two or more drugs in their lifetime, and this association was estimated to be independent of sex, age, school enrollment in the past year as well as history of working part or full time in the prior year. About 20% of the students who ever used two or more drugs received some drug-related help, however 50-SST reported they would like to use drugs less. Service utilization was associated with higher numbers of drugs ever used, but not with higher levels of parental involvement. Discussion: Parental involvement seems to play a major role as a protective factor against drug use initiation among students, but does not differentiate drug users who seek help from those who do not. Further research is needed to answer whether this is due to students with higher levels of parental involvement having less problematic patterns of drug use. The discrepancy between wanting to use drugs less and service utilization points to the need for further research into the factors that may influence service utilization and, ultimately, recovery. [ABSTRACT FROM AUTHOR]

The purpose of this article is to review the research status of illicit drug use and its data sources in Latin America, with particular attention to the research that has been produced in the past 15 years in epidemiology of illicit drug use services utilization, and relationship between HIV and drug use. This article complements the series of articles that are published in this same volume which examine drug abuse research (epidemiology, prevention, and treatment) and HIV prevention in Latinos residing in the United States. This review resulted from extensive international and national searches using the following databases: Current Contents Connect, Social and Behavioral Sciences; EBSCO; EMBASE(R) Psychiatry; Evidence Based Medicine (through OVID); Medline, Neurosciences, PsychINFO, Pubmed, BIREME/PAHO/WHO--Virtual Health Library, and SciELO. Papers selected for further review included those published in Spanish, English, and Portuguese in peer-reviewed journals. From the evidence reviewed, it was found that the published research literature is heavily concentrated on descriptive epidemiologic surveys, providing primarily prevalence rates and general information on associated factors. Evidence on patterns of service delivery and HIV prevention and treatment is limited. The cumulative scope of this research clearly indicates variability in quantity and quality of research across Latin American nations and the need for greater uniformity in data collection elements, methodologies, and the creation of international collaborative research networks. [ABSTRACT FROM AUTHOR]

Objective This study describes the prevalence, adequacy and correlates of 12-month mental health service use among participants in the Mexican Adolescent Mental Health Survey. Methods The authors conducted face-to-face household surveys of a probability sample of 3005 adolescents aged 12DS17 years residing in the Mexico City metropolitan area during 2005. The prevalence of mental health disorders and the use of services were assessed with the computer-assisted adolescent version of the World Mental Health Composite International Diagnostic Interview. Correlates of service use and adequate treatment were identified in logistic regression analyses that took into account the complex sample design and weighting process. Findings Less than one in seven respondents with psychiatric disorders used any mental health services during the previous year. Respondents with substance-use disorders reported the highest prevalence of service use and those with anxiety disorders the lowest. Approximately one in every two respondents receiving any services obtained treatment that could be considered minimally adequate. Conclusion We found large unmet needs for mental health services among adolescents with psychiatric disorders in Mexico City. Improvements in the mental health care of Mexican youth are urgently needed. Copyright © 2008 World Health Organization [ABSTRACT FROM AUTHOR]

Background: Agua celeste, or "heavenly water", is the street name for a sky-blue colored solvent reportedly inhaled or ingested to produce an intoxicating effect. Study aims were to (1) describe prevalence of agua celestse (AC) use, and (2) identify correlates of lifetime and recent use of AC use among female sex workers who also inject drugs (FSW-IDUs) in northern Mexico.Methods: Between 2008 and 2010, baseline data from FSW-IDUs≥18 years old living in Tijuana or Ciudad Juarez participating in a longitudinal behavioral intervention were analyzed using logistic regression.Results: Among 623 FSW-IDUs (307 from Tijuana and 316 from Ciudad Juarez (CJ)), 166 (26%) reported ever using AC, all of whom lived in CJ. Among the CJ sample, lifetime prevalence of AC use was 53%, median age of first use was 16 years (IQR: 14-23), and 10% reported it as their first abused substance. Ever using AC was independently associated with ever being physically abused and younger age, and was marginally associated with initiating injection drug use and regular sex work at age eighteen or younger. Among those ever using AC, 70/166 (42.2%) reported using it within the last 6 months, which was independently associated with using drugs with clients before or during sex, being on the street more than 8h per day, and younger age.Discussion: We observed considerable geographic variation in the use of AC in northern Mexico. Future studies exploring factors influencing use, its precise formulation(s), and its potential health effects are needed to guide prevention and treatment. [ABSTRACT FROM AUTHOR]

Background: It is unclear whether the normative sequence of drug use initiation, beginning with tobacco and alcohol, progressing to cannabis and then other illicit drugs, is due to causal effects of specific earlier drug use promoting progression, or to influences of other variables such as drug availability and attitudes. One way to investigate this is to see whether risk of later drug use in the sequence, conditional on use of drugs earlier in the sequence, changes according to time-space variation in use prevalence. We compared patterns and order of initiation of alcohol, tobacco, cannabis, and other illicit drug use across 17 countries with a wide range of drug use prevalence.Method: Analyses used data from World Health Organization (WHO) World Mental Health (WMH) Surveys, a series of parallel community epidemiological surveys using the same instruments and field procedures carried out in 17 countries throughout the world.Results: Initiation of "gateway" substances (i.e. alcohol, tobacco and cannabis) was differentially associated with subsequent onset of other illicit drug use based on background prevalence of gateway substance use. Cross-country differences in substance use prevalence also corresponded to differences in the likelihood of individuals reporting a non-normative sequence of substance initiation.Conclusion: These results suggest the "gateway" pattern at least partially reflects unmeasured common causes rather than causal effects of specific drugs on subsequent use of others. This implies that successful efforts to prevent use of specific "gateway" drugs may not in themselves lead to major reductions in the use of later drugs. [ABSTRACT FROM AUTHOR]

Mexico-U.S. migration creates situations that may cause psychological distress. The purpose of this research project was to study the impact of father's physical absence due to international migration (FPAIM) on adolescent offspring of rural immigrants from Zacatecas, Mexico. Stressors and compensators were studied from the adolescent's perspective and were analyzed using a stress-mediator-consequences theoretical framework. Qualitative (n = 24) and quantitative (n = 310) methodologies were used with a nonrandom sample of adolescents. Results show that the FPAIM is an ambivalent experience for adolescents that has positive and negative elements. Though migrants' children seem to be more vulnerable to psychosocial stress than are the offspring of nonmigrants, gender, not father's absence, appears to be the most important risk factor for psychological distress. [ABSTRACT FROM AUTHOR]

Latent autoimmune diabetes in adults (LADA) is characterized by the presence of glutamate decarboxylase autoantibodies (GADA). LADA has intermediate features between type 1 diabetes and type 2 diabetes. In addition, genetic risk factors for both types of diabetes are present in LADA. Nonetheless, evidence about the genetics of LADA in non-European populations is scarce. This study aims to perform a genome-wide association study with a phenome-wide association study of LADA in a southeastern Mexican population. We included 59 patients diagnosed with LADA from a previous study and 3121 individuals without diabetes from the MxGDAR/ENCODAT database. We utilized the GENESIS package in R to perform the genome-wide association study (GWAS) of LADA and PLINK for the phenome-wide association study (PheWAS) of LADA features. Nine polymorphisms reach the nominal association level (1 × 10 -5 ) in the GWAS. The PheWAS showed that rs7305229 is genome-wide and associated with serum GADA levels in our sample ( p = 1.84 × 10 -8 ). rs7305229 is located downstream of the FAIM2 gene; previous reports associate FAIM2 variants with childhood obesity, body mass index, body adiposity measures, lymphocyte CD8+ activity, and anti-thyroid peroxidase antibodies. Our findings reveal that rs7305229 affects the GADA levels in patients with LADA from southeastern Mexico. More studies are needed to determine if this risk genotype exists in other populations with LADA.

Contemporary research on the genomics of Attention Deficit Hyperactivity Disorder (ADHD) often underrepresents admixed populations of diverse genomic ancestries, such as Latin Americans. This study explores the relationship between admixture and genetic associations for ADHD in Colombian and Mexican cohorts. Some 546 participants in two groups, ADHD and Control, were genotyped with Infinium PsychArray®. Global ancestry levels were estimated using overall admixture proportions and principal component analysis, while local ancestry was determined using a method to estimate ancestral components along the genome. Genome-wide association analysis (GWAS) was conducted to identify significant associations. Differences between Colombia and Mexico were evaluated using appropriate statistical tests. 354 Single-nucleotide polymorphisms (SNPs) and Single-nucleotide variants (SNVs) related to some genes and intergenic regions exhibited suggestive significance (p-value < 5*10e-5) in the GWAS. None of the variants revealed genome-wide significance (p-value < 5*10e-8). The study identified a significant relationship between risk SNPs and the European component of admixture, notably observed in the LOC105379109 gene. Despite differences in risk association loci, such as FOXP2, our findings suggest a possible homogeneity in genetic variation's impact on ADHD between Colombian and Mexican populations. Current reference datasets for ADHD predominantly consist of samples with high European ancestry, underscoring the need for further research to enhance the representation of reference populations and improve the identification of ADHD risk traits in Latin Americans., (© 2024. The Author(s).)

Background: The use of stimulants and other substances with the purpose of enhancing, maintaining, and prolonging sexual activity is known as sexualized substance use. Also known as chemsex, this pattern of use has been mainly explored in high-income countries. The aim of this article was to assess the feasibility, acceptability, and usefulness of a community- evidence-based harm reduction intervention among Mexican gay, bisexual, and other men who have sex with men (gbMSM) adults who reported sexualized stimulant use in the past 6 months and who were not enrolled in any psychosocial treatment., Methods: The in-person intervention was designed in partnership with gbMSM who used substances. It consisted of 39 harm reduction strategies before, during, and after episodes of use. The components of the intervention were health and self-care, safety, and psychopharmacology. The intervention was delivered at a university campus, a public recreational space, and an HIV public clinic. Feasibility to deliver the intervention was assessed based on enrolment and completion rates; acceptability through a 28-item, 5-point Likert scale (140 max.) constructed and validated for the Mexican population with good reliability coefficients; usefulness through a 5-point Likert scale ("not useful"-"very useful") for each of the 39 strategies; and potential behavioral change by subtracting the likelihood of implementing each strategy minus the frequency of use of the technique before the intervention., Results: Participants (n = 19; recruitment rate = 35.2%; completion rate = 84.2%) rated the intervention as acceptable with a mean score of 121.6 (SD = 7.5). The highest potential for behavioral change was regarding the use of information about the half-life of stimulants, polysubstance use, and overdose prevention., Conclusions: This intervention is feasible when provided within public health services where potential participants are already in contact. Harm reduction strategies need to surpass sexually transmitted infections prevention and HIV care and focus on substance use and mental health strategies., (© 2024. The Author(s).)

Internationally, HIV-related stigma and crystal methamphetamine (meth) use have been described as barriers to treatment adherence among gay, bisexual, and other men who have sex with men (gbMSM). Crystal meth use has been increasing among gbMSM in the Metropolitan Area of Mexico City (MAMC). Therefore, this study aimed to determine the association between HIV-related stigma and HIV treatment adherence among gbMSM who use crystal meth in the MAMC. This study was undertaken as part of an exploratory study of crystal meth use in the MAMC. The data were collected from September to December 2021 through an encrypted online survey. Participants (n = 89) were gbMSM adults living with HIV who reported crystal meth use in the past month that were recruited through an online snowball sampling. The online survey included questions about HIV treatment adherence, sexual behaviors, the Alcohol, Smoking, and Substance Involved Screening Test, and the HIV-Related Stigma Mechanisms Scale. Logistic regression analyses assessed the association between HIV-related stigma and HIV treatment adherence. The multivariate logistic regression model showed that, controlling for health insurance [adjusted odds ratio (AOR) = 0.13; 95% confidence intervals (CI)  = 0.02-0.59] and educational level (AOR = 0.16; 95% CI = 0.02-0.88), non-adherence to HIV treatment was independently associated with higher HIV-related stigma (AOR = 1.06; 95% CI = 1.01-1.12). Public health policies must include HIV-related stigma and substance use in treating gbMSM with HIV., (© 2024. The Author(s).)

This article reports on effects of two earthquakes in Mexico on adolescents attending middle school. The earthquakes struck in close succession during the implementation of a school-based prevention program, providing an opportunity to assess emotional distress due to the earthquakes and whether the life skills taught in the program affected how students coped with the natural disaster. The objectives were to (1) evaluate the earthquakes' impact on students' distress; (2) assess if distress is associated with internalizing symptomology and externalizing behaviors; and (3) investigate if students receiving the original and adapted versions of the intervention coped better with the events. A Mexico-US research team culturally adapted keepin' it REAL to address connections between substance use among early adolescents in Mexico and exposure to violence. A random sample of public middle schools from three cities (Mexico City, Guadalajara, and Monterrey), stratified by whether they held morning or afternoon sessions, was selected. A total of 5522 7th grade students from 36 schools participated in the study. Students answered pretest and posttest questionnaires; the latter assessed earthquake-related distress and coping strategies. Earthquake-related distress was associated with all measures of undesired internalizing symptomology and externalizing behaviors. Compared to controls, students in the adapted intervention reported less aggressive and rule-breaking externalizing behavior and less violence perpetration. However, these intervention effects were not moderated by the level of earthquake-related distress, and they were not mediated by positive or negative coping. The findings have implications for prevention intervention research and policy as natural and human-made disasters occur more often., (© 2023. Society for Prevention Research.)

Objective: The COVID-19 pandemic has affected the mental health of populations around the world, but few longitudinal studies of its impact on suicidal thoughts and behaviors have been published especially from low- and middle-income countries., Methods: This is a prospective cohort study of 1,385 first-year students from 5 Universities in Mexico followed-up for 1 year. We report 1-year cumulative incidence of suicidal thoughts and behaviors before (September 19, 2019-March 29, 2020) and during the COVID-19 period (March 30, 2020-June 30, 2020), focusing on those in the COVID-19 period with risk conditions and positive coping strategies during the pandemic., Results: There was an increase in the incidence of suicidal ideation during the COVID-19 period compared to the pre-COVID-19 period (RR 1.65, 95%CI 1.08-2.50). This increase was mostly found among students with heightened sense of vulnerability (RR 1.95), any poor coping behavior (RR 2.40) and a prior mental disorder (RR 2.41). While we found no evidence of an increased risk of suicidal planning or attempts, there was evidence that those without lifetime mental health disorders were at greater risk of suicidal plans than those with these disorders especially if they had poor coping strategies (RR 3.14)., Conclusion: In the short term, how students deal with the pandemic, being at high risk and having poor coping behavior, increased the new occurrence of suicidal thoughts and behaviors. Studies with longer follow-up and interventions to reduce or enhance these behaviors are needed.HIGHLIGHTSSuicidal ideation increased during the COVID-19 periodThose with heightened sense of vulnerability and poor coping were more affectedStudies with longer follow-up are needed.

Background: Perception of drug adulteration has increased in Mexico, but there is little research on adulterants and toxicity. The aim of this study was to identify drug composition in an electronic music outdoor festival nearby Mexico City., Methods: The participants completed a questionnaire with demographic data, harm reduction strategies, drug-use patterns, history, and the drug they expected to find. We took a small sample of each substance and prepared it for drug checking. A two-section drug testing station was placed within the grounds of the festival. Interaction with participants occurred at the front part. Drug checking was conducted at the rear part. The service was free of charge, voluntary and confidential. Forty persons aged 22 to 48 years participated (mode = 28), of which 92.5% were male, most (82.5%) were single. Through the Substance Analysis Program of "ReverdeSer Collective," we conducted the testing with the attendants that provided 51 drug samples, following ethical and biosafety protocols. We used colorimetry, Fourier Transform Infrared Spectroscopy, and fentanyl immunoassay strips for sample analysis., Results: Substances of choice among attendants were psychostimulants (MDMA and other amphetamine-like drugs) and hallucinogens. Most samples contained what the users expected plus adulterants. Main adulterants were methylene-dioxy-ethyl-amphetamine, methylene-dioxy-propyl-amphetamine, hydroxyamphetamine, and the selective serotonin reuptake inhibitor venlafaxine. Fentanyl was present in 2 out of 4 cocaine samples and in 14 of the 22 confirmed MDMA samples., Conclusions: Some of the adulterants found pose serious health risks, especially fentanyl, amphetamine-like substances, and venlafaxine. Therefore, it is urgent to monitor these adulterants at electronic music festivals and to implement prevention, treatment, and harm reduction public policies. Naloxone distribution and drug-assisted therapies should be part of government programs in Mexico., (© 2023. The Author(s).)

Objective: Untreated mental disorders are important among low- and middle-income country (LMIC) university students in Latin America, where barriers to treatment are high. Scalable interventions are needed. This study compared transdiagnostic self-guided and guided internet-delivered cognitive behavioral therapy (i-CBT) with treatment as usual (TAU) for clinically significant anxiety and depression among undergraduates in Colombia and Mexico., Method: 1,319 anxious, as determined by the Generalized Anxiety Disorder-7 (GAD-7) = 10+ and/or depressed, as determined by the Patient Health Questionnaire-9 (PHQ-9) = 10+, undergraduates (mean [SD] age = 21.4 [3.2]); 78.7% female; 55.9% first-generation university student) from seven universities in Colombia and Mexico were randomized to culturally adapted versions of self-guided i-CBT (n = 439), guided i-CBT (n = 445), or treatment as usual (TAU; n = 435). All randomized participants were reassessed 3 months after randomization. The primary outcome was remission of both anxiety (GAD-7 = 0-4) and depression (PHQ-9 = 0-4). We hypothesized that remission would be higher with guided i-CBT than with the other interventions., Results: Intent-to-treat analysis found significantly higher adjusted (for university and loss to follow-up) remission rates (ARD) among participants randomized to guided i-CBT than either self-guided i-CBT (ARD = 13.1%, χ12 = 10.4, p = .001) or TAU (ARD = 11.2%, χ12 = 8.4, p = .004), but no significant difference between self-guided i-CBT and TAU (ARD = -1.9%, χ12 = 0.2, p = .63). Per-protocol sensitivity analyses and analyses of dimensional outcomes yielded similar results., Conclusions: Significant reductions in anxiety and depression among LMIC university students could be achieved with guided i-CBT, although further research is needed to determine which students would most likely benefit from this intervention. (PsycInfo Database Record (c) 2023 APA, all rights reserved).