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Cristian Ramos-Vera,1 Angel García O’Diana,1 Dennis Calle,1 Miguel Basauri-Delgado,2 Bruno Bonfá-Araujo,3 Ariela Raissa Lima-Costa,4 Mirko Duradoni,5 Shagufta Nasir,6 Yaquelin E Calizaya-Milla,7 Jacksaint Saintila8 1Faculty of Health Sciences, Universidad César Vallejo, Lima, Peru; 2Postgraduate School, Universidad Femenina del Sagrado Corazón, Lima, Peru; 3Faculty of Social Science, the University of Western Ontario, London, Canada; 4Graduate Program of Psychology, Universidade São Francisco, Campinas, Brazil; 5Department of Education, Literatures, Intercultural Studies, Languages and Psychology, University of Florence, Florence, Italy; 6Department of Psychiatry and Forensic Medicine, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; 7Faculty of Health Sciences, Universidad Peruana Unión, Lima, Peru; 8Faculty of Health Sciences, Universidad Señor de Sipán, Chiclayo, PeruCorrespondence: Jacksaint Saintila, Faculty of Health Sciences, Universidad Señor de Sipán, Carretera a Pimentel, Km 5, Chiclayo, Lambayeque, 14001, Peru, Email jacksaintsaintila@gmail.comBackground: Previous research has suggested that manipulation and callousness are central to Dark Triad traits, but it has not identified which specific manifestations are expressed across various countries.Objective: This study aimed to identify the core and overlapping manifestations of Dark Triad traits across 10 countries.Methods: We used the Short Dark Triad (SD3) scale and assessed a sample of 8093 participants (59.7% women, M(age) = 32.68 years). For graphical representation, the spinglass algorithm was applied to understand the cluster distribution among Machiavellianism, psychopathy, and subclinical narcissism traits. Centrality indices were used to identify the most influential items, and the clique-percolation algorithm was employed to detect shared attributes among multiple Dark Triad items.Results: Straightforward SD3-21 items demonstrated better interpretability as aversive traits within the broader system. Items with higher centrality values were those related to short-term verbal manipulation from the psychopathy domain, clever manipulation, strategic revenge-seeking from Machiavellianism, and narcissistic motivations for connecting with significant individuals. The most predicted items were linked to planned revenge, using information against others from Machiavellianism, short-term psychopathic verbal manipulation, and narcissistic belief of specialness based on external validation. Items like short-term verbal manipulation had overlaps with both psychopathy and narcissism clusters, while clever manipulation overlapped with Machiavellianism and psychopathy.Conclusion: This cross-cultural study highlights the central role of verbal manipulation within the Dark Triad traits, along with identifying overlapping items among traits measured using straightforward SD3 scale items. In line with our findings, future research that incorporates a wide range of cultural contexts is encouraged to establish the consistency of these findings with the SD3 Scale or alternative measures.Keywords: dark triad traits, network analysis, personality, subclinical traits, cross-cultural

Cristian Ramos-Vera,1 Dennis Calle,1 Yaquelin E Calizaya-Milla,2 Jacksaint Saintila3 1Research Area, Universidad Cesar Vallejo (UCV), Lima, Perú; 2Faculty of Health Sciences, Universidad Peruana Unión, Lima, Perú; 3School of Medicine, Universidad Señor de Sipán, Chiclayo, PerúCorrespondence: Jacksaint Saintila, School of Medicine, Universidad Señor de Sipán, Carretera a Pimentel, Km 5, Chiclayo, 14001, Perú, Email jacksaintsaintila@gmail.comBackground: The study of Dark Triad traits and emotional variables has been conducted in numerous regions; however, there is a lack of research focusing on Latin American samples and considering variables such as sex and age. Incorporating these variables could enhance our understanding of underlying aversive patterns.Purpose: This study aimed to analyze the associations between Dark Triad traits and emotional intelligence in Peruvian adults.Methods: Data were collected in 2021 and 272 adults (M=31.8 years, 68% female) participated through online surveys via non-probability purposive sampling. Dirty Dozen and Trait Meta-Mood Scales were used. Two partial correlation network models were applied between the study variables with and without controlling for gender and age. Bridge-expected influence and predictability analysis were calculated to find interconnected traits and higher connections, respectively.Results: Subclinical psychopathy primarily showed negative associations with emotional clarity (r=− 0.17), followed by emotional attention (r=− 0.08) and emotional repair in networks with and without age and gender variables. Machiavellianism consistently displayed a negative association with emotional repair (r=− 0.13) in both estimated networks. Conversely, subclinical narcissism exhibited a positive association solely with emotional attention (r=0.15). Furthermore, younger age was linked to higher Machiavellianism (r=− 0.23), females showed higher emotional attention (r=0.11), and narcissism connected intrapersonal emotional domains with Dark Traits (bridge expected influence > 1.25) while Machiavellianism exhibited greater predictability (r2> 0.45) due to reinforcement by other Dark Traits.Conclusion: This study revealed negative connections between the Dark Triad and emotional intelligence traits, except for narcissism, which was positively associated with emotional attention and functioned as a “bridge” between all traits. However, relying solely on this single positive emotional aspect of narcissism may not be adequate to characterize it as possessing fully adaptive emotional traits. Findings suggest that detailed aspects of emotional intelligence and sociodemographic factors can provide valuable insights into the complex nature of aversive patterns and their broader impact on society.Keywords: Machiavellianism, narcissism, subclinical psychopathy, emotional intelligence, network analysis

Cristian Ramos-Vera,1 Andy R Sánchez-Villena,2 Dennis Calle,1 Yaquelin E Calizaya-Milla,3 Jacksaint Saintila4 1Área de Investigación, Universidad Cesar Vallejo (UCV), Lima, Perú; 2Facultad de Ciencias de La Salud, Universidad Privada del Norte, Cajamarca, Perú; 3Facultad de Ciencias de la Salud, Universidad Peruana Unión, Lima, Perú; 4Escuela de Medicina Humana, Universidad Señor de Sipán, Chiclayo, PerúCorrespondence: Jacksaint Saintila, Escuela de Medicina Humana, Universidad Señor de Sipán, Km 5, Carretera a Pimentel, Chiclayo, Lambayeque, 14001, Perú, Email jacksaintsaintila@gmail.comBackground: Although the importance of the therapeutic alliance in the treatment process and health outcomes is recognized, so far, there has been no evaluation in the Peruvian context that considers possible individual differences that could influence this assessment.Purpose: This study assessed the psychometric properties of the WAI-S-P in a sample of individuals from Peru who are receiving psychological therapy. Furthermore, a network analysis was conducted to investigate the direct relationships between the therapeutic alliance and several relevant sociodemographic variables.Methods: The short version of the Working Alliance Inventory was used in a sample of 241 participants (Mage=32.58, SD=12.67) that had attended less than 6 sessions. Three models were considered, including a three-factor and a two-factor correlated model, as well as a bifactor model. In addition, a network of partial associations was created including the overall therapeutic alliance, sex, age, and number of psychotherapeutic sessions.Results: The bifactor model, with an overall therapeutic alliance factor and two specific factors (“contact” and “contract”), better fit the data. Invariance of the structure by sex and age showed equitable measurement. On the other hand, network analysis revealed a positive correlation between total session attendance and therapeutic alliance. Men reported higher therapeutic alliance, while women had higher total session attendance.Conclusion: The results of this study suggest that the therapeutic alliance is better represented by a bifactor model and demonstrates invariance across sex and age in Peruvian adults. Additionally, findings indicate that differences in life experiences and the sex of patients may need to be verified in future studies to better understand nuanced needs in forming therapeutic alliances at least in the early stages of session attendance.Keywords: Working Alliance Inventory, patients, psychotherapy, psychometric properties, network analysis

Cristian Ramos-Vera,1 Dennis Calle,1 Helen Collacso Fiesta,1 Lorena Lisbett Lamilla,1 Antonio Serpa-Barrientos,2 Jacksaint Saintila3 1Research Area, Faculty of Health Sciences, Universidad César Vallejo, Lima, Perú; 2Escuela de Psicología, Universidad Nacional Mayor de San Marcos, Lima, Perú; 3Escuela de Medicina Humana, Universidad Señor de Sipán, Chiclayo, PerúCorrespondence: Jacksaint Saintila, Escuela de Medicina Humana, Facultad de Ciencias de la Salud, Universidad Señor de Sipán, Km 5, Carretera a Pimentel, Chiclayo, Lambayeque, 14001, Perú, Email jacksaintsaintila@gmail.comIntroduction: One of the key psychosocial factors that impact mental and emotional health is social support. While much research has been conducted on the role of social support in the lives of cancer patients, there is a lack of studies that consider populations who need specific tools to assess this concept.Purpose: The aim of this study was to evaluate the psychometric properties of the MOS Social Support Scale (1991) in 499 Peruvian cancer patients between the ages of 18 and 87 (M= 46.30, SD = 15.747).Methods: In this study, three models of the MOS were analyzed based on 19-item versions (four factor, second order and bifactor model).Results: The results showed a better psychometric fit in the 19-item bifactor model with optimal fit indices through the structural equation method (SB-χ 2/df = 1.94, CFI = 0.966, TLI= 0.955, SRMR = 0.038 and RMSEA = 0.058). Additionally, there was evidence of configural, metric and scalar invariance with this instrument according to the gender of the surveyed cancer patients. Convergent validity using a network analysis approach revealed positive associations between social support dimensions and quality of life.Conclusion: Emotional support and positive interactions dimensions were found to be important interconnections in the overall network, as indicated by their greater centralities. Therefore, this instrument could be suggested as a reliable way to evaluate cancer patients and their perceived support.Keywords: social support, factor invariance, oncology, cancer, network analysis

Diana Beatriz Ramirez Luque,1 Neirru L Rocha Huaman,1 Yaquelin E Calizaya-Milla,1,&ast; Sergio E Calizaya-Milla,1 Cristian Ramos-Vera,2 Jacksaint Saintila3,&ast; 1Escuela de Nutrición Humana, Universidad Peruana Unión, Lima, Perú; 2Facultad de Ciencias de la Salud, Universidad Cesar Vallejo, Lima, Perú; 3Escuela de Medicina, Universidad Señor de Sipán, Chiclayo, Perú&ast;These authors contributed equally to this workCorrespondence: Jacksaint Saintila, Escuela de Medicina, Universidad Señor de Sipán, Chiclayo, 14001, Lambayeque, Perú, Email saintilajack@crece.uss.edu.peBackground: Body self-perception and dietary self-efficacy may represent an important factor in the prevention of excess body weight.Purpose: This study evaluated body self-perception, dietary self-efficacy, and body mass index (BMI) in the Peruvian population.Methods: A cross-sectional online survey was administered to 190 men and 210 women. Each participant was shown 9 Stunkard anatomical silhouettes corresponding to BMI values. The results obtained were classified as underweight, normal weight, overweight, and obese. The Dieting Self-Efficacy Scale (DIET-SE) was also applied. Chi-square statistic, Kruskal–Wallis, Student t-test, and ANOVA were used to explore differences in means and proportions.Results: Age was significantly higher in those who underestimated their weight and who were dissatisfied with their body (p = 0.000). BMI was higher in men, most were dissatisfied with their body (p< 0.05), and were more likely to underestimate their weight compared to women (p = 0.000). Those participants who were dissatisfied with their body and who underestimated their weight were more likely to have an elevated BMI compared to those who were satisfied and who did not underestimate their weight. All participants had low dietary self-efficacy (LDSE), with a little higher proportion in men compared to women (62.6% vs 61.4%). The majority (45.9%) reported little confidence to resist high-calorie food temptations. More than half of the participants reported body dissatisfaction and LDSE, this was more frequent in men compared to women.Conclusion: It is necessary to develop and implement preventive measures to improve self-perception of the body, taking into account factors such as gender, age, and eating habits.Keywords: dietary self-efficacy, BMI, body self-perception, obesity, Peru

Background: There is limited information on how healthy behaviors and individual health perceptions mediate the relationship between eating behaviors and noncommunicable diseases in adults. This study aimed to evaluate the mediating role of these factors in the relationship between eating behaviors and comorbidity in U.S. adults., Methods: A cross-sectional predictive study using data from 5,247 adults from the Health Information National Trends Survey (HINTS) 5, cycle 3 (2019) was conducted. Structural equation modeling (SEM) was used to assess the mediating effect., Results: The model showed good fit (χ2/df = 1.22, CFI = 971, TLI = 959, RMSEA = 0.050, SRMR = 0.036). It was found that self-perceived health totally mediated the relationship between eating behaviors and comorbidities (β = - 0.026, p < .001). Additionally, healthy behaviors and self-perceived health together mediated the relationship between eating behaviors and comorbidities (β = - 0.025, p < .001). A direct relationship was also observed between healthy behaviors and comorbidities, mediated by self-perceived health (β = - 0.103, p < .001)., Conclusion: The study concludes that eating behaviors are significantly related to comorbidities through the mediation of healthy behaviors and self-perceived health., (© 2024. The Author(s).)

A number of measures and scales have been developed for the ICD-11 personality disorder (PD) diagnosis, including severity and trait dimensions. The present systematic review and meta-analysis sought to evaluate the internal consistency of these measures across different populations and cultures. A systematic search was conducted across four databases where relevant studies were subjected to explicit eligibility criteria resulting in 49 included studies and 370 effect sizes. Study characteristics were tabulated, their methodological quality was evaluated, and findings were synthesized using random effects meta-analysis. Findings overall indicated that measures of ICD-11 PD severity and trait domains have adequate levels of internal consistency (α/ω = 0.82, 95% CI [0.81; 0.83], I 2  = 97.3%). Aspects such as sample, country, language, format, and measured construct were significant sources of variation. Additional meta-analyses revealed that some measures performed better than others for certain dimensions. Internal consistency was overall supported across ICD-11 measures of severity and trait domains. Future research should further investigate the interrater reliability, test-retest reliability and stability, and alignment with interview-based PD diagnoses., (© 2024 The Author(s). Personality and Mental Health Published by John Wiley & Sons Ltd.)

Background: Personality disorder (PD) in ICD-11 is defined primarily by self and interpersonal dysfunction and optionally by other qualifiers. This definition is inseparable from relativism of cultural determinants., Aims: This review aimed to synthesize the relevant aspects of the influence of culture on clinical practice and health management for this condition, aligning them to the ICD-11 PD model., Method: In Scopus, we systematically searched for studies that included the text strings: cultur* | personality AND (disorder* OR patholog*) without any restrictions on publication date or language or other exclusion criteria, up to November 2022., Results: Evidence suggests that cultural variables in ethnic groups (Western and non-Western) such as the individualist/collectivist philosophy, historical/generational trauma, immigration, acculturation, religion, and gender influence the etiology, semiology, epidemiology, evaluation, diagnosis, treatment, and management of health services for ICD-11 PD. We discuss the limitations and propose future lines of research on this topic based on our knowledge and experience. In this review, we provide the scientific community and clinicians with relevant cultural information to guide their practice and propose strategies to manage PD from the ICD-11 model., Conclusions: More research is needed using mixed study methodologies on stigma, the experiences of patients, clinicians, and health agencies, to reduce the care gaps and achieve a culturally comprehensive, inclusive, and competent use of this new model.

Changes in dietary patterns and body weight have become a focus of research in undergraduate students. This study compared breakfast consumption, intake of foods high in saturated fat, and BMI between medical and non-medical students. A comparative cross-sectional study was conducted in 4,561 Peruvian university students, of whom 1,464 (32.1%) were from the medical field and 3,097 (67.9%) from the non-medical field. We compared the frequency of breakfast consumption (categorized as regular: 6 to 7 days/week; occasional: 3 to 5 days/week; and rarely or never: 0 to 2 days/week) and the frequency of consumption of foods high in saturated fat. We created simple and multiple linear and Poisson regression models with robust variance to evaluate the association of the mentioned variables with academic fields. Non-medical students (Adjusted Prevalence Ratio [PR] = 0.92, 95% CI 0.86-0.99; p = 0.008) were less likely to eat breakfast regularly compared to medical students. Likewise, consumption of foods high in saturated fats was higher in non-medical students (B = 1.47, 95% CI 0.91-2.04; p < 0.001) compared to medical students. Similarly, the mean BMI of these students was significantly higher than that of medical students (B = 0.33, 95% CI 0.12-0.53; p = 0.002). Although medical students reported relatively healthy eating habits and a lower BMI, there is a widespread need to promote improved diet and lifestyle among the entire university population to reduce the risks of communicable diseases and improve quality of life., (© 2024. The Author(s).)

Background: The concept of entrapment has been highlighted as a transdiagnostic element that manifests itself in disorders such as depression, anxiety, and suicidal ideation. Although research has been conducted in different contexts independently, a comprehensive multi-country study to assess gender differences in entrapment through network analysis has not yet been carried out. The objective of this study was to evaluate the entrapment network in men and women at the multinational level., Methods: A sample of 2,949 participants, ranging in age from 18 to 73 years from six countries (Germany, Iran, Spain, Slovakia, El Salvador, and Peru), was considered. They completed the entrapment scale. A network analysis was performed for both men and women to identify the connectivity between indicators and the formation of clusters and domains, in addition to the centrality assessment in both sex groups., Results: The study findings revealed the presence of a third domain focused on external interpersonal entrapment in the network of men and women. However, in relation to the interconnectivity between domains, variations were evidenced in both networks, as well as in centrality, it was reported that men present a greater generalized entrapment in various aspects of life, while women tend to experience a more focused entrapment in expressions of intense emotional charge., Conclusion: The multinational study identified variations in the structure of entrapment between genders, with three domains (internal, external, and external-interpersonal) and differences in the interaction of indicators and groupings, as well as discrepancies in centrality., 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 Ramos-Vera, Calle, Quispe-Callo, Höller, Forkmann, Ordoñez-Carrasco, Čopková, Lichner, Lobos-Rivera, Calizaya-Milla and Saintila.)

Background: The link between physical and mental health and screen time in adolescents has been the subject of scientific scrutiny in recent years. However, there are few studies that have evaluated the association between social network addiction (SNA) and metabolic risk in this population., Objective: This study determined the association between SNA and anxiety symptoms with the risk of metabolic syndrome (MetS) in adolescents., Methods: A cross-sectional study was conducted in Peruvian adolescents aged 12 to 18 years, who completed a Social Network Addiction Questionnaire and the Generalized Anxiety Disorder 2-item scale (GAD-2), between September and November 2022. A total of 903 participants were included in the study using a non-probability convenience sample. Sociodemographic and anthropometric data were also collected. Binary logistic regression was used to explore the association between SNA and anxiety symptoms with MetS in a cross-sectional analysis., Results: Males were more likely to have MetS than females (OR = 1.133, p = 0.028). Participants who were 16 years of age or older and those with excess body weight were 2.166, p = 0.013 and 19.414, p < 0.001 times more likely to have MetS, respectively. Additionally, SNA (OR = 1.517, p = 0.016) and the presence of anxiety symptoms (OR = 2.596, p < 0.001) were associated with MetS., Conclusion: Our findings suggest associations between SNA, anxiety symptoms, and MetS among youth. However, more studies are needed to better understand this association and to deepen the possible clinical and public health implications., 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 Saintila, Oblitas-Guerrero, Larrain-Tavara, Lizarraga-De-Maguiña, Bernal-Corrales, López-López, Calizaya-Milla, Serpa-Barrientos and Ramos-Vera.)

The health crisis caused by COVID-19 in the United Kingdom and the confinement measures that were subsequently implemented had unprecedented effects on the mental health of older adults, leading to the emergence and exacerbation of different comorbid symptoms including depression and anxiety. This study examined and compared depression and anxiety symptom networks in two specific quarantine periods (June-July and November-December) in the older adult population in the United Kingdom. We used the database of the English Longitudinal Study of Aging COVID-19 Substudy, consisting of 5797 participants in the first stage (54% women) and 6512 participants in the second stage (56% women), all over 50 years of age. The symptoms with the highest centrality in both times were: "Nervousness (A1)" and "Inability to relax (A4)" in expected influence and predictability, and "depressed mood (D1"; bridging expected influence). The latter measure along with "Irritability (A6)" overlapped in both depression and anxiety clusters in both networks. In addition, a the cross-lagged panel network model was examined in which a more significant influence on the direction of the symptom "Nervousness (A1)" by the depressive symptoms of "Anhedonia (D6)", "Hopelessness (D7)", and "Sleep problems (D3)" was observed; the latter measure has the highest predictive capability of the network. The results report which symptoms had a higher degree of centrality and transdiagnostic overlap in the cross-sectional networks (invariants) and the cross-lagged panel network model of anxious and depressive symptomatology., (© 2024. The Author(s).)

Background: The prevalence of obesity continues to increase among university students and the general population. Consumption of a diet high in saturated fats could be one of the risk factors., Objective: The consumption of foods high in saturated fats, the vegetarian diet pattern, and sociodemographic characteristics associated with excess body weight (overweight/obesity) were evaluated in Peruvian university students., Methods: A cross-sectional study was carried out selecting 5,608 Peruvian university students through no probabilistic convenience sampling. The survey was carried out during the months of February and April 2022. The Chi-square test and binary logistic regression analysis were used to evaluate the association between diet (saturated fats intake and dietary pattern) and sociodemographic factors with excess body weight in a cross-sectional analysis., Results: It was observed that students who reported high consumption of foods high in saturated fats (OR B  = 1.14) and those who had a non-vegetarian dietary pattern (OR B  = 2.76) were found to be more likely to have excess body weight. On the contrary, students who reported adherence to the vegetarian diet pattern for more than 5 years were less likely to be overweight or obese (OR B  = 0.84). Being ≥26 years of age (OR B  = 3.28), living in urban areas (OR B  = 1.68) and coastal areas of the country (OR B  = 1.17), and enrolled in the engineering faculty (OR B  = 1.19), were significantly associated with excess body weight., Conclusion: The findings of the current study evidenced several factors associated with excess body weight in university students. Therefore, it is necessary to promote and implement healthy lifestyle programs, considering sociodemographic and dietary aspects such as age and dietary intake to control and prevent obesity in university students., 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 Saintila, Ruiz Mamani, Ramos-Vera, Serpa-Barrientos, Oblitas-Guerrero, Lizarraga-De-Maguiña and Calizaya-Milla.)

Background: Excess body weight and an unhealthy lifestyle are a risk factor for noncommunicable diseases. University students are susceptible to unhealthy habits and obesity. This study compared body mass index (BMI) and healthy lifestyle practices among university students from four academic disciplines: Health Sciences, Business Sciences, Human Sciences and Education, and Engineering/Architecture., Methods: A cross-sectional study was carried out using a sample of 6,642 university students selected by non-probability convenience sampling. The Diet and Healthy Lifestyle Scale (DEVS), the Peruvian validation of the Vegetarian Lifestyle Index (VLI), was used to assess healthy lifestyle practices., Results: Students in the areas of Business Sciences and Engineering/Architecture had a higher BMI than their peers in Health Sciences (B = 0.35, 95% CI: 0.15-0.56 and 0.32, 95% CI: 0.13-0.52; p = 0.001). Additionally, these students tended to adopt less healthy lifestyle (B = -0.11, 95% CI: -0.20 to -0.01 and -0.09, 95% CI: -0.18 to -0.00; p < 0.05) compared to those in Health Sciences., Conclusion: Although students of Health Sciences and Human Sciences and Education exhibited healthy lifestyle patterns, there is a clear need to improve eating and living habits in general among the university population to mitigate the risk factors associated with non-communicable diseases., 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 Saintila, Calizaya-Milla, Carranza-Cubas, Serpa-Barrientos, Oblitas-Guerrero and Ramos-Vera.)

Background: Short sleep duration in healthcare professionals is a recurring concern among researchers. On the other hand, the prevalence of burnout in this population group is experiencing exponential growth. Therefore, this study aimed to explore the association between sleep duration and burnout in healthcare professionals., Methods: This is a cross-sectional study. Data were collected by applying a non-probabilistic convenience sampling, considering a sample of 300 healthcare professionals from the public sector in Peru. The association between variables was explored using multivariate logistic regression. Values of p < 0.05 were considered statistically significant., Results: The results of the analysis in the crude models revealed that both men and women who slept < 7 h during workdays and days off were 8.33 (95% CI = 2.68-13.99, p = 0.004) and 17.18 (95% CI = 10.50-23.87, p < 0.001) times more likely to have burnout compared to those who reported ≥7 h, respectively. After adjusting for confounding variables, the association remained statistically significant., Conclusion: The findings of this study underscore the critical importance of sleep duration in the incidence of burnout among healthcare professionals. In the context of the global challenges to the mental and physical health of these professionals, our results highlight the urgent need to implement strategies at the organizational and individual level. This includes promoting a better work-life balance, and effective stress management and improved sleep quality., 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 Saintila, Soriano-Moreno, Ramos-Vera, Oblitas-Guerrero and Calizaya-Milla.)

Background: University students often experience significant changes in their eating habits, which can increase the risk of developing eating disorders (ED). This situation calls for the creation of brief assessment tools to identify college students who may be most at risk. The aim of the study was to determine the psychometric properties of the Eating Attitudes Test-8 (EAT-8) in a Peruvian university population; additionally, the possible differences in the scores of the instrument according to sociodemographic variables, such as gender and age, were examined., Methods: A psychometric study was conducted on 610 participants ( M = 24.3, SD = 2.16, and 61.5% female), aged 19 to 31 years, belonging to four universities of different professional careers., Results: The unidimensional eight-item model was found to have fit indices that confirm acceptable factorial validity ( X 2 /df = 3.23, CFI = 0.984, TLI = 0.977, RMSEA = 0.061, SRMR = 0.049) and an internal consistency of 0.833 for the Cronbach's alpha coefficient and 0.838 for the McDonald's omega coefficient. In addition, the EAT-8 was reported to be invariant according to gender and age; likewise, there were no significant differences in the age and gender categories., Conclusion: The EAT-8 has solid psychometric properties, including validity, reliability, and invariance, in the Peruvian university population, which supports its ability to assess the risk of developing ED in this specific group., 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 © 2023 Ramos-Vera, Basauri-Delgado, Obregón and Saintila.)

Background: The concept of Grit refers to a person's ability to maintain perseverance and passion in the pursuit of long-term objectives. However, research on the applicability of the Grit-Original scale (Grit-O) in the Latin American context is limited., Objective: This instrumental design study aimed to analyze the structure of this scale and its factorial invariance in relation to gender, as well as to examine its convergent validity with job satisfaction and happiness., Methods: A sample of 364 Peruvian workers that were selected through non-probabilistic convenience sampling in 2021., Results: The results of the confirmatory factor analysis showed that the two-dimensional structure of 12 items presented adequate goodness-of-fit indices. Additionally, the instrument is invariant between men and women. Likewise, the convergent relationship between the Grit scale, job satisfaction, and happiness variables was confirmed, which supports the validity of the instrument in the study context., Conclusion: The findings of the study confirm that the GRIT-O is a measure with adequate psychometric properties in the Peruvian context., 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 © 2023 Ramos-Vera, Soza-Herrera, Quispe-Callo, Serpa-Barrientos, Calizaya-Milla and Saintila.)

Background: Although the relationship between health status and dietary intake has been extensively studied in the general population, there is a lack of research that has specifically examined the association between frequency of breakfast consumption and cardiometabolic risk in university teachers., Objective: To determine the association between the frequency of breakfast consumption and cardiometabolic risk in university teachers., Methods: A cross-sectional study was conducted in 176 teachers from a private university located in the eastern region of Lima, Peru ( M age : 37.0 years; SD: 0.8, range: 24-59 years). The study was conducted during the period from December 2019 to February 2020. Information was collected on anthropometric and biochemical parameters and frequency of breakfast consumption. Multinomial logistic regression models were used to explore the association between frequency of breakfast with sociodemographic, anthropometric, and biochemical variables., Results: The highest prevalence of excess body weight (44.4%) was observed in those who consumed breakfast 0 to 2 days/week, but without statistical differences. Those who reported Low-density lipoprotein cholesterol (LDL-C) < 160 mg/dL were 77% less likely to fall into the 3-5 day/week breakfast frequency category than those who reported a regular frequency of breakfast (6 to 7 days/week) (Adjusted OR = 0.23, 95% CI 0.08 to 0.73; p < 0.05). In addition, teachers who reported a breakfast frequency of 3 to 5 days/week were 83% more likely to have a glucose concentration < 110 mg/dL compared to those who consumed breakfast of 6 to 7 days/week (Adjusted OR = 0.17, 95% CI 0.04 to 0.75; p < 0.05)., Conclusion: Skipping breakfast for an extended period of time can have detrimental effects on cardiometabolic health. Promoting the benefits of breakfast could be a health message of great public health interest., 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 © 2023 Saintila, Baquedano-Santana, Calizaya-Milla, Ramos-Vera, Barrientos and Carranza-Esteban.)

Depression in young people is considered a public health problem, given that it affects their personal, social, and academic lives; therefore, early detection of depressive symptoms is of importance for a favorable prognosis. This study aimed to estimate the psychometric properties of the second edition of the Reynolds Adolescent Depression Scale (RADS-2) in Peruvian adolescents. The sample was composed of 917 Peruvian adolescents, aged 13 to 18 years (M = 15,241, SD = 1,020), who were selected from two public educational institutions in Metropolitan Lima. Confirmatory factor analysis supported the 25-item model with the four-dimensional structure and its overall and interdimensional reliability. This structure was found to be gender invariant. Finally, network analysis was performed to assess the relationships and centralities of the depressive symptoms of the validated version of the RADS-2. The results show that the RADS-2 measure is a consistent and reliable test that yields valid results in the Peruvian adolescent context., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Ramos-Vera et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: People with depression are at increased risk for comorbidities; however, the clustering of comorbidity patterns in these patients is still unclear., Objective: The aim of the study was to identify latent comorbidity patterns and explore the comorbidity network structure that included 12 chronic conditions in adults diagnosed with depressive disorder., Methods: A cross-sectional study was conducted based on secondary data from the 2017 behavioral risk factor surveillance system (BRFSS) covering all 50 American states. A sample of 89,209 U.S. participants, 29,079 men and 60,063 women aged 18 years or older, was considered using exploratory graphical analysis (EGA), a statistical graphical model that includes algorithms for grouping and factoring variables in a multivariate system of network relationships., Results: The EGA findings show that the network presents 3 latent comorbidity patterns, i.e., that comorbidities are grouped into 3 factors. The first group was composed of 7 comorbidities (obesity, cancer, high blood pressure, high blood cholesterol, arthritis, kidney disease, and diabetes). The second pattern of latent comorbidity included the diagnosis of asthma and respiratory diseases. The last factor grouped 3 conditions (heart attack, coronary heart disease, and stroke). Hypertension reported higher measures of network centrality., Conclusion: Associations between chronic conditions were reported; furthermore, they were grouped into 3 latent dimensions of comorbidity and reported network factor loadings. The implementation of care and treatment guidelines and protocols for patients with depressive symptomatology and multimorbidity is suggested., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (Copyright © 2023 Cristian Ramos-Vera et al.)

Post-traumatic growth is the psychological capacity to perceive positive changes facing high-stress or potentially traumatic events and may be especially useful in lessening their effects in adolescents' lives. Present study aimed to evaluate the psychometric properties of the Post-Traumatic Growth Inventory (PTGI) in 662 Peruvian adolescents who suffered the death of an immediate family member over the last 4 years. Firstly, an exploratory graphical analysis (EGA) was conducted to determine the best parsimonious structure of the instrument and confirmed with its respective factor models. The results report adequate fit indices in the EGA Bifactor model. Furthermore, another structural model is included, which reports significant latent effects of the time elapsed since the relative's death and gender (male) on PTGI general factor. Likewise, gender measure was significantly related to items 3, 7, and 11, which is linked to personal growth., 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.

Introduction: University students constantly face a number of health challenges related to an unhealthy diet, characterized by a high intake of saturated fats., Objective: This study aimed to analyze the psychometric properties of the Spanish version of the Block Fat Screener (BFS-E) food frequency questionnaire in a university population., Methods: An observational analytical study of instrumental type was carried out in 5608 Peruvian university students. Based on the Block Fat Screener questionnaire, a back-translation and cultural adaptation process was carried out. The validity of the questionnaire was determined through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), hypothesizing a unidimensional structure. For the determination of reliability, the alpha coefficients were considered; likewise, the ω and H coefficients were used to evaluate the construct. The model explained 63% of the cumulative variance., Results: The CFA confirmed the unidimensionality of the 16-item questionnaire with appropriate goodness-of-fit indicators; therefore, which model of the Peruvian version adequately fits the observed data. The values of the reliability coefficients were higher than 0.90, with ordinal α = 0.94, ω = 0.94, and H = 0.95., Conclusion: The Spanish version of the Block Fat Screener food frequency questionnaire presents adequate psychometric properties and is therefore a valid scale to quickly measure fat intake in university students in a Latin American context., 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 © 2023 Saintila, Morales-García, Calizaya-Milla, Ruiz Mamani, Huancahuire-Vega, Calizaya-Milla and Ramos-Vera.)

Background: The COVID-19 pandemic and its subsequent health restrictions had an unprecedented impact on mental health, contributing to the emergence and reinforcement of various psychopathological symptoms. This complex interaction needs to be examined especially in a vulnerable population such as older adults., Objective: In the present study we analyzed network structures of depressive symptoms, anxiety, and loneliness from the English Longitudinal Study of Aging COVID-19 Substudy over two waves (Months of June-July and November-December 2020)., Methods: For this purpose, we use measures of centrality (expected and bridge-expected influence) in addition to the Clique Percolation method to identify overlapping symptoms between communities. We also use directed networks to identify direct effects between variables at the longitudinal level., Results: UK adults aged >50 participated, Wave 1: 5,797 (54% female) and Wave 2: 6,512 (56% female). Cross-sectional findings indicated that difficulty relaxing, anxious mood, and excessive worry symptoms were the strongest and similar measures of centrality (Expected Influence) in both waves, while depressive mood was the one that allowed interconnection between all networks (bridge expected influence). On the other hand, sadness and difficulty sleeping were symptoms that reflected the highest comorbidity among all variables during the first and second waves, respectively. Finally, at the longitudinal level, we found a clear predictive effect in the direction of the nervousness symptom, which was reinforced by depressive symptoms (difficulties in enjoying life) and loneliness (feeling of being excluded or cut off from others)., Conclusion: Our findings suggest that depressive, anxious, and loneliness symptoms were dynamically reinforced as a function of pandemic context in older adults in the UK., 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 © 2023 Ramos-Vera, García O'Diana, Basauri, Calle and Saintila.)

We aimed to evaluate whether an ultra-short version of the Posttraumatic Growth Inventory (PTGI) has adequate psychometric properties, with a Colombian sample ( N  = 931) vulnerable to SaRS-CoV-2 infection. Results indicated that adequate indicators of goodness-of-fit, convergent validity, internal consistency, and factorial invariance. Therefore, this instrument is recommended for the screening of posttraumatic growth associated with the COVID-19 pandemic that may be present in the Colombian population.

Background: The stigma associated with human immunodeficiency virus (HIV) can lead to prejudice and discrimination against people who have been infected by this virus, consequently, it is important to have a validated tool to measure this phenomenon. However, there is only 1 national precedent that has validated the scores of this instrument in its 21-item version. Therefore, this study examined the bifactor structural equation method (SEM) and multidimensional item response theory (MIRT) structure of a 12-item human immunodeficiency virus stigma scale in Peruvian adults., Methods: We evaluated 342 patients (57.6% female and 42.45% male) diagnosed with HIV receiving highly active antiretroviral therapy (HAART) from a hospital located in East Lima, aged 18 to 45 years ( M  = 31.4, SD = 9.79). A SEM was used to test 2 measurement models, a 4-factor correlated oblique model and a bifactor model due to high interfactor relationships., Results: Acceptable fit indices were identified for the oblique model (χ 2 /df = 1.26, SRMR = 0.044, RMSEA [90% CI] = 0.028 [0.000-0.047], CFI = 0.996, TLI = 0.994). In the same way, similar results were evident for the bifactor model (χ 2 /df = 1.14, SRMR = 0.039, RMSEA [90% CI] = 0.020 [0.000-0.044], CFI = 0.998, TLI = 0.997), however, in the latter it showed a greater explanation for the unidimensional model ( H  = 0.87, PUC = 0.82, LCA = 0.70), which was also evidenced by the bifactor MIRT analysis., Conclusion: It is concluded that the 12-item HIV Stigma Scale meets the psychometric properties of internal structure and unifactorial reliability.

Background: Emotional eating (EmE) is one of the most common eating behaviors maladaptive among young adults, however, in the Peruvian context, it remains unexplored., Objective: The aim of the study was to determine the association between negative EmE, sociodemographic characteristics, physical activity, sleep duration, and mental and physical health in young adults., Methods: A cross-sectional study was conducted in 400 young Peruvian adults living in three regions of Peru (coast, jungle, and highlands). An online survey was used to collect information on sociodemographic characteristics, physical activity, sleep duration, depressive symptoms, anxiety, hypertension, and negative EmE. In addition, self-reported anthropometric data were collected to calculate body mass index (BMI)., Results: Approximately 55.8% of women presented negative EmE. Logistic regression analysis revealed that participants aged 30-39 years were less likely to have negative EmE in both female and male gender, OR; 0.24, 95% CI; 0.08-0.66, p<0.01 and OR; 0.40, 95% CI; 0.16-0.97, p<0.05, respectively. Perform physical activity 3 to 4 times 5.22 (95% CI: 1.31-20.78), 1 to 2 times a week 5.77 (95% CI: 1.91-17.44), and never 15.18 (95% CI: 3.90-59.00) were associated with negative EmE. Moreover, sleeping less than 7 hours per day (OR; 2.26, 95% CI; 1.04-4.90), depressive symptoms (OR = 6.29, 95% CI: 1.27-31.19), anxiety (OR = 14.13, 95% CI: 2.46-80. 97, p<0.01), hypertension (OR = 7.58, 95% CI: 1.24-46.17), and BMI ≥25 (overweight/obese) (OR = 1.51, 95% CI: 1.66-3.41) were associated with negative EmE., Conclusion: The findings show that there is an association between negative EmE, sociodemographic characteristics, physical activity, sleep duration, and mental and physical health in young adults., Competing Interests: The authors declare that there is no conflict of interest., (© 2022 Calderón-Asenjo et al.)

Introduction: Enneagram typologies may impact psychological well-being and stressful situations in college students. However, the literature is still limited in the study of dynamic personality models such as the Enneagram in Spanish-speaking university students, and a better understanding is needed., Objective: To analyze network associations and centrality measures of Enneagram personality typologies in Peruvian university students., Methods: A total of 859 Peruvian university students responded to two instruments assessing: The Pangrazzi's Enneagram personality types and healthy personality to psychosocial stress. All instruments showed good psychometric values (validity and consistency). A regularized cross-sectional network structure was estimated with Gaussian graphical model and the graphical LASSO., Results: Enneagram types 4, 5, and 6 presented the highest and positive associations in the network structure. Type 6 emerged as the node with the highest predictability. The healthy personality and type 7 acted as bridges between the communities, with types 6, 7, and 8 being the most central nodes., Conclusion: The findings suggest that Enneagram type 7 with healthy personality to psychosocial stress plays an important role in the development of the causal activation of the network model. The network shows causal associations between psychosocial stress and types 6, 7, 8, and 9., 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 Ramos-Vera, Barrientos, Baños-Chaparro, Saldarriaga and Saintila.)

Background: People with cognitive impairment may be exposed to an increased risk of comorbidities; however, the clustering of comorbidity patterns in these patients is unclear., Objective: To explore the network structure of chronic comorbidity in a U.S. national sample spanning all 50 U.S. states with more than 170,000 participants reporting perceived cognitive impairment., Methods: This is a cross-sectional study conducted using Behavioral Risk Factor Surveillance System (BRFSS) secondary data collected in 2019 and covering 49 U.S. states, the District of Columbia, Guam, and the Commonwealth of Puerto Rico. A total of 15,621 non-institutionalized U.S. adult participants who reported "yes" to the subjective cognitive impairment question were considered, of whom 7,045 were men and 8,576 were women. All participants were aged 45 years or older. A statistical graphical model was used that included clustering algorithms and factorization of variables in a multivariate network relationship system [exploratory graphical analysis (EGA)]., Results: The results of the EGA show associations between the comorbid conditions evaluated. These associations favored the clustering of various comorbidity patterns. In fact, three patterns of comorbidities have been identified: (1) arthritis, asthma, respiratory diseases, and depression, (2) obesity, diabetes, blood pressure high, and blood cholesterol high, and (3) heart attack, coronary heart disease, stroke, and kidney disease., Conclusion: These results suggest the development of interdisciplinary treatment strategies in patients with perceived cognitive impairment, which could help to design an integrated prevention and management of the disease and other related health problems, such as Alzheimer's disease and related dementias., 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 Ramos-Vera, Saintila, O'Diana and Calizaya-Milla.)

Context: Knowledge, beliefs, and attitudes toward palliative care (PC) constitute barriers to its access. Few studies have focused on the intrinsic relationship between these variables, and none has examined the relationship between them and self-care self-efficacy., Objective: To examine the direct and indirect effects of self-care self-efficacy, knowledge, and beliefs on attitudes toward PC., Methods: A cross-sectional predictive study was conducted. Self-care self-efficacy, knowledge, attitudes, and beliefs about PC were analyzed using information from the Health Information National Trends Survey (HINTS 5, cycle 2, 2018). Data from 1,162 participants were considered. Structural equation modeling (SEM) was used to represent the statistical mediation model with latent and observable variables., Results: The structural model presents positive coefficients indicating that self-care self-efficacy significantly predicts knowledge ( β = 0.127, p < 0.001) and beliefs ( β = 0.078, p = 0.023). Similarly, knowledge is associated with attitudes ( β = 0.179, p < 0.001) and beliefs ( β = 0.213, p < 0.001). The beliefs measure is also significantly related to attitudes ( β = 0.474, p < 0.001). In addition, this structural multiple mediation model shows optimal goodness-of-fit indices: χ 2 /df = 3.49, CFI = 0.983, TLI = 0.976, RMSEA = 0.046 [90% CI: 0.037-0.056], SRMR = 0.038., Conclusion: Self-care self-efficacy is significantly associated with knowledge and beliefs about PC, which in turn are related to each other. Altogether, these variables predict positive attitudes toward PC. Understanding the relationship between these variables is relevant for targeting-specific populations and designing timely strategies to improve access to PC.

An important article was published, whicht evaluated statistically significant associations (p < 0.05) using the odds ratio (OR), in the first issue of volume 113 of this journal. The study evaluated a relationship between C-reactive protein levels (CRP > 100) and the histological diagnosis of gangrenous acute cholecystitis in patients who underwent cholecystectomy (OR = 3.1).

Background: Non-communicable diseases and psychiatric pathologies are the health problems that most affect the population in the United States., Objective: This study aimed to examine the mediating role of patient-centered communication (PCC) in the relationship between satisfaction with medical care, physical health, and emotional well-being in American men., Methods: A cross-sectional - predictive study was carried out. The variables analyzed were satisfaction with medical care, physical health, and emotional well-being. Information from the Health Information National Trends Survey Data (HINTS) was used; HINTS 5, cycle 3 (collected between January and June 2019) and 4 (2020). Data from 3338 men were considered (mean age: M  = 55.40, SD = 19.53). Data analyses were carried out using structural equation modeling (SEM) to represent the statistical mediation model with latent and observable variables., Results: Analyses showed that the variables were significantly related ( P  < .01). In the mediation model, there is evidence that satisfaction predicts communication (β = .764, P  < .001) and this, in turn, is related to physical health (β = .079, P  = .007) and emotional well-being (β = .145, P  < .001). In addition, the standardized estimates of the structural multiple mediation model presented acceptable goodness-of-fit indices: χ 2 /gl = 2.24, CFI = 0.999, TLI = 0.999, RMSEA = 0.019 [90% CI: 0.013-0.022], SRMR = 0.018., Conclusion: Patient-centered communication plays a significant dual mediating role in the relationship between satisfaction with medical care, physical health, and emotional well-being, respectively. Therefore, PCC is essential in healthcare for American men.

Introduction: Alcohol consumption constitutes one of the main modifiable risk factors that contribute to the increase in the global burden of non-communicable diseases (NCDs). The objective of this study was to determine the effects of the consumption of alcoholic beverages on the state of physical health and its equivalence according to gender., Methods: Cross-sectional data from the Health Information National Trends Survey (HINTS) of the National Cancer Institute (NCI) (n = 3865), collected during 2020 were used. Structural equation modeling was applied to assess the fit of the model, which included the prediction of measures of alcohol consumption in physical health and the equivalence of measurements of the proposed structural model in men and women., Results: The proposed structural model reported adequate goodness-of-fit indices (SBχ²/gl = 3.817, CFI = 0.984, TLI = 0.968, RMSEA [90% CI] = 0.027 [0.016-0.039]; SRMR = 0.016). Frequent alcohol consumption had a negative effect on physical health ( b = -0.13, P < .01). Similarly, occasional alcohol consumption negatively predicted elevated BMI and chronic conditions such as, diabetes, hypertension, CVD, and cancer ( b = -0.09, P < .01). In addition, drinking patterns of alcoholic beverages affect physical health in equal ways for men and women., Conclusion: The findings highlight that frequent and occasional alcohol consumption significantly affected physical health in a negative way. Future interventions could address ways to encourage the adoption of a healthy lifestyle to reduce the risks of chronic conditions derived from excessive alcohol consumption.

The COVID-19 pandemic has been implicated in several mental health challenges faced by many people. These challenges can also arise due to the fear of being infected with COVID-19 and engaging in preventative behavior. This study investigated the mediating role of post-traumatic stress symptomology and psychological distress in the relationship between fear of COVID-19 and preventive health behavior. A sample of 1172 individuals (mean age = 22.9 years, 54.5% females) participated in the online survey. Correlation analysis revealed that preventive health behavior has a positive relationship with fear of COVID-19 and post-traumatic stress symptomology but a negative relationship with psychological distress. Further analysis indicated that post-traumatic stress symptomology and psychological distress mediated the relationship between fear of COVID-19 and preventive health behavior. Post-traumatic stress symptomology caused by the fear of COVID-19 could contribute to improving preventive health behavior while psychological distress caused by the fear of COVID-19 tends to hinder preventive health behavior. It is recommended that public and private agencies should assist in promoting COVID-19 targeted education. Attention should also be focused on people's mental health status as means of preventing COVID-19., Competing Interests: Conflict of InterestThe authors declare that they have no conflict of interest., (© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2021.)

Background: Depressive symptoms can affect people's quality of life and social environment. In addition, in severe situations, they can lead to suicidal behaviors., Objective: This study aimed to analyze the differences in depressive symptoms in underweight and obese Peruvian adults., Methods: A cross-sectional study was carried out based on secondary data obtained from the Instituto Nacional de Estadística e Informática (INEI), Lima, Peru. A sample of 10 053 participants was considered, of which 55.96% were women. Two Gaussian plot models were estimated and the levels of depressive symptomatology were compared between the 2 groups (adults with underweight and obese)., Results: A total of 1510 (15.02%) were underweight adults and 8543 (84.98%) were obese adults. There were differences in the reporting of depressive symptoms in the underweight group; the most central items were "Depressed mood" (PH2), "Tiredness/low energy" (PH4), and "Psychomotor difficulties" (PH8)., Conclusion: This study provides new evidence on the dynamic relationship between depressive symptoms according to the body mass index categories (underweight and obese) assessed.