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A binational team of investigators culturally adapted, implemented, and tested the efficacy in Mexico of keepin' it REAL, a US-designed prevention intervention for youth. This article reports on the social validity of the adapted intervention by assessing its feasibility, acceptability, and utility, as perceived by participating middle school students, teachers/implementers, and school administrators. Middle schools (N = 36) were randomly assigned to (1) the culturally adapted version for Mexico (Mantente REAL), (2) the original intervention from the USA (keepin' it REAL) translated into Spanish, or (3) a control condition (treatment as usual). Adult and child feedback about the adapted and original versions of the intervention indicate that both are feasible to implement in the Mexican context. Implementation fidelity was equally high for both versions of the manualized intervention. Students, however, were more satisfied with the culturally adapted version than with the non-adapted version. They reported gaining more knowledge, finding it more acceptable, applicable, and authentic, and they reported discussing the program with their family and friends more often. The findings support the feasibility of engaging classroom teachers to implement manualized prevention programs in Mexico. These findings also advance prevention science by documenting the importance of cultural adaptation as a means to increase students' identification with and acceptability of efficacious school-based interventions. The article discusses the practice, policy, and future prevention research implications of the findings for Mexico and their potential generalizability to other middle- and lower-income countries.

Objective: ICD-11 clinical guidelines for mental and behavioral disorders must be tested in clinical settings to guarantee their usefulness worldwide. The purpose of this study was to evaluate inte...

Introduction. Frontline COVID-19 healthcare workers (FLHCWs) are at a high-risk of suffering occupational stress- and trauma-related mental health problems, including burnout and compassion fatigue (B&CF). Given the time limitations (due to their heavy workloads) and need to minimize face-to-face interventions (in order to avoid contagions), psychological interventions for FHCWs should be as brief and remote as possible. Objective. To evaluate the usability and clarity of evidence-based psycho-educational videos to prevent B&CF, to deal with uncooperative, hostile, and anxious patients and relatives, and to use personal protective equipment (PPE), from the perspective of Mexican FLHCWs. Method. Based on a convenience sampling by intensity approach, videos were distributed requesting feedback based on specific questions through WhatsApp to FLHCWs. Field notes were used to triangulate the information. Results. Content analysis of feedback from a final sample of 24 participants ‒75% women, 42 ± 8.4 years old‒ yielded three general thematic categories and seven subthemes: 1. content evaluation, which included three subthemes: utility, pertinence, and practicality; 2. dissemination and other needs, with two subcategories: willingness to share and receive more videos (other needs); and 3. format aspects, also comprising two subthemes: attractiveness and duration. All participants found the videos content very beneficial, relevant, and applicable to the workplace and even in their everyday personal and family life, and were willing to share them and to receive more videos on other issues, including strategies to manage problems related to isolation. Discussion and conclusion. Escalation of this remote preventive intervention to other COVID-19 centers and future similar epidemics is recommended.

The present text comments on Stockwell and colleagues' paper documenting the high burden of alcohol use in COVID-19 related mortality in the USA and Canada in North America and the absence of a control policy in several countries of the world. This comment adds information about the third country in North America, Mexico. It describes alcohol use during the COVID lockdown and its consequences, highlighting the control efforts through public health policies and ponders the weaknesses of the current response to the health crisis and opportunities in the aftermath.

Background: Schizophrenia diagnosis is associated with special communication difficulties between clinicians, service users and caregivers, which may hinder the therapeutic alliance, treatment comp...

Objective Describe and analyze the mental health service and medical needs of a group of transgender men from the point when they changed their gender identity to male. Material and method Transgender men volunteers who attended a specialized care center in Mexico City answered a qualitative semi-structured interview to explore their needs as well as the adversities they unnecessarily face due to the lack of information and care for their condition. Interviews were audio-recorded and transcribed for thematic analysis. Results Respondents began to develop their transgender identity in childhood; however, during that time, almost none of them had any helpful contact with a health professional. Those who did receive some form of care received mistreatment rather than positive feedback. It was not until adulthood that they obtained facts about a specialized care center. Conclusion It is necessary for health professionals to have information about sexual diversity and be trained to meet the needs of transgender children, in order to have information on places and professionals who accompany them and advise on available treatments such as hormone blockers or treatments. The study includes a small but important sample. However, the currently hostile, discriminatory environment, significantly exposes transgender people to developing mental health problems.

Alcohol is one of the most important risk factors for premature mortality and disability. Premature mortality disproportionately affects low- and middle-income countries (LMICs) (WHO 2011a); more than 85 percent of all deaths attributable to alcohol occur in these nations (Room and others 2013; WHO 2011a). This chapter updates the chapter on alcohol in Disease Control Priorities in Developing Countries, 2nd ed. (DCP2) (Rehm and others 2006), with new scientific evidence for interventions based on population, community, and individuals, with an emphasis on evidence from LMICs.Alcoholic beverages vary with respect to their raw material, method of production, alcohol content, and presentation. Beverages are usually classified as fermented or distilled. In addition to the alcohol that appears in official statistics, many countries have a substantial amount of unrecorded alcohol, which may include illegally produced or smuggled alcohol products, but also surrogate alcohol (nonbeverage alcohol not officially intended for human consumption) and legal but unrecorded alcohol products (Lachenmeier, Sarash, and Rehm 2009).

The perception that those with schizophrenia will be aggressive persists among the wider population. Some studies report that women generally perceive more aggression than men. It is not clear how ...

Introduction. There is a wide range of possible combinations in relation to sex at birth, gender identity, and sexual orientations. Specific medical and psychological treatment needs may also vary depending on these combinations. Objective. In order to promote interventions that focus on the perceived needs of those directly involved, the aim of the present case study is to describe the clinical and life experiences of a 43-year old transgender woman with cryptorchidism and examine the interplay between this relative common testicular problem at birth, gender identity, and sexual orientation formation processes from her own perspective. Method. An in-depth interview was conducted at a specialized care centre in Mexico City, Mexico. The interview was audio recorded and transcribed for a content analysis. Results. The case under analysis was assigned to the male sex and identified herself as a transgender woman and lesbian. Although it is not possible to conclude that her gender identity or sexual orientation is related to her antecedent of cryptorchidism, as she reflected on her related negative experiences, she concluded that her gender identity and sexual orientation trajectories, as well as her life in general, would have been completely different if there were no clinical interventions in her early development. Discussion and conclusion. The present case could have been benefited from not receiving early treatment for her cryptorchidism. There is an urgent need for the development of standardized protocols or algorithms for physical and mental health care professionals, which focus on supportive guidance rather than adjustment to parental and medical expectations.

For the forthcoming ICD-11, the ICD-10 category of Gender Identity Disorder of Childhood has been reformulated as Gender Incongruence of Childhood (GIC) and moved out of the mental disorders chapter. Proponents of eliminating the GIC diagnosis altogether claim that it is unnecessary and inherently harmful, although they do not eschew the diagnosis for adolescents and adults. Using a qualitative methodology, this study examined the impact of receiving a diagnosis related to gender identity as a child among transgender people who had had this experience, and evaluated participants’ views of the acceptability and usefulness of the ICD-11 GIC proposal. Participants receiving health services at a specialized public clinic for transgender health in Mexico City who had received some form of diagnosis in childhood were referred to participate in a semistructured interview. A sample of 12 transgender people (eight transgender women and four transgender men; ages 18–49) was necessary to reach saturation. Diagnoses received were non-specific rather than formal gender identity diagnoses, were experienced by participants as negative, and were used to justify potentially harmful interventions. However, when participants reviewed the ICD-11 proposals for GIC, all indicated that the category was necessary and important and could have a range of personal, familial, and social benefits. They agreed with its placement in a new chapter on Conditions Related to Sexual Health and endorsed the proposed definition and name of the category. Although this study involved a small and specific sample, the results raise questions about the claim that the diagnosis is inherently harmful and universally deplored by transgender people.

This paper describes a plan for the attention of addictions from a public health perspective; it defines strengths of this perspective and its limitations to face the special challenges that the problem represents for social policies; adopts a wider perspective that includes the integration of health and social issues in measuring policy results having as a main aim the benefit of the person and of the communities with a perspective of the populations well being. It describes the challenge the country faces as producer, route of traffic and rates of consumption, analyzes briefly the evidence of public policies and makes a series of recommendations.

The aim of the present article is to review recent research on the prevalence and correlates of inhalant use.During the review period more prevalence studies have been conducted in the developing world, adding information to the ongoing studies that are periodically undertaken in the more developed countries. These studies suggest that inhalant use is widespread among children and adolescents and is increasing among females in the developing and developed world. Not all surveys report inhalants as a separate group from other illegal substances; data by type of inhalants are even rarer, and few studies address abuse or dependence. New evidence suggests lower reliability rates for the diagnostic criteria of dependence as compared with other substances, suggesting the need for a review including the evidence of withdrawal. Studies conducted in the period identify vulnerable groups and suggest an increased risk of injecting drug use, HIV, suicidality and psychiatric disorders among inhalant users.The extension of inhalant abuse and its adverse consequences argues for greater efforts to advance classification and to increase knowledge through research, including the evaluation of prevention and treatment models.

Schizophrenia is a severe mental disorder that causes serious and persistent disability in multiple domains. People with schizophrenia are also often exposed to widespread sigma, discrimination, and human rights abuse. There is a large and persistent treatment gap for people with schizophrenia and their caregivers globally and in LAMIC;To address this gap, emerging observational evidence from LAMIC suggests that a task-sharing strategy involving community health workers (CHWs) is a feasible option for delivering services to people with schizophrenia and their families . However, there is no RCT evidence from LAMIC that such an approach is more effective than usually available care. The community care for people with schizophrenia in India (COPSI) RCT tested the clinical and cost-effectiveness of a collaborative community-based care (CCBC) intervention with usual, facility-based care (FBC). The FBC + CCBC intervention was superior in reducing symptoms and disability associated with schizophrenia and in improving adherence with treatment.

To validate the Substance Use Risk Profile Scale (SURPS) in a sample of Mexican adolescents, this brief 23-item self-report questionnaire has been developed to screen four high-risk personality traits for substance misuse, to guide targeted approaches to prevention of addictions in adolescents. The scale has been previously validated in United Kingdom, Canada, Sri Lanka and China. A sample of 671 adolescents aged 11–17 completed a Spanish translation of the SURPS as well as other measures of personality and substance use. The Spanish translation of the SURPS has moderate internal consistency, and demonstrated a four-factor structure very similar to the original scale. The four subscales show good concurrent validity and three of the subscales were found to correlate with measures of substance use. The Spanish translation of the SURPS seems to be a valid and sensitive scale that can be used in a Mexican adolescent population.

La cocaína deriva del nombre científico de la planta Erythroxylon coca: su aspecto es el de un polvo blanco, fino y cristalino. Fue aislada de las hojas de la planta por el químico alemán Friedrich Gaedcke, en 1885. Sin embargo, es a Albert Niemann a quién se le otorga el crédito de haberla aislado en 1859 como la conocemos.

Mexico is a country affected by drugs in every aspect: it is a drug producing country of heroin, marihuana and methamphetamines, mainly for external markets but also for the growing internal demand; it is a transit country for cocaine that has found its way through the Central American and Mexican corridor on its way to external markets and for the internal supply. As a result of the increasing availability of substances and a favorable social environment, it has become a consuming country; drug experimentation use and dependence of illegal drugs, although still low, have increased. The abuse/dependence of legal substances such as alcohol and tobacco are the main substance abuse problems; only the abuse of pharmaceuticals remains low and relatively stable, mainly as a result of low availability for medical purposes and therefore limited scope for deviation. Social costs are considerable, as happens in other countries in the region, violence being the most prevailing characteristic of the drug scene, increasing from 2008 onwards. Within these important challenges for health and security, it is also true that significant, continuous efforts have been made by demand reduction programs at the national level since 1972 and adapted to the changing circumstances. This editorial seeks to tell the story of drug transitions in Mexico and the programs that have been implemented and discusses areas of opportunity for a new approach.

This paper describes a plan for the attention of addictions from a public health perspective; it defines strengths of this perspective and its limitations to face the special challenges that the problem represents for social policies; adopts a wider perspective that includes the integration of health and social issues in measuring policy results having as a main aim the benefit of the person and of the communities with a perspective of the populations well being. It describes the challenge the country faces as producer, route of traffic and rates of consumption, analyzes briefly the evidence of public policies and makes a series of recommendations.

Introducción La depresión es un problema de salud pública que conlleva costos importantes para el individuo y la sociedad. Con la finalidad de establecer prioridades basadas en evidencias para la asignación de recursos en el cuidado de la salud mental, es necesario integrar los costos y la efectividad de las intervenciones y especificar los paquetes esenciales para su tratamiento. En esta dirección, la Organización Mundial de la Salud convocó al Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, como centro colaborador, a participar en el proyecto «Seleccionando intervenciones que son costo-efectivas» (WHO-CHOICE, por sus siglas en inglés: CHOosing Interventions that are Cost-Effective). El presente texto presenta los hallazgos del estudio de relación costo-efectividad de diferentes intervenciones clínicas para el tratamiento de la depresión en México, considerando su implantación en los servicios de atención primaria a la salud.

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.

Un grupo de investigadores y clínicos de diversas especialidades, reunidos por la Coordinación de Institutos Nacionales de Salud y Hospitales de Alta Especialidad, ha analizado en forma conjunta los principales problemas de adicciones que aquejan al país con el fin de identificar campos para la colaboración interinstitucional y hacer propuestas de política pú- blica. Este grupo previamente publicó un documento sobre el abuso de bebidas con alcohol y en esta ocasión abordará el tema del consumo de Cannabis. El grupo de trabajo identificó el consumo de esta sustancia como segunda prioridad en la problemática del consumo de drogas en nuestro país