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Author: search.filters.author.Medina-Mora, María ElenaSubject: search.filters.subject.Adolescence

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    Diagnostic profiles in adolescence and emerging adulthood: transition patterns and risk factors
    (Elsevier, 2023) Torre-Luque, Alejandro de la; Borges, Guilherme; Benjet, Corina; Orozco, Ricardo; Medina-Mora, María Elena; Ayuso-Mateos, Jose Luis; Department of Legal Medicine, Psychiatry and Pathology, Universidad Complutense de Madrid, Spain; af.delatorre@ucm.es (A. de la Torre-Luque)
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    Chronic childhood adversity and stages of substance use involvement in adolescents
    (ELSEVIER IRELAND LTD, ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND, 2013) Benjet, Corina; Borges, Guilherme; Medina-Mora, María Elena; Méndez, Enrique; Natl Inst Psychiat Ramon de la Fuente, Calzada Mexico Xochimilco 101, Mexico City 14370, DF, Mexico.; cbenjet@imp.edu.mx
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    La dependencia y los problemas asociados con el consumo de drogas en México
    (1995) Villatoro Velázquez, Jorge A.; Medina-Mora, María Elena; López Lugo, Elsa K.; Juárez García, Francisco L.; Rivera Guevara, Edith; Investigadores del Instituto Mexicano de Psiquiatría
    En este trabajo se presentan las prevalencias de los usuarios con síndrome de deprendencia y con problemas asociados con el consumo de drogas, así como los predictores sociodemográficos y de hábitos de consumo que conllevan a que un usuario desarrolle la dependencia. La investigación forma parte de la Encuesta Nacional de Adicciones (ENA), realizada por el Instituto Mexicano de Psiquiatría y la Dirección General de Epidemiología, que se llevó a cabo en población urbana de 12 a 65 años con lugar fijo de residencia. La escala para evaluar los problemas asociados al consumo de drogas (EPACD), consistió de 18 reactivos que evaluaron el área psicológica, de dependencia, sociofamiliar, que se aplicó en su totalidad a los 522 usuarios con que se conformó la muestra final de este estudio. En general, los resultados de la presente investigación, indican que los usuarios reportan con más frecuencia tener problemas psicológicos (33.8%) asociados a su consumo. Con respecto a los predictores del síndrome de dependencia a las drogas, en donde se empleó la técnica estadística de regresión logística, se encontró que aun cuando existen diferencias importantes en la distribución sociodemográfica de estos sujetos (quienes son hombres menores de 25 años y con estudios de preparatoria, presentan más el síndrome), el poliuso y la frecuencia de consumo son los principales predictores. Finalmente, el hallazgo más relevante es que el consumo problemático no es una dimensión separada del consumo de drogas. Aspecto que traducido en aplicaciones prácticas, indica que las acciones encaminadas a reducir el consumo (programas de prevención), tendrán un impacto directo en la reducción de los problemas y la sintomatología de dependencia que presente el usuario de drogas.
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    Epidemiología de los trastornos de la conducta alimentaria en una muestra representativa de adolescentes
    (Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Calz. México-Xochimilco 101, Col. San Lorenzo Huipulco, Tlalpan, México, D.F. Tel. 4160-5000., 2012) Benjet, Corina; Méndez, Enrique; Borges, Guilherme; Medina-Mora, María Elena; Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz.; cbenjet@imp.edu.mx
    Objetivos. El presente trabajo tiene el objetivo de estimar la prevalencia de anorexia nervosa, bulimia nervosa y el trastorno por atracones en la población general de adolescentes del Distrito Federal. Asimismo se pretende proporcionar una descripción de las características socio-demográficas y clínicas de los jóvenes que cumplen criterios diagnósticos según el DSM-IV para estos trastornos, la proporción de discapacidad, comorbilidad psiquiátrica y conducta suicida para cada trastorno y estimar la utilización de servicios. Material y métodos. Los datos provienen de la Encuesta Mexicana de Salud Mental Adolescente, una encuesta con diseño probabilístico y multietápico representativa de adolescentes entre los 12 y 17 años, residentes del Distrito Federal y área conurbada. Se entrevistó a 3005 adolescentes en sus hogares utilizando como instrumento diagnóstico la Entrevista Internacional Diagnóstica Compuesta (WMH-CIDI-A), aplicada cara a cara, por medio de una computadora portátil, por encuestadores capacitados. La tasa de respuesta fue de 71%. Resultados. La prevalencia alguna vez de anorexia, bulimia y el trastorno por atracones se estima en 0.5%, 1.0% y 1.4%, respectivamente. Entre 83 y 100% reportan discapacidad y todos aquellos con anorexia y casi la mitad de aquellos con bulimia y atracones reportan discapacidad grave. Sin embargo, ni una cuarta parte con uno de estos trastornos ha recibido tratamiento a pesar de la discapacidad que generan. Hay mayor prevalencia de trastornos comórbidos, conducta suicida y adversidades psicosociales en jóvenes con trastornos alimentarios que en aquellos sin ellos. Conclusiones. Los hallazgos muestran una brecha entre las necesidades de atención y el tratamiento para estos trastornos en nuestra población adolescente. Señalan la importancia de programas para la prevención de conductas alimentarias riesgosas, la detección temprana con un enfoque en grupos vulnerables (por ejemplo quienes han sufrido alguna adversidad como abuso sexual), y la reducción de barreras para la búsqueda y utilización de servicios.
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    The association of chronic adversity with psychiatric disorder and disorder severity in adolescents
    (SPRINGER, 233 SPRING ST, NEW YORK, NY 10013 USA, 2011) Benjet, Corina; Borges, Guilherme; Méndez, Enrique; Fleiz, Clara; Medina-Mora, María Elena; Inst Nacl Psiquiatria, Dept Invest Epidemiol, Direcc Invest Epidemiol & Psicosociales, Calzada Mexico Xochimilco 101, Mexico City 14370, DF, Mexico.; cbenjet@imp.edu.mx
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    Service use among Mexico City adolescents with suicidality
    (ELSEVIER SCIENCE BV, PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS, 2010) Borges, Guilherme; Benjet, Corina; Medina-Mora, María Elena; Orozco, Ricardo; Familiar, Itziar; Nock, Matthew K.; Wang, Philip S.; Inst Nacl Psiquiatria Ramon de la Fuente, Direcc Invest Epidemiol & Psicosociales, Mexico City 14370, DF, Mexico; guibor@imp.edu.mx
    Background: We report the lifetime and 12-month prevalence and associations of mental health treatment among Mexican adolescents with suicide-related outcomes (SROs; including ideation, plans, gestures and attempts). Methods: A representative multistage probability household survey of 3005 adolescents aged 12 to 17 years residing in the Mexico City Metropolitan Area was carried out in 2005. Discrete-time survival analyses were used to assess the relationships between SROs and receiving treatment for emotional, alcohol, or drug problems. Results: The prevalence of lifetime service use among respondents with SROs was 35% for those with ideation only, 44% for those with ideation and plan, 49% for those with gesture and 50% for those with attempt; the prevalence of 12-month service use was 10%, 24%, 6% and 21%, respectively. Timing between onset of SRO and receiving treatment for emotional, alcohol, or drug problems showed that about 50% of adolescents will have contact with a service provider before developing any SRO. Healthcare professionals were the most likely to be consulted, followed by school-based programs. Limitations: This survey was limited to adolescents living in one of the largest metropolitan areas in the world and the analyses used data on retrospectively reported ages of onset that are subject to recall errors. Conclusions: Most suicidal adolescents do not receive treatment, and many adolescents develop their suicidality in spite of prior contacts with service providers. Interventions to increase treatment, prevention, and monitoring are sorely needed for this vulnerable population. (C) 2009 Elsevier B.V. All rights reserved.
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    Evaluating the drug use "gateway" theory using cross-national data: Consistency and associations of the order of initiation of drug use among participants in the WHO World Mental Health Surveys
    (ELSEVIER IRELAND LTD, ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND, 2010) Degenhardt, Louisa; Dierker, Lisa; Chiu, Wai Tat; Medina-Mora, María Elena; Neumark, Yehuda; Sampson, Nancy; Alonso, Jordi; Angermeyer, Matthias; Anthony, James C.; Bruffaerts, Ronny; De Girolamo, Giovanni; De Graaf, Ron; Gureje, Oye; Karam, Aimee N.; Kostyuchenko, Stanislav; Lee, Sing; Lepine, Jean-Pierre; Levinson, Daphna; Nakamura, Yosikazu; Posada-Villa, José; Stein, Dan; Wells, J. Elisabeth; Kessler, Ronald C.; Univ New S Wales, Natl Drug & Alcohol Res Ctr, Sydney, NSW 2052, Australia; l.degenhardt@unsw.edu.au
    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. (C) 2009 Elsevier Ireland Ltd. All rights reserved.
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    Descriptive Epidemiology of Chronic Childhood Adversity in Mexican Adolescents
    (Elsevier Science Inc, 360 Park Ave South, New York, NY 10010-1710 USA, 2009) Benjet, Corina; Borges, Guilherme; Medina-Mora, María Elena; Zambrano, Joaquín; Cruz, Carlos; Méndez, Enrique; Inst Nacl Psiquiatria, Dept Invest Epidemiol, Direcc Invest Epidemiol & Psicosociales, Calzada Mexico Xochimilco 101, Mexico City 14370, DF, Mexico.; cbenjet@imp.edu.mx
    Purpose: To estimate the prevalence of adversity (neglect and abuse, parental loss, parental psychopathology, economic adversity, and serious physical illness), the interrelatedness of adversities, and their socio-demographic correlates. Methods: This is a multistage probability survey of 3005 adolescents aged 12-17 years residing in Mexico City. Youth were administered the computer-assisted adolescent version of the World Mental Health Composite International Diagnostic Interview in their homes. The childhood and posttraumatic stress disorder sections provided information regarding adversity. Descriptive and logistic regression analyses were performed considering the multistage and weighted sample design. Results: A total of 68% of adolescents have experienced at least one type of chronic childhood adversity, whereas almost 7% have experienced four of more. The most frequent adversity is economic adversity followed by witnessing domestic violence. Boys experience more neglect than girls, and girls experience more sexual abuse than boys. Family dysfunction adversities tend to clump together such that youth exposed to abuse of any form also report witnessing domestic violence and parental mental pathology. Youth whose parents have divorced are likely to experience economic adversity. Parental death is independent of experiencing other childhood adversities. Older adolescents, school drop-outs, those with young mothers, those with more siblings, and those whose parents have less education are more likely to experience adversity. Conclusions: Although most adolescents have experienced some adversity, a small group is exposed to many adversities. Understanding the distribution of adversities may help us to identify at-risk youth and to better interpret the findings from studies on the role of adversity in diverse health outcomes. (C) 2009 Society for Adolescent Medicine. All rights reserved.
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    Traumatic events and suicide-related outcomes among Mexico City adolescents
    (Wiley-Blackwell, Commerce Place, 350 Main ST, Malden 02148, MA USA, 2008) Borges, Guilherme; Benjet, Corina; Medina-Mora, María Elena; Orozco, Ricardo; Molnar, Beth E.; Nock, Matthew K.; Inst Nacl Psiquiatria Ramon de la Fuente, Direcc Invest Epidemiol & Psicosociales, Mexico City 14370, DF, Mexico; guibor@imp.edu.mx
    Background: We report the prevalence and associations between traumatic events and suicidal ideation, suicide plans and suicide attempts among Mexican adolescents. Methods: The data are from a representative multistage probability household survey of 3,005 adolescents aged 12 to 17 years residing in the Mexico City Metropolitan Area that was carried out in 2005. We used discrete time survival analyses to model the net impact of retrospectively reported prior occurrence of traumatic events on ideation, plans and attempts, taking into account the onset of psychiatric disorders. Results: Prevalence of suicidality was high among respondents with traumatic events, ranging from a 43% prevalence of suicidal ideation among those with a history of 'Being raped' to a 25% prevalence of suicide attempts among those that reported 'Purposely injured, tortured or killed someone.' In cross-sectional estimates, any traumatic event was associated with an increase of 3.2 times the odds of suicide ideation, 5.1 times the odds of a plan and 6.6 times the odds of an attempt. Number of events was also associated with increasing suicidality such that those with three or more events were 13.7 times more likely to report a suicide attempt than those with none. Multivariate discrete time survival models that took into account a large number of demographic, suicide-related and psychiatric disorder variables reduced in strength but did not alter these basic relationships. Conclusions: We conclude that traumatic events such as rape and sexual assault have a profound impact upon suicidality and that this relationship is not entirely explained by the onset of psychiatric disorders. Comprehensive interventions for adolescent victims of traumatic events, especially those with a history of cumulative events, should include, but not be restricted to, treatment of any associated psychiatric disorder.
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    Adolescent alcohol use and alcohol use disorders in Mexico City
    (2014) Benjet, Corina; Borges, Guilherme; Méndez, Enrique; Casanova, Leticia; Medina-Mora, María Elena; Department of Epidemiological and Psychosocial Research, National Institute of Psychiatry Ramon de la Fuente; cbenjet@imp.edu.mx
    OBJECTIVE:  To estimate the prevalence, sex, age distribution, and socio-demographic correlates of any alcohol use, consumption patterns, and any alcohol use disorder in a representative sample of Mexican adolescents. METHODS:  3005 youth (52.1% female) aged 12-17 from a stratified multistage area probability sample were representative of adolescents residing in the Mexico City Metropolitan Area. Alcohol use and disorder and their socio-demographic correlates were evaluated with the World Mental Health adolescent version of the Composite International Diagnostic Interview. Data were post-stratified to the total Mexico City adolescent population. RESULTS:  59% has used alcohol, this proportion increasing significantly with age. By age 17, 82.5% has used alcohol. Consumption patterns are mostly of low/moderate quantity or infrequent high quantity. Lifetime DSM-IV alcohol use disorder criteria are met by 3.8%, reaching 8.1% for 16-17 years-olds. While males have greater frequency and quantity of drinking, there are no gender differences for alcohol use disorders. Non-school attending youth have twice the odds of a lifetime (OR=2.0, 95% CI=1.13-3.53) and 12-month disorder (OR=2.1, 95% CI=1.10-4.15). Low parental monitoring is associated with 1.72 times the odds of a lifetime disorder (95% CI=1.10-2.68). CONCLUSIONS:  Over a third of 12 year-olds had ever drunk an alcoholic beverage in their lifetime suggesting that the prevention of alcohol use and disorders must begin in late childhood. Initiatives to foment parental monitoring and to prevent, identify, and treat alcohol use problems in non-school attending youth in particular should be a priority for the wellbeing of Mexico City adolescents.