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Prevalence of Depression and Generalized Anxiety Disorder Among Mexican Indigenous Adolescents and Young Adults: Challenges for Healthcare

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Abstract

Providing evidence on mental disorders in indigenous adolescents is critical to achieving universal health coverage (UHC). The prevalence of symptoms of depression and generalized anxiety disorder symptoms were estimated for 2082 adolescents aged 14–20 years in Chiapas, Mexico. Mental disorders were assessed using the 9-item Patient-Health Questionnaire and the 7-item Generalized Anxiety Disorder Scale. Among the adolescents evaluated, 35.8% suffered from depression or generalized anxiety disorder. Of those, 6.1% reported a previous diagnosis. 32.1% of adolescents with both mental disorders reported having attempted suicide. Gender, substance use, adverse living experiences and living conditions were correlated to the presence of depression and/or generalized anxiety disorder. It is mandatory for Mexican health authorities to develop effective instruments aiming to screen and diagnose mental health conditions in adolescents, as well as to provide timely treatment in primary health-care units.

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References

  1. Hardgrove A, Boyden J, Dornan P, Pells K (2014) Youth vulnerabilities in life course transitions. United Nations Development Program, p 51. https://hdr.undp.org/en/content/youth-vulnerabilities-life-course-transitions

  2. Sawyer SM, Afifi RA, Bearinger LH, Blakemore S-J, Dick B, Ezeh AC et al (2012) Adolescence: a foundation for future health. Lancet 379(9826):1630–1640

    Article  Google Scholar 

  3. Sawyer SM, Azzopardi PS, Wickremarathne D, Patton GC (2018) The age of adolescence. Lancet Child Adolesc Heal 2(3):223–228

    Article  Google Scholar 

  4. Gray SL, Culpepper CL, Welsh DP (2012) Adolescence. In: Second E (ed) Ramachandran VSBT-E of HB. Academic Press, San Diego, pp 22–29

    Google Scholar 

  5. National Academies of Sciences and Medicine E (2019) Adolescent Development. In: Bonnie RJ, Backes EP (eds) The promise of adolescence: realizing opportunity for all youth, 1st edn. The National Academies Press, Washington, DC, pp 37–76

    Google Scholar 

  6. Tsai M-C, Hsieh Y-P, Strong C, Lin C-Y (2015) Effects of pubertal timing on alcohol and tobacco use in the early adulthood: a longitudinal cohort study in Taiwan. Res Dev Disabil 36:376–383

    Article  Google Scholar 

  7. World Health Organization, WHO (2019) Adolescent mental health. Fact sheets. https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health Accessed 7 Jun 2019

  8. World Health Organization, WHO (2014) Health for the world’s adolescents: a second chance in the second decade: summary. World Health Organization, Geneva

    Google Scholar 

  9. Kieling C, Baker-Henningham H, Belfer M, Conti G, Ertem I, Omigbodun O et al (2011) Child and adolescent mental health worldwide: evidence for action. Lancet 378(9801):1515–1525

    Article  Google Scholar 

  10. Yatham S, Sivathasan S, Yoon R, da Silva TL, Ravindran AV (2018) Depression, anxiety, and post-traumatic stress disorder among youth in low and middle income countries: A review of prevalence and treatment interventions. Asian J Psychiatr 38:78–91

    Article  Google Scholar 

  11. World Health Organization, WHO (2017) Depression and other common mental disorders: global health estimates. World Health Organization, Geneva 27. https://apps.who.int/iris/bitstream/handle/10665/254610/WHO-MSD-MER-2017.2-eng.pdf

  12. Benjet C, Borges G, Medina-Mora ME, Méndez E, Fleiz C, Rojas E et al (2009) Diferencias de sexo en la prevalencia y severidad de trastornos psiquiátricos en adolescentes de la Ciudad de México. Salud Ment 32(2):155–163

    Google Scholar 

  13. Bautista CF, Velázquez JV, Icaza MEMM, López MM, López M, Robles NO (2012) Sociodemographic and personal factors related to depressive symptomatology in the Mexican population aged 12 to 65. Rev Bras Psiquiatr. 34(4):395–404

    Article  Google Scholar 

  14. González-Forteza C, Hermosillo de la Torre AE, Vacio-Muro M, Peralta R, Wagner FA (2015) Depresión en adolescents. Un problema oculto para la salud pública y la práctica clínica. Bol Med Hosp Infant Mex. 72(2):149–155

    PubMed  Google Scholar 

  15. Lara GAG, Zúñiga JO, Pérez OC, Solís SH, Jiménez CEP, Méndez MC (2018) Variables predictoras de la ideación suicida y sintomatología depresiva en adolescentes de Chiapas, México. Ciência & Saúde Coletiva, Scielo pp 1089–1096

  16. Lin C-Y, Tsai M-C (2016) Effects of family context on adolescents’ psychological problems: moderated by pubertal timing, and mediated by self-esteem and interpersonal relationships. Appl Res Qual Life 11(3):907–923

    Article  Google Scholar 

  17. Romito P, Beltramini L, Escribà-Agüir V (2013) Intimate partner violence and mental health among italian adolescents: gender similarities and differences. Violence Against Women 19(1):89–106

    Article  Google Scholar 

  18. Decker MR, Peitzmeier S, Olumide A, Acharya R, Ojengbede O, Covarrubias L et al (2014) Prevalence and health impact of intimate partner violence and non-partner sexual violence among female adolescents aged 15–19 years in vulnerable urban environments: a multi-country study. J Adolesc Heal 55(6):S58–67

    Article  Google Scholar 

  19. Pan American Health Organization, PAHO (1999) Overview of the exclusion of social protection in health in Latin America and the Caribbean. Washington D.C. https://iris.paho.org/xmlui/handle/123456789/42726

  20. King M, Smith A, Gracey M (2009) Indigenous health part 2: the underlying causes of the health gap. Lancet 374(9683):76–85

    Article  Google Scholar 

  21. Montenegro RA, Stephens C (2006) Indigenous health in Latin America and the Caribbean. Lancet 367(9525):1859–1869

    Article  Google Scholar 

  22. Zinck K, Marmion S (2011) Global focus, local acts: providing mental health services to indigenous people. Arch Psychiatr Nurs 25(5):311–319

    Article  Google Scholar 

  23. Pan American Health Organization, PAHO (2016) Promoting Mental Health in Indigenous Populations. Experiences from Countries. A collaboration between PAHO/WHO, Canada, Chile and Partners from the Region of the Americas 2014–2015. 1st ed. Pan American Health Organization/World Health Organization, Washington D.C. 53 p. https://iris.paho.org/xmlui/bitstream/handle/123456789/28415/9789275118979_eng.pdf?sequence=1&isAllowed=y

  24. Tuesta I, García M, Ramires I, Beldi ML, Tobón LM, Tobón MP (2012) Suicidio adolescente en pueblos indígenas: tres estudios de caso [Internet]. 1st ed. IWGIA (ed) UNICEF, Panamá. 252 p. https://repositories.lib.utexas.edu/bitstream/handle/2152/15666/0575_suicidios-unicef.pdf

  25. Berenzon S, Lara MA, Robles R, Medina-Mora ME (2013) Depresión: estado del conocimiento y la necesidad de políticas públicas y planes de acción en México. Salud Publica Mex 55(1):74–80

    Article  Google Scholar 

  26. Elliott ML, Aguerrebere M, Elliott PF (2019) Depression in rural communities and primary care clinics in Chiapas, Mexico. J Epidemiol Glob Health 9(2):103–106

    PubMed  PubMed Central  Google Scholar 

  27. Gobierno del Estado de Chiapas (2014) Programa Regional de Desarrollo 2013–2018. Región XI Sierra Mariscal. Chiapas. https://www.siese.chiapas.gob.mx/wp-content/themes/siese/pdf/Planeacion/Planes-regionales/11.PDR.XI.Sierra.Mariscal.pdf

  28. Gobierno del Estado de Chiapas (2014) Programa Regional de Desarrollo 2013–2018. Región VI Frailesca. Secretaría de Hacienda, Chiapas. https://www.siese.chiapas.gob.mx/wp-content/themes/siese/pdf/Planeacion/Planes-regionales/06.PRD.VI.Frailesca.pdf

  29. Instituto Nacional de Estadística, Geografía e Informática, INEGI (2016) Panorama sociodemográfico de Chiapas 2015. Mexico City

  30. Association, WM (2013) World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA 310(20):2191–2194

    Article  Google Scholar 

  31. Consortium TRedc. Research electronic Data Capture (RedCap) [Internet]. [cited 2018 Sep 5]. Available from: https://www.project-redcap.org/

  32. Löwe B, Unützer J, Callahan CM, Perkins AJ, Kroenke K (2004) Monitoring depression treatment outcomes with the patient health questionnaire-9. Med Care 42(12):1194–1201

    Article  Google Scholar 

  33. Spitzer RL, Kroenke K, Williams JBW, Löwe B (2006) A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med 166(10):1092–1097

    Article  Google Scholar 

  34. Borghero F, Martínez V, Zitko P, Vöhringer PA, Cavada G, Rojas G (2018) Tamizaje de episodio depresivo en adolescentes Validación del instrumento PHQ-9. Rev Med Chil 146(4):479–486

    Article  Google Scholar 

  35. Richardson LP, McCauley E, Grossman DC, McCarty CA, Richards J, Russo JE et al (2010) Evaluation of the patient health questionnaire-9 item for detecting major depression among adolescents. Pediatrics 126(6):1117–1123

    Article  Google Scholar 

  36. Baader M T, Molina F JL, Venezian B S, Rojas C C, Farías S R, Fierro-Freixenet C, et al (2012) Validación y utilidad de la encuesta PHQ-9 (Patient Health Questionnaire) en el diagnóstico de depresión en pacientes usuarios de atención primaria en Chile. Revista chilena de neuro-psiquiatría, Scielocl pp 10–22.

  37. Arrieta J, Aguerrebere M, Raviola G, Flores H, Elliott P, Espinosa A et al (2017) Validity and utility of the Patient Health Questionnaire (PHQ)-2 and PHQ-9 for screening and diagnosis of depression in rural Chiapas, Mexico: a cross-sectional study. J Clin Psychol 73(9):1076–1090

    Article  Google Scholar 

  38. García-Campayo J, Zamorano E, Ruiz MA, Pardo A, Pérez-Páramo M, López-Gómez V et al (2010) Cultural adaptation into Spanish of the generalized anxiety disorder-7 (GAD-7) scale as a screening tool. Health Qual Life Outcomes 8(1):8

    Article  Google Scholar 

  39. Plummer F, Manea L, Trepel D, McMillan D (2016) Screening for anxiety disorders with the GAD-7 and GAD-2: a systematic review and diagnostic metaanalysis. Gen Hosp Psychiatry 39:24–31

    Article  Google Scholar 

  40. Mossman SA, Luft MJ, Schroeder HK, Varney ST, Fleck DE, Barzman DH et al (2017) The Generalized Anxiety Disorder 7-item scale in adolescents with generalized anxiety disorder: Signal detection and validation. Ann Clin Psychiatry 29(4):227–234A

    PubMed  PubMed Central  Google Scholar 

  41. Dalenius T, Hodges JL Jr (1959) Minimum variance stratification. J Am Stat Assoc 54(285):88–101

    Article  Google Scholar 

  42. StataCorp (2017) Stata statistical software: Release 15. StataCorp LLC, College Station, TX

    Google Scholar 

  43. Van Droogenbroeck F, Spruyt B, Keppens G (2018) Gender differences in mental health problems among adolescents and the role of social support: results from the Belgian health interview surveys 2008 and 2013. BMC Psychiatry 18(1):6

    Article  Google Scholar 

  44. Allen J, Balfour R, Bell R, Marmot M (2014) Social determinants of mental health. Int Rev Psychiatry 26(4):392–407

    Article  Google Scholar 

  45. Lin C-Y, Ganji M, Pontes HM, Imani V, Broström A, Griffiths MD et al (2018) Psychometric evaluation of the Persian Internet Disorder Scale among adolescents. J Behav Addict 7(3):665–675

    Article  Google Scholar 

  46. Wartberg L, Kriston L, Kammerl R, Petersen K-U, Thomasius R (2015) Prevalence of pathological internet use in a representative German sample of adolescents: results of a latent profile analysis. Psychopathology 48(1):25–30

    Article  Google Scholar 

  47. Strong C, Lee C-T, Chao L-H, Lin C-Y, Tsai M-C (2018) Adolescent internet use, social integration, and depressive symptoms: analysis from a longitudinal cohort survey. J Dev Behav Pediatr. 39(4):318–324

    Article  Google Scholar 

  48. Llanos Hernández L (2012) Transformaciones socioculturales en las tierras indias de Chiapas. En: Estado del Desarrollo Económico y Social de los Pueblos Indígenas de Chiapas. In: Estado del desarrollo económico y social de los pueblos indígenas de Chiapas [Internet]. 1st ed. Chiapas: Programa Universitario México Nación Multicultural-UNAM / Gobierno del Estado de Chiapas. p 8. https://www.nacionmulticultural.unam.mx/edespich/images/diagnostico_y_perspectivas/Economia_sociedad_y_desarrollo/Situacion_agraria_y_conflictos_sociales/recuadros/5_transformaciones_agrarias_y_estrategias.pdf

  49. Vargas Terrez BE, Villamil Salcedo V (2016) La salud mental y la atención primaria en México. Experiencias de un modelo de atención colaborativa. vol. 39, Salud mental, scielomx. pp 3–9

  50. Martínez Martínez KI, Pacheco Trejo AY, Echeverría San Vicente L, Medina-Mora ME (2016) Barriers to technology transfer: qualitative study of brief interventions and treatment centers for addiction. Salud Ment 39(5):257–265

    Article  Google Scholar 

  51. World Health Organization, WHO (2018) Mental health in primary care: illusion or inclusion? World Health Organization, Geneva 27. https://apps.who.int/iris/bitstream/handle/10665/326298/WHO-HIS-SDS-2018.38-eng.pdf

  52. Chisholm D, James S, Sekar K, Kumar KK, Murthy RS, Saeed K et al (2000) Integration of mental health care into primary care: demonstration cost-outcome study in India and Pakistan. Br J Psychiatry 176(6):581–588

    Article  Google Scholar 

  53. Borowsky SJ, Rubenstein LV, Meredith LS, Camp P, Jackson-Triche M, Wells KB (2000) Who is at risk of nondetection of mental health problems in primary care? J Gen Intern Med 15(6):381–388

    Article  Google Scholar 

  54. Baxter AJ, Patton G, Scott KM, Degenhardt L, Whiteford HA (2013) Global epidemiology of mental disorders: what are we missing? PLoS ONE 8(6):e65514

    Article  Google Scholar 

  55. World Health Organization, WHO (2008) Integrating mental health into primary care: a global perspective. In: Funk M, Ivbijaro G, Saraceno B, Melvyn F, Epping-Jordan J, Faydi E (eds) World Health Organization, Singapore. 224 p. https://apps.who.int/iris/bitstream/handle/10665/43935/9789241563680_eng.pdf

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Acknowledgements

The authors gratefully acknowledge the support of the Global Alliance for Chronic Diseases (GACD) and the National Council of Science and Technology of Mexico (CONACYT).

Funding

Funding was provided by Global Alliance for Chronic Diseases (GACD) and the National Council of Science and Technology of Mexico (CONACYT) (Grant No. 291102).

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Authors and Affiliations

  1. Center for Health Systems Research, National Institute of Public Health, Cuernavaca, Mexico

    Edson Serván-Mori & María Cecilia González-Robledo

  2. School of Medicine, Autonomous University of the State of Morelos, Cuernavaca, Mexico

    Luz María Gonzalez-Robledo

  3. National School of Nursing and Obstetrics, National Autonomous University of Mexico, Mexico City, Mexico

    Gustavo Nigenda

  4. Center for Evaluation and Surveys Research, National Institute of Public Health, Cuernavaca, Mexico

    Amado D. Quezada

  5. Partners in Health Mexico, Jaltenango, Chiapas, Mexico

    Fátima Gabriela Rodríguez-Cuevas

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  1. Edson Serván-Mori
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  2. Luz María Gonzalez-Robledo
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  3. Gustavo Nigenda
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  5. María Cecilia González-Robledo
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Correspondence to Luz María Gonzalez-Robledo.

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Serván-Mori, E., Gonzalez-Robledo, L.M., Nigenda, G. et al. Prevalence of Depression and Generalized Anxiety Disorder Among Mexican Indigenous Adolescents and Young Adults: Challenges for Healthcare. Child Psychiatry Hum Dev 52, 179–189 (2021). https://doi.org/10.1007/s10578-020-01001-9

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