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Half of mental disorders have their first onset before adulthood when the presence of a disorder may be particularly disruptive to developmental milestones. Retrospective prevalence estimates have been shown to underestimate the burden of mental illness and scarce data are available on the incidence of disorders throughout the adolescent period, especially in developing countries. Thus, the objective was to determine the incidence of mental disorders in an 8-year period from adolescence to young adulthood, onset of service use and their predictors in a Mexican cohort. 1071 respondents from a representative two-wave panel sample participated in the Mexican Adolescent Mental Health Survey in 2005 and in the follow-up survey in 2013. Disorders were evaluated with the World Mental Health Composite International Diagnostic Interview. 37.9% experienced the onset of a psychiatric disorder and 28.4% sought services for the first time. Substance use disorders had the greatest incidence, followed by mood and behavior disorders, anxiety disorders and lastly eating disorders. Sex, age, school dropout, childhood adversities and prior mental disorders predicted the onset of new disorders. Being female, having more educated parents and most classes of disorder predicted first time service use. These findings contribute to a paradigm shift in conceptions of mental disorder similar to how we think of common physical afflictions as near universal experiences across the life course, but less frequent at any given moment. Adolescents are particularly vulnerable. Therefore, public health policy should focus on early universal promotion of positive mental health and structural determinants of mental health.

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Our purpose was to obtain epidemiological measures of the association between habitual alcohol consumption, alcohol consumption before the event and alcohol abuse/dependence, and emergency room (ER) attendance compared to the general population in Pachuca-Hidalgo, a city located in the central area of Mexico. The study was a population based case-control design. Data consisted of breath samples to estimated blood alcohol concentration, as well as an interviewer-administered questionnaire, collected on a 24-hr basis, during the entire week, in each of the three main ERs of Pachuca. Cases were all patients who visited the three main hospitals ERs during the study period, classified according to their status as an injured or noninjured (medically ill) patient (n = 1511). The general population sample (n = 920) serves as a comparison group for both types of patients. Injured patients in the ER sample were significantly more likely to report high frequency/high quantity of drinking during the last 12 months than the general population [odds ratio and 95% confidence intervals = 5.55 (1.72-17.97)] and to report drinking within 6 hr before the injury. These relationships did not hold for noninjured patients. Both types of patients were more likely to report high frequency of drunkenness during the preceding 12 months, to be positive for alcohol dependence and to report drug use. We found in the city of Pachuca, a large relationship between habitual alcohol consumption and ER injuries. These findings support associations of alcohol consumption and admission to an emergency room found in ER and general population studies in other countries. Due to the increases in the risk found for abuse/dependent in both injured and noninjured patients, they both would benefit with a brief intervention strategy for reducing their alcohol consumption.

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