Depression is an important public health problem. It is the fourth cause of disease in the world in terms of lost years of healthy life. In Mexico, it ranks first in terms disability for women and ninth for men. There is a high comorbidity between depression and other mental disorders such as anxiety and substance abuse, as well as other serious and chronic physical conditions (e.g. diabetes, and heart disease). Despite the impact of depressive disorders in the quality of life of the population, there is a large proportion of people who don't get treatment, delaying seeking help and thus don't receive adequate assistance. The aim of this paper is to present an analysis of depression status in the Mexican population from a public health perspective; it includes prevalence and associated factors, gaps in care, characteristics of the use of services and treatments available. The paper concludes with a presentation of the implications for research and mental health policy in Mexico.

Male adolescents who have worked the previous year, have high exposure within the family and are affiliated with drug using peers are at increased risk of becoming drug users and subject to depression and suicidal ideation as well as drug-related social problems.

Objective Despite the high prevalence of mental disorders in Mexico, minimal mental health services are available and there are large gaps in mental health treatment. Community-based primary care settings are often the first contact between patients and the health system and thus could serve as important settings for assessing and treating mental disorders. However, no formal assessment has been undertaken regarding the feasibility of implementing these services in Mexico. Before tools are developed to undertake such an assessment, a more nuanced understanding of the microprocesses affecting mental health service delivery must be acquired. Methods A qualitative study used semistructured interviews to gather information from 25 staff in 19 community-based primary care clinics in Mexico City. Semistructured interviews were analyzed by using the meaning categorization method. In a second phase of coding, emerging themes were compared with an established typology of barriers to health care access. Results Primary care staff reported a number of significant barriers to implementing mental health services in primary care clinics, an already fragile and underfunded system. Barriers included the following broad thematic categories: service issues, language and cultural issues, care recipient characteristics, and issues with lack of knowledge. Conclusions Results indicate that the implementation of mental health services in primary care clinics in Mexico will be difficult. However, the information in this study can help inform the integration of mental health into community-based primary care in Mexico through the development of adequate evaluative tools to assess the feasibility and progress of integrating these services.

Introduction Although first sexual experience (understood as first sexual intercourse) is one of the most commonly assessed characteristics of adolescents, recent research emphasizes the importance of understanding other related social factors. This study highlights factors associated with first sexual experience in a nationally representative sample of adolescent students in Mexico. Aims The goals of this study were (i) to determine the proportion of adolescents aged 12–17 who had had their first sexual experience; (ii) to identify the factors associated with first sexual experience; and (iii) to analyze the conditions (condom use, substance use) in which first sexual experience takes place. Method The data presented in this study are drawn from the 2014 National Survey on Drug Use in Students (Spanish acronym ENCODE), undertaken with the purpose of identifying the prevalence of drug use and associated variables, including sexual activity, in Mexican students. Kaplan-Meier analysis was used to estimate the probability of first sexual experience at a given age, taking sex as an outcome variable and age as a follow-up period. Logistic regression was used to assess possible factors for sexual initiation. Main Outcome Measures Validated standard questionnaires were used to assess sociodemographic characteristics, first sexual experience (framed as first sexual intercourse), frequency of sexual relations, sexual partners, sexual preference (framed as preferred sex of partners), substance use, having a physical illness or a behavioral problem, condom or other contraceptive use, as well as the absence or presence of parents, parents’ educational attainment, and parents’ substance use. Results A total of 26,187 students aged 12–17 participated. Of this total, 14.8% had already had their first sexual experience, at a median age of 15; 64.5% used some type of contraceptive, and 53.2% used condoms. Proportional probabilities for having first sexual experience using age as a follow-up period showed that the probability of having sex earlier was higher among boys than girls: the probability of having sex at age of 15 was 26.5% for boys and 13.9% for girls. Predictors of first sexual experience included substance use (alcohol OR = 2.5, tobacco OR = 2.6, and other drugs OR = 2.3), having a mother who used drugs (OR= 2.2), sexual preference (female homosexual, OR = 2.2), and sex (male, OR = 2.1). Conclusions Boys are more likely to have had a first sexual experience than girls. Future strategies should incorporate specifically targeted elements with different messages that consider adolescents’ sex and age.

This study is part of the National School Survey on drug use by high school students in Mexico. The validity, reliability, and results of the Antisocial Acts Scale in Mexico City (n = 3,501) are discussed. Using factorial analyses of the Antisocial Acts Scale, two major sources of variability were observed. The first one is related to antisocial acts with severe social consequences, in which violence and drug selling are included, and the second one is related to thefts. Significant differences were found in the number of offenses among groups of different gender, age, and occupation during the previous year. More antisocial acts were perpetrated by alcohol and drug users than by nonusers. In a logistic regression model, it was found that the main risk factors for perpetrating antisocial acts were being male, using alcohol, and using other drugs.

Yalom (1995) has stated that psycho-educational interventions could be made more effective by incorporating a focus on the interpersonal process. A qualitative analysis is proposed to investigate the degree of fidelity with which a psycho-educational intervention for women with depressive symptoms was delivered and to identify Yalom's significant therapeutic mechanisms operating in group therapy. The intervention consisted of six 2 two-hour weekly sessions organized around educational material. Eight groups were conducted with 5-19 participants each. A qualitative analysis was undertaken based on Kvale's (1996) technique of 'categorization of meanings' for the transcribed registers of audiotaped recordings. The analysis led to the definition of five major group process categories: establishment of rules, educational exchange, experiential exchange, reflexive work designed to achieve cognitive and behavioural change, and limitations on the exchange process. It showed that the facilitators largely adhered to the goals of the intervention, its strategies and model, and that the main limitations concerned facilitators' and participants'speaking for over-long periods of time and facilitators' failure to cover all the material due to lack of time. The subsequent analysis identified four of Yalom's categories: installation of hope, didactic instruction, catharsis, and universality. In support of Yalom's assertion, we concluded that this exercise was useful in that it highlighted important therapeutic factors that could be more purposefully manipulated in the future.

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It is necessary to integrate evaluation and attention for patients' caregivers, recognizing them as individuals and elucidating their constructed meanings and the dynamics established in their relationship with patients. In this way, there would be a more integrative clinical approach of the patient-caregiver relationship, considering not only the necessary pharmacological treatments but also accompanying both patient and family, along the path they travel as they experience BD.