How Having a Clear Why Can Help Us Cope With Almost Anything: Meaningful Well-Being and the COVID-19 Pandemic in México.

Background: Coronavirus disease 2019 (COVID-19) has resulted in an increase in known risk factors for mental health problems. Mexico adopted lockdown and physical distancing as a containment strategy with potential consequences on day to day life, such as social isolation, loss of income and loneliness that can have important consequences in terms of mental health. Objective: We aimed to examine the effect of the initial phases of the COVID-19 pandemic on psychological distress, well-being and perceived physical health among Mexican-base respondents and to examine whether coping strategies would play a potential intermediating role in relation to these variables. Under the Existential Positive Psychology perspective, an emphasis was made on meaning-centered coping. Methods: A cross-sectional study was conducted between April 30 and June 16th 2020 among 604 Mexicans-base respondents of which 471 were women and 132 men. Data was collected by using online questionnaires. Psychological distress was measured using the Depression, Anxiety, and Stress Scale (DASS-21). The Brief COPE Inventory was used to assess problem-focused and emotion-focused coping strategies. We also used the Meaning-Centered Coping Scale (MCCS). PERMA-Profiler was used to assess well-being, perceived physical health, and loneliness. Profiler and Descriptive analyses and bivariate linear regression were performed to examine the association of variables. Results: 45.9% of the participants reported moderate to extremely severe psychological distress. Our results demonstrate that problem-focused and emotion-focused coping were positively related to psychological distress, whereas meaning-centered coping was negatively associated with distress. Furthermore, psychological distress played a potential negative role in the perceived physical health, while meaning-centered coping and well-being buffered the negative influence of psychological distress on perceived physical health (completely standardized indirect effect = -0.01, SE: 0.012, 95% CI [-0.065; -0.017]. Conclusion: Meaning-centered coping was found to suppress the negative influence of psychological distress on sensation of decreased physical health corroborating the critical role of meaning in life in promoting well-being. Future studies can further examine the value of the critical role of meaning in life in promoting well-being as a protective factor against severe distress during traumatic events. Findings of this study can be used to orient policies and interventions aimed to alleviate suffering in the midst of the COVID-19 pandemic.

Characterizing a two-pronged epidemic in Mexico of non-communicable diseases and SARS-Cov-2: factors associated with increased case-fatality rates.

BACKGROUND: People with a previous diagnosis of non-communicable diseases (NCDs) are more likely to develop serious forms of COVID-19 or die. Mexico is the country with the fourth highest fatality rate from SARS-Cov-2, with high mortality in younger adults. OBJECTIVES: To describe and characterize the association of NCDs with the case-fatality rate (CFR) adjusted by age and sex in Mexican adults with a positive diagnosis for SARS-Cov-2. METHODS: We studied Mexican adults aged ≥20 years who tested positive for SARS-Cov-2 during the period from 28 February to 31 July 2020. The CFR was calculated and associations with history of NCDs (number of diseases and combinations), severity indicators and type of institution that treated the patient were explored. The relative risk (RR) of death was estimated using Poisson models and CFR was adjusted using logistic models. RESULTS: We analysed 406 966 SARS-Cov-2-positive adults. The CFR was 11.2% (13.7% in men and 8.4% in women). The CFR was positively associated with age and number of NCDs (p trend <0.001). The number of NCDs increased the risk of death in younger adults when they presented three or more NCDs compared with those who did not have any NCDs [RR, 46.6; 95% confidence interval (CI), 28.2, 76.9 for women; RR, 16.5; 95% CI, 9.9, 27.3 for men]. Lastly, there was great heterogeneity in the CFR by institution, from 4.6% in private institutions to 18.9% in public institutions. CONCLUSION: In younger adults, higher CFRs were associated with the total number of NCDs and some combinations of type 2 diabetes, chronic kidney disease, chronic obstructive pulmonary disease and cardiovascular disease.

Depressive symptoms among poor older adults in Mexico: prevalence and associated factors.

OBJECTIVE: To describe the presence of depressive symptoms (DS) and factors associated with them among poor Mexican older male and female adults (OA). METHODS: A survey was conducted among OA enrolled in a governmental poverty relief program (Oportunidades) in Mexico. Participants completed a short version of the Center for Epidemiologic Studies Depression Scale and answered questions about health and life conditions. RESULTS: The prevalence of DS over the cutoff point was 43% (confidence interval (CI) 39.5-46.4). DS were associated with different variables among male and female participants. For men, difficulties in performing daily life activities were associated with DS over the cutoff point (odds ratio (OR) 2.62, CI 1.58-4.34) and literacy was associated with less DS (OR 0.46, CI 0.31-0.68). For women, difficulties with daily life activities were associated with more DS (OR 2.50, CI 1.57-3.97), and being head of the family was also positively associated (OR 1.81, CI 1.11-2.93). CONCLUSIONS: DS were frequent among this sample of poor OA. The differences between men and women in variables associated with DS highlight the importance of considering the gendered aspects of growing old.

Depressive symptoms among poor older adults in Mexico: prevalence and associated factors / Síntomas depresivos en adultos mayores pobres de México: prevalencia y factores asociados

OBJECTIVE: To describe the presence of depressive symptoms (DS) and factors associated with them among poor Mexican older male and female adults (OA). METHODS: A survey was conducted among OA enrolled in a governmental poverty relief program (Oportunidades) in Mexico. Participants completed a short version of the Center for Epidemiologic Studies Depression Scale and answered questions about health and life conditions. RESULTS: The prevalence of DS over the cutoff point was 43 percent (confidence interval (CI) 39.5-46.4). DS were associated with different variables among male and female participants. For men, difficulties in performing daily life activities were associated with DS over the cutoff point (odds ratio (OR) 2.62, CI 1.58-4.34) and literacy was associated with less DS (OR 0.46, CI 0.31-0.68). For women, difficulties with daily life activities were associated with more DS (OR 2.50, CI 1.57-3.97), and being head of the family was also positively associated (OR 1.81, CI 1.11-2.93). CONCLUSIONS: DS were frequent among this sample of poor OA. The differences between men and women in variables associated with DS highlight the importance of considering the gendered aspects of growing old.

OBJETIVO: Describir la presencia de síntomas depresivos (SD) y los factores asociados con ellos en adultos y adultas mayores pobres de México. MÉTODOS: Se realizó una encuesta a adultos y adultas mayores registrados en un programa gubernamental de alivio de la pobreza (Oportunidades) en México. Los participantes completaron una versión abreviada de la Escala de Depresión del Centro de Estudios Epidemiológicos y respondieron preguntas sobre su salud y condiciones de vida. RESULTADOS: La prevalencia de SD por encima del nivel de corte fue de 43 por ciento (intervalo de confianza de 95 por ciento [IC95 por ciento]: 39,5 a 46,4). Los SD se asociaron con diversas variables en los hombres y mujeres participantes. En hombres, la dificultad para realizar actividades de la vida diaria se asoció con la presencia de SD por encima del nivel de corte (razón de posibilidades [odds ratio, OR] = 2,62; IC95 por ciento: 1,58 a 4,34) y saber leer se asoció con menos SD (OR = 0,46; IC95 por ciento: 0,31 a 0,68). En las mujeres, la dificultad para realizar actividades de la vida diaria se asoció con más SD (OR = 2,50; IC95 por ciento: 1,57 a 3,97), al igual que ser la cabeza de la familia (OR = 1,81; IC95 por ciento: 1,11 a 2,93). CONCLUSIONES: Los SD fueron frecuentes en esta muestra de adultos mayores pobres. Las diferencias entre hombres y mujeres en cuanto a las variables asociadas con los SD subrayan la importancia de tomar en cuenta los aspectos de género asociados con el envejecimiento.