[Detection of alcohol consumption at the first level of care in Mexico during the COVID-19 pandemicDetecção do consumo de álcool no nível da atenção primária no México durante a pandemia de COVID-19]. / Detección del consumo de alcohol en el primer nivel de atención en México durante la pandemia de COVID-19.

Objective: To measure the impact of the COVID-19 pandemic on the implementation of a program for timely detection, brief intervention, and referral for treatment of alcohol consumption in health centers at the first level of care in Mexico City. Methods: The data were collected at 18 health centers in Mexico City between 2019 and 2021, as part of a larger study. A total of 287 participating health professionals measured their patients' alcohol consumption using the AUDIT-C test. The patients' demographic aspects and consumption patterns were analyzed, as well as care actions (detection, brief intervention, provision of leaflets, monitoring, and referral) at three points in time: before the COVID-19 pandemic, during confinement, and after confinement. Parametric and nonparametric tests were performed to identify the relationship and differences between the variables at the three points. Results: A total of 9090 people who consumed alcohol were identified; detection of consumption fluctuated in the three periods studied (26%, 53%, and 37%, respectively). Medium- and high-risk consumption was more frequent among young men with higher schooling during and after confinement. In the post-confinement period, monitoring and referral actions increased. Conclusions: Measuring the impact of the pandemic on the implementation of a program for timely detection of alcohol consumption, brief intervention, and referral for treatment in health centers helps to develop health policies by age, gender, schooling, and type of consumption at the first level of care.

Objetivo: Medir o efeito da pandemia de COVID-19 na implementação de um programa de detecção oportuna, intervenção breve e encaminhamento para tratamento pelo consumo de álcool em centros de saúde no nível da atenção primária na Cidade do México. Métodos: Foram coletados dados em 18 centros de saúde na Cidade do México entre 2019 e 2021, como parte de um estudo mais amplo. Participaram 287 profissionais de saúde, que mediram o consumo de álcool de seus pacientes com o teste AUDIT-C. Foram analisados aspectos demográficos e o padrão de consumo dos pacientes, bem como as medidas em termos de atendimento (triagem, intervenção breve, entrega de folhetos, monitoramento e encaminhamento) em três momentos: antes da pandemia de COVID-19, durante o confinamento e após o confinamento. Foram feitos testes paramétricos e não paramétricos para identificar a relação e as diferenças entre as variáveis nos três períodos. Resultados: Foram identificadas 9.090 pessoas com consumo de álcool, sendo que a porcentagem de consumo detectada flutuou nos três períodos estudados (26%, 53% e 37%, respectivamente). O consumo de médio e alto risco foi mais prevalente entre homens jovens e com nível maior de escolaridade durante e após o confinamento. No período posterior ao confinamento, as medidas de monitoramento e encaminhamento aumentaram. Conclusões: Medir o impacto da pandemia na implementação de um programa de detecção oportuna, intervenção breve e encaminhamento para tratamento do consumo de álcool em centros de saúde ajuda na formulação de políticas de saúde por idade, gênero, escolaridade e tipo de consumo para o primeiro nível de atenção.

Psycho-Emotional Factors Associated with Depressive Symptoms during Lockdown Due to the COVID-19 Pandemic in the Mexican Population.

The COVID-19 pandemic has had a significant impact on mental health, leading to the increase of depressive symptoms. Identifying these symptoms and the factors associated with them in women and men will allow us to understand possible mechanisms of action and develop more specific interventions. An online survey was conducted from 1 May to 30 June 2020 using snowball sampling; the final sample comprised 4122 adult inhabitants of Mexico; 35% of the total sample displayed moderate-to-severe depressive symptoms, with a greater proportion of depression being among female respondents. A logistic regression analysis revealed that individuals under 30 years of age, those with high levels of stress due to social distancing, those with negative emotions, and those who reported a significant impact of the pandemic on their lives have a higher risk of depression. Women with a history of mental health treatment and men with a history of chronic disease were also more likely to experience depressive symptoms. Social environment and sex are factors that intervene in the development of depressive symptoms, meaning that appropriate early identification and intervention models should be designed for the care of men and women in highly disruptive situations such as the recent pandemic.

Detección del consumo de alcohol en el primer nivel de atención en México durante la pandemia de COVID-19

[RESUMEN]. Objetivo. Medir el efecto de la pandemia de COVID-19 en la implementación de un programa de detección oportuna, intervención breve y referencia para tratamiento por consumo de alcohol en centros de salud del primer nivel de atención de la Ciudad de México. Métodos. Se recopilaron los datos en 18 centros de salud de la Ciudad de México entre 2019 y 2021, como parte de un estudio más amplio. Participaron 287 profesionales de la salud, quienes midieron el consumo de alcohol de sus pacientes con la prueba AUDIT-C. Se analizaron aspectos demográficos y patrones de con- sumo de los pacientes, así como las acciones de atención (detección, intervención breve, entrega de folletos, monitoreo y referencia) en tres momentos: antes de la pandemia de COVID-19, durante el confinamiento y luego del confinamiento. Se realizaron pruebas paramétricas y no paramétricas para identificar la relación y las diferencias entre las variables en los tres períodos. Resultados. Se identificaron 9090 personas con consumo de alcohol; el porcentaje de detección del con- sumo tuvo fluctuaciones en los tres períodos estudiados (26%, 53% y 37%, respectivamente). El consumo de riesgo medio y alto fue más frecuente entre hombres jóvenes y con mayor escolaridad durante y después del confinamiento. En el período posconfinamiento aumentaron las acciones de monitoreo y referencia. Conclusiones. La medición del impacto de la pandemia en la implementación de un programa de detección oportuna, asesoramiento breve y referencia para el tratamiento del consumo de alcohol en centros de salud ayuda a elaborar políticas en salud por edad, género, escolaridad y tipo de consumo para el primer nivel de atención.

[ABSTRACT]. Objective. To measure the impact of the COVID-19 pandemic on the implementation of a program for timely detection, brief intervention, and referral for treatment of alcohol consumption in health centers at the first level of care in Mexico City. Methods. The data were collected at 18 health centers in Mexico City between 2019 and 2021, as part of a lar- ger study. A total of 287 participating health professionals measured their patients' alcohol consumption using the AUDIT-C test. The patients' demographic aspects and consumption patterns were analyzed, as well as care actions (detection, brief intervention, provision of leaflets, monitoring, and referral) at three points in time: before the COVID-19 pandemic, during confinement, and after confinement. Parametric and nonparametric tests were performed to identify the relationship and differences between the variables at the three points. Results. A total of 9090 people who consumed alcohol were identified; detection of consumption fluctuated in the three periods studied (26%, 53%, and 37%, respectively). Medium- and high-risk consumption was more frequent among young men with higher schooling during and after confinement. In the post-confinement period, monitoring and referral actions increased. Conclusions. Measuring the impact of the pandemic on the implementation of a program for timely detection of alcohol consumption, brief intervention, and referral for treatment in health centers helps to develop health policies by age, gender, schooling, and type of consumption at the first level of care.

[RESUMO]. Objetivo. Medir o efeito da pandemia de COVID-19 na implementação de um programa de detecção opor- tuna, intervenção breve e encaminhamento para tratamento pelo consumo de álcool em centros de saúde no nível da atenção primária na Cidade do México. Métodos. Foram coletados dados em 18 centros de saúde na Cidade do México entre 2019 e 2021, como parte de um estudo mais amplo. Participaram 287 profissionais de saúde, que mediram o consumo de álcool de seus pacientes com o teste AUDIT-C. Foram analisados aspectos demográficos e o padrão de consumo dos pacientes, bem como as medidas em termos de atendimento (triagem, intervenção breve, entrega de folhetos, monitoramento e encaminhamento) em três momentos: antes da pandemia de COVID-19, durante o confinamento e após o confinamento. Foram feitos testes paramétricos e não paramétricos para identificar a relação e as diferenças entre as variáveis nos três períodos. Resultados. Foram identificadas 9.090 pessoas com consumo de álcool, sendo que a porcentagem de con- sumo detectada flutuou nos três períodos estudados (26%, 53% e 37%, respectivamente). O consumo de médio e alto risco foi mais prevalente entre homens jovens e com nível maior de escolaridade durante e após o confinamento. No período posterior ao confinamento, as medidas de monitoramento e encaminhamento aumentaram. Conclusões. Medir o impacto da pandemia na implementação de um programa de detecção oportuna, intervenção breve e encaminhamento para tratamento do consumo de álcool em centros de saúde ajuda na formulação de políticas de saúde por idade, gênero, escolaridade e tipo de consumo para o primeiro nível de atenção.

Detección del consumo de alcohol en el primer nivel de atención en México durante la pandemia de COVID-19 / Detection of alcohol consumption at the first level of care in Mexico during the COVID-19 pandemic / Detecção do consumo de álcool no nível da atenção primária no México durante a pandemia de COVID-19

RESUMEN Objetivo. Medir el efecto de la pandemia de COVID-19 en la implementación de un programa de detección oportuna, intervención breve y referencia para tratamiento por consumo de alcohol en centros de salud del primer nivel de atención de la Ciudad de México. Métodos. Se recopilaron los datos en 18 centros de salud de la Ciudad de México entre 2019 y 2021, como parte de un estudio más amplio. Participaron 287 profesionales de la salud, quienes midieron el consumo de alcohol de sus pacientes con la prueba AUDIT-C. Se analizaron aspectos demográficos y patrones de consumo de los pacientes, así como las acciones de atención (detección, intervención breve, entrega de folletos, monitoreo y referencia) en tres momentos: antes de la pandemia de COVID-19, durante el confinamiento y luego del confinamiento. Se realizaron pruebas paramétricas y no paramétricas para identificar la relación y las diferencias entre las variables en los tres períodos. Resultados. Se identificaron 9 090 personas con consumo de alcohol; el porcentaje de detección del consumo tuvo fluctuaciones en los tres períodos estudiados (26%, 53% y 37%, respectivamente). El consumo de riesgo medio y alto fue más frecuente entre hombres jóvenes y con mayor escolaridad durante y después del confinamiento. En el período posconfinamiento aumentaron las acciones de monitoreo y referencia. Conclusiones. La medición del impacto de la pandemia en la implementación de un programa de detección oportuna, asesoramiento breve y referencia para el tratamiento del consumo de alcohol en centros de salud ayuda a elaborar políticas en salud por edad, género, escolaridad y tipo de consumo para el primer nivel de atención.

ABSTRACT Objective. To measure the impact of the COVID-19 pandemic on the implementation of a program for timely detection, brief intervention, and referral for treatment of alcohol consumption in health centers at the first level of care in Mexico City. Methods. The data were collected at 18 health centers in Mexico City between 2019 and 2021, as part of a larger study. A total of 287 participating health professionals measured their patients' alcohol consumption using the AUDIT-C test. The patients' demographic aspects and consumption patterns were analyzed, as well as care actions (detection, brief intervention, provision of leaflets, monitoring, and referral) at three points in time: before the COVID-19 pandemic, during confinement, and after confinement. Parametric and nonparametric tests were performed to identify the relationship and differences between the variables at the three points. Results. A total of 9090 people who consumed alcohol were identified; detection of consumption fluctuated in the three periods studied (26%, 53%, and 37%, respectively). Medium- and high-risk consumption was more frequent among young men with higher schooling during and after confinement. In the post-confinement period, monitoring and referral actions increased. Conclusions. Measuring the impact of the pandemic on the implementation of a program for timely detection of alcohol consumption, brief intervention, and referral for treatment in health centers helps to develop health policies by age, gender, schooling, and type of consumption at the first level of care.

RESUMO Objetivo. Medir o efeito da pandemia de COVID-19 na implementação de um programa de detecção oportuna, intervenção breve e encaminhamento para tratamento pelo consumo de álcool em centros de saúde no nível da atenção primária na Cidade do México. Métodos. Foram coletados dados em 18 centros de saúde na Cidade do México entre 2019 e 2021, como parte de um estudo mais amplo. Participaram 287 profissionais de saúde, que mediram o consumo de álcool de seus pacientes com o teste AUDIT-C. Foram analisados aspectos demográficos e o padrão de consumo dos pacientes, bem como as medidas em termos de atendimento (triagem, intervenção breve, entrega de folhetos, monitoramento e encaminhamento) em três momentos: antes da pandemia de COVID-19, durante o confinamento e após o confinamento. Foram feitos testes paramétricos e não paramétricos para identificar a relação e as diferenças entre as variáveis nos três períodos. Resultados. Foram identificadas 9.090 pessoas com consumo de álcool, sendo que a porcentagem de consumo detectada flutuou nos três períodos estudados (26%, 53% e 37%, respectivamente). O consumo de médio e alto risco foi mais prevalente entre homens jovens e com nível maior de escolaridade durante e após o confinamento. No período posterior ao confinamento, as medidas de monitoramento e encaminhamento aumentaram. Conclusões. Medir o impacto da pandemia na implementação de um programa de detecção oportuna, intervenção breve e encaminhamento para tratamento do consumo de álcool em centros de saúde ajuda na formulação de políticas de saúde por idade, gênero, escolaridade e tipo de consumo para o primeiro nível de atenção.

Humor in Life Scale (EHV): Development and Evidence of Validity and Reliability in Spanish Speakers / Escala de Humor ante la Vida (EHV): Desarrollo, Evidencias de Validez y Confiabilidad en Hispanohablantes

Abstract Despite the growing attention given to the study of humor, a measure in the Spanish language of people's experience and enjoyment of humor in everyday life is still missing. The present study describes the development and validation of the EHV (from the Spanish Escala de Humor ante la Vida, Humor in Life Scale). In phase I, the items were developed using focus groups and interviews; their content validity was assessed through expert judgment. In phase II, the EHV was answered by two Mexican samples (N=1380), women and men, from 18 to 66 years; it was administered together with the Numeric Rating Scale of Humor and the Positive and Negative Affect Schedule, in both printed and electronic formats. The exploratory factor analysis supported the single factor structure and the confirmatory factor analysis showed adequate fit indices for the final eight-item scale; the factor structure was partially invariant between sexes. Reliability indices were satisfactory. Convergent and discriminant validity tests showed that the EHV is related to a global measure of humor and positive and negative affect. In sum, the results indicate that the EHV is a brief, valid and reliable measure to assess humor in life in Spanish speakers.

Resumen A pesar de la creciente atención que se ha otorgado al estudio del sentido del humor, no se contaba con un instrumento en español que evaluara la experiencia y el disfrute del humor en la vida diaria. La investigación constó de dos fases. En la primera, a partir de grupos focales y entrevistas, se elaboraron 30 reactivos potenciales. Para evaluar su validez de contenido, se obtuvieron índices V de Aiken de los juicios de cuatro expertos. Los 14 reactivos que alcanzaron el criterio fueron sometidos a un piloteo, después del cual la escala quedó conformada por 11 reactivos, con siete opciones de respuesta. En la segunda fase, la EHV se aplicó, junto con la Escala de Evaluación Numérica del Humor (una medida global de humor) y la Escala de Afecto Positivo y Negativo (PANAS), a dos muestras de población general (n1=1380 y n1=550), hombres y mujeres con edades de 18 a 66 años. La aplicación de la batería se efectuó tanto en línea como en formato impreso en diversos lugares públicos. El análisis factorial exploratorio mostró una estructura unidimensional que explicó el 55.97% de la varianza total; dos reactivos fueron eliminados. Se obtuvieron índices de ajuste adecuados al someter a análisis factorial confirmatorio a la EHV, los cuales mejoraron con la eliminación de un reactivo, por lo que la escala quedó finalmente conformada por ocho reactivos. El AVE fue >.50 y los índices de confiabilidad alfa y omega resultaron >.91. Al evaluar la invarianza de la estructura factorial de la EHV por sexo, ésta resultó parcial, ya que se obtuvieron índices dentro de los criterios señalados para el modelo métrico y para el fuerte, pero no todos para el estricto. La correlación entre la EHV y la Escala de Evaluación Numérica del Humor resultó, como se esperaba, alta y positiva, así como con el factor de afecto positivo del PANAS, en tanto que lo opuesto se observó con el factor de afecto negativo. Tener creencias espirituales o religiosas y tener una pareja no mostraron relación con los puntajes de la EHV. Estos resultaron apoyaron la validez convergente y discriminante de la EHV. En conclusión, la EHV es un instrumento breve y unidimensional, con evidencias de validez y confiabilidad, que evalúa la experiencia y disfrute del humor en la vida cotidiana en personas de habla hispana.

Development and Psychometric Properties of the Adversity and Stress Scale (ASS): Validation in the Adult Mexican Population.

Since stress is known to play a role in the development of physical and mental illness, empirically validated measurements are required to assess the effect of adverse events such as the COVID-19 pandemic. The purpose of this study was to develop and evaluate the psychometric properties of the Adversity and Stress Scale (ASS). A sample of 3937 adults living in Mexico was used. The structure of the instrument was evaluated using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Construct validity was measured through associations between the ASS and psychological symptoms. In the EFA, the relational and contextual dimensions of stress were identified. A good fit was obtained in the CFA (CFI = 0.980, RMSEA = 0.040). The ASS score was associated with all the selected variables in the expected direction, and internal consistency was α = .86. The ASS is a valid, reliable measure, with the potential to be used in other adverse events.

Psychoactive Substance Use and Its Relationship to Stress, Emotional State, Depressive Symptomatology, and Perceived Threat During the COVID-19 Pandemic in Mexico.

People can increase their use of psychoactive substances in response to stressful situations as a maladaptive mechanism for reducing negative affective states. It is therefore necessary to examine changes in the use of such substances and their relationship to mental health in light of the COVID-19 pandemic. Objective: Evaluate the relationship between psychoactive substances and stress, emotional state, and symptomatology during the COVID-19 lockdown in Mexico. Method: A national survey was conducted, using the free Google Forms platform, of residents of Mexico aged 18 and older. The survey was disseminated through social media. Results: The sample comprised 4,122 individuals, mostly women (71.8%), with an age range of 18-81 years (M = 37.08, SD = 12.689), of which 46.8% were single, and 42.9% married. In general, there was a reduction in substance use during the first 2 months of the quarantine; the most commonly used substances were alcohol, tobacco, and tranquilizers. Respondents who described having greater use than before the pandemic presented greater stress, depressive symptomatology, and perceived threat than those who did not use substances. Conclusions: Respondents who did not use substances reported lower levels of stress, depressive symptomatology, impact of the coronavirus pandemic, and perception of its threat. Women reported greater stress, depressive symptomatology, and emotional intensity than men.