To assess the accuracy of WMH-ICS online screening scales for evaluating four common mental disorders (Major Depressive EpisodeMDE, Mania/HypomaniaM/H, Panic DisorderPD, Generalized Anxiety ...DisorderGAD) and suicidal thoughts and behaviorsSTB used in the UNIVERSAL project.
Clinical diagnostic reappraisal was carried out on a subsample of the UNIVERSAL project, a longitudinal online survey of first year Spanish students (18-24 years old), part of the WHO World Mental Health-International College Student (WMH-ICS) initiative. Lifetime and 12-month prevalence of MDE, M/H, PD, GAD and STB were assessed with the Composite International Diagnostic Interview-Screening Scales CIDI-SC, the Self-Injurious Thoughts and Behaviors Interview SITBI and the Columbia-Suicide Severity Rating Scale C-SSRS. Trained clinical psychologists, blinded to responses in the initial survey, administered via telephone the Mini-International Neuropsychiatric Interview MINI. Measures of diagnostic accuracy and McNemar χ2 test were calculated. Sensitivity analyses were conducted to maximize diagnostic capacity.
A total of 287 students were included in the clinical reappraisal study. For 12-month and lifetime mood disorders, sensitivity/specificity were 67%/88.6% and 65%/73.3%, respectively. For 12-month and lifetime anxiety disorders, these were 76.8%/86.5% and 59.6%/71.1%, and for 12-month and lifetime STB, 75.9%/94.8% and 87.2%/86.3%. For 12-month and lifetime mood disorders, anxiety disorders and STB, positive predictive values were in the range of 18.1-55.1% and negative predictive values 90.2-99.0%; likelihood ratios positive were in the range of 2.1-14.6 and likelihood ratios negative 0.1-0.6. All outcomes showed adequate areas under the curve AUCs (AUC>0.7), except M/H and PD (AUC = 0.6). Post hoc analyses to select optimal diagnostic thresholds led to improved concordance for all diagnoses (AUCs>0.8).
The WMS-ICS survey showed reasonable concordance with the MINI telephone interviews performed by mental health professionals, when utilizing optimized cut-off scores. The current study provides initial evidence that the WMS-ICS survey might be useful for screening purposes.
Online alcohol screening may be helpful in preventing alcohol use disorders. We assessed psychometric properties of an online version of the Alcohol Use Disorders Identification Test (AUDIT) among ...Spanish university students. We used a longitudinal online survey (the UNIVERSAL project) of first-year students (18–24 years old) in five universities, including the AUDIT, as part of the WHO World Mental Health International College Student (WMH-ICS) initiative. A reappraisal interview was carried out with the Timeline Followback (TLFB) for alcohol consumption categories and the Mini International Neuropsychiatric Interview (MINI) for alcohol use disorder. Reliability, construct validity and diagnostic accuracy were assessed. Results: 287 students (75% women) completed the MINI, of whom 242 also completed the TLFB. AUDIT’s Cronbach’s alpha was 0.82. The confirmatory factor analysis for the one-factor solution of the AUDIT showed a good fit to the data. Significant AUDIT score differences were observed by TLFB categories and by MINI disorders. Areas under the curve (AUC) were very large for dependence (AUC = 0.96) and adequate for consumption categories (AUC > 0.7). AUDIT cut-off points of 6/8 (women/men) for moderate-risk drinking and 13 for alcohol dependence showed sensitivity/specificity of 76.2%/78.9% and 56%/97.5%, respectively. The online version of the AUDIT is useful for detecting alcohol consumption categories and alcohol dependence in Spanish university students.
There are not enough nationwide studies on perinatal HIV transmission in connection with a combination of antiretroviral treatments in Spain. Our objectives were to study sociodemographic changes and ...trends in the rates of HIV diagnoses and perinatal transmission in Spain from 1997 to 2015.
A retrospective study using data from Spanish Paediatric HIV Network (CoRISpe) and Spanish Minimum Basic Data Set (MDBS) was performed. HIV- diagnosed children between 1997 and 2015 were selected. Sociodemographic, clinical and immunovirological data of HIV-infected children and their mothers were studied in four calendar periods (P1: 1997-2000; P2: 2001-2005; P3: 2006-2010; P4: 2011-2015). Rates of perinatal HIV diagnoses and transmission from 1997 to 2015 were calculated.
A total of 532 HIV-infected children were included in this study. Of these children, 406 were Spanish (76.3%) and 126 immigrants (23.7%). A decrease in the number of HIV diagnoses, 203 (38.2%) children in the first (P1), 149 (28%) in the second (P2), 130 (24.4%) in the third (P3) and 50 (9.4%) in the fourth (P4) calendar periods was studied. The same decrease in the Spanish HIV-infected children (P1, 174 (46.6%), P2, 115 (30.8%), P3, 65 (17.4%) and P4, 19 (5.1%)) was monitored. However, an increase in the number of HIV diagnoses by sexual contact (P1: 0%; P2: 1.3%; P3: 4.6%; P4: 16%) was observed. The rates of new perinatal HIV diagnoses and perinatal transmission in Spanish children decreased from 0.167 to 0.005 per 100,000 inhabitants and 11.4% to 0.4% between 1997 and 2015, respectively.
A decline of perinatal HIV diagnoses and transmission was observed. However, an increase of teen-agers HIV diagnoses with sexual infection was studied. Public awareness campaigns directed to teen-agers are advisable to prevent HIV infection by sexual contact.
Suicide is a leading cause of death among young people. While suicide prevention is considered a research and intervention priority, longitudinal data is needed to identify risk and protective ...factors associate with suicidal thoughts and behaviors. Here we describe the UNIVERSAL (University and Mental Health) project which aims are to: (1) test prevalence and 36-month incidence of suicidal thoughts and behaviors; and (2) identify relevant risk and protective factors associated with the incidence of suicidal thoughts and behaviors among university students in Spain.
An ongoing multicenter, observational, prospective cohort study of first year university students in 5 Spanish universities. Students will be assessed annually during a 36 month follow-up. The surveys will be administered through an online, secure web-based platform. A clinical reappraisal will be completed among a subsample of respondents. Suicidal thoughts and behaviors will be assess with the Self-Injurious Thoughts and Behaviors Interview (SITBI) and the Columbia-Suicide Severity Rating Scale (C-SSRS). Risk and protective factors will include: mental disorders, measured with the Composite International Diagnostic Interview version 3.0 (CIDI 3.0) and Screening Scales (CIDI-SC), and the Epi-Q Screening Survey (EPI-Q-SS), socio-demographic variables, self-perceived health status, health behaviors, well-being, substance use disorders, service use and treatment. The UNIVERSAL project is part of the International College Surveys initiative, which is a core project within the World Mental Health consortium. Lifetime and the 12-month prevalence will be calculated for suicide ideation, plans and attempts. Cumulative incidence of suicidal thoughts and behaviors, and mental disorders will be measured using the actuarial method. Risk and protective factors of suicidal thoughts and behaviors will be analyzed by Cox proportional hazard models.
The study will provide valid, innovative and useful data for developing prevention programs for youth suicide and for improving early identification for high-risk students. The longitudinal design of this study will improve causal interpretation of analyzed associations, needed for generating and validating predictive models. It will represent the first results about suicidal thoughts and behaviors in the Spanish university population. The World Mental Health Survey collaboration will permit accurate cross-national comparisons.
Depression and anxiety are both prevalent among university students. They frequently co-occur and share risk factors. Yet few studies have focused on identifying students at highest risk of ...first-onset and persistence of either of these conditions.
Multicenter cohort study among Spanish first-year university students. At baseline, students were assessed for lifetime and 12-month Major Depressive Episode and/or Generalized Anxiety Disorder (MDE-GAD), other mental disorders, childhood-adolescent adversities, stressful life events, social support, socio-demographics, and psychological factors using web-based surveys; 12-month MDE-GAD was again assessed at 12-month follow-up.
A total of 1253 students participated in both surveys (59.2% of baseline respondents; mean age = 18.7 (SD = 1.3); 56.0% female). First-onset of MDE-GAD at follow-up was 13.3%. Also 46.7% of those with baseline MDE-GAD showed persistence at follow-up. Childhood/Adolescence emotional abuse or neglect (OR= 4.33), prior bipolar spectrum disorder (OR= 4.34), prior suicidal ideation (OR=4.85) and prior lifetime symptoms of MDE (ORs=2.33-3.63) and GAD (ORs=2.15-3.75) were strongest predictors of first-onset MDE-GAD. Prior suicidal ideation (OR=3.17) and prior lifetime GAD symptoms (ORs=2.38-4.02) were strongest predictors of MDE-GAD persistence. Multivariable predictions from baseline showed AUCs of 0.76 for first-onset and 0.81 for persistence. 74.9% of first-onset MDE-GAD cases occurred among 30% students with highest predicted risk at baseline.
Self-report data were used; external validation of the multivariable prediction models is needed.
MDE-GAD among university students is frequent, suggesting the need to implement web-based screening at university entrance that identify those students with highest risk.
•13.3% students had first-onset of MDE and/or GAD at 12-month follow-up.•Among students with baseline MDE and/or GAD, 46.7% persisted at 12-month follow-up.•Strongest predictors were lifetime symptoms of MDE-GAD and prior suicidal ideation.•Multivariable models provided AUCs 0.76–0.81 to predict first-onset and persistence.•74.9% onset MDE-GAD cases occur in 30% students at highest predicted baseline risk.
•Mental disorders among first-year Spanish university students are common.•35.7% of students screened positive for 12-month mental disorder.•Depression and generalized anxiety disorder are the most ...frequent disorders.•29.2% of students with mental disorders report severe role impairment.•12.6% of students with mental disorder receive mental health treatment.
The university period carries risk for onset of common mental disorders. Epidemiological knowledge on mental disorders among Spanish university students is limited.
To estimate lifetime and 12-month prevalence, persistence and age-of-onset of mental disorders among Spanish first-year university students, as well as associated role impairment and mental health treatment use.
First-year university students (N=2,118; 55.4% female; mean age=18.8 years) from five Spanish universities completed a web-based survey, screening possible DSM–IV mental disorders (major depressive episode(MDE), mania/hypomania, generalized anxiety disorder(GAD), panic disorder(PD), alcohol abuse/dependence(AUD), drug abuse/dependence(DUD), and adult attention-deficit/hyperactivity disorder(ADHD)). Role impairment and treatment associated with mental disorders were assessed.
Lifetime and 12-month prevalence of any possible mental disorder was 41.3%(SE=1.08) and 35.7%(SE=1.05), respectively. Persistence (i.e., ratio of 12-month to lifetime prevalence) was 86.4%(SE=1.58). Median age-of-onset was 14 for adult ADHD, 15 for mood disorders and AUD, and 16 for anxiety disorders and DUD. One third (29.2%) of 12-month disorders were associated with role impairment. Twelve-month PD (OR=4.0;95%CI=1.9-8.5) had the highest odds for role impairment. Only 12.6% of students with 12-month disorder received any mental health treatment. Twelve-month treatment was the highest among those students with 12-month GAD (OR=7.4;95%CI=3.7-14.8).
The assessment of mental disorders was based on self-reports. Cross-sectional nature of the data prevents causal associations.
One third of Spanish university students report a common mental disorder in the past year, and one third of those report severe role impairment. Only one out of eight students with 12-month mental disorders receives mental health treatment.
La lectura constituye un elemento fundamental que posibilita a los seres humanos la capacidad de aprender. Los problemas en el rendimiento lector son muy comunes en niños. Uno de los factores ...asociados con estas dificultades son los problemas de lateralidad. En consecuencia, el objetivo de esta investigación es valorar la influencia que puede tener la lateralidad, como componente neuropsicológico, en el rendimiento lector. Para comprobar si se da esta relación se evaluó la lateralidad y el rendimiento lector de 30 alumnos entre los 6 y los 9 años a través de pruebas como el Test de Lateralidad de la Prueba Neuropsicológica y pruebas de comprensión y velocidad lectora, así como se han comparado estos resultados con el rendimiento de los alumnos en la materia de Lengua. Los resultados muestran una correlación significativa entre las variables velocidad y comprensión lectora y el rendimiento en lengua. Sin embargo, esta relación no fue significativa comparando estas variables con la lateralidad. Estos resultados sugieren la necesidad de continuar investigando en esta área, así como la necesidad de incluir en los centros programas de intervención global y general que tengan como finalidad, no sólo intervenir en los casos con dificultades, sino intentar prevenirlas desde edades tempranas.
•Suicidal ideation is common among first-year Spanish university students.•3.4% students present suicidal ideation for first-time at 12-month follow-up.•21.2% of students with previous suicidal ...ideation report follow-up suicidal ideation.•12-month mood disorder is the strongest risk factor for follow-up suicidal ideation.•University sense of membership has a protective effect on follow-up suicidal ideation.
Background: Longitudinal evidence about risk and protective factors for suicidal ideation among university students is limited.
Methods: 12-month first-onset and persistence of suicidal ideation (SI) among Spanish first-year university students were estimated using baseline (T1) and 12-month follow-up (T2) online surveys. Information about STBs, childhood/adolescence adversities, positive relationships, mental disorders, recent stressful experiences, and university sense of membership was assessed. Logistic regression analysis was used to study risk/protective factors of first-onset and persistence of suicidal ideation (SI).
Results: A total of 1,248 respondents (58.9% response) were included. Mean age at baseline was 18.7 (SD = 1.3) and 56.0% were female. 7.3% reported 12-month SI at T2. Incidence of new SI cases was 3.4% and, among students with SI at T1, 21.2% also reported SI at T2 (persistence). Risk factors of T2 SI included 12-month mood disorder at T2 both without (aOR = 12.08 95% CI 5.45–26.80) or with (aOR = 7.2 95% CI 2.91–17.80) lifetime mood at T1, past lifetime suicide attempt (aOR = 8.79 95% CI 2.37–32.64) and plan without attempt (aOR = 4.72 95% CI 2.32–9.61), and 12-month physical or sexual assault (aOR = 3.28 95% CI 1.13–9.46). Twelve-month mood at T2 withoutT1 lifetime mood (aOR = 11.27 95% CI 3.02–42.14) and childhood/adolescence emotional abuse or neglect (aOR = 3.41 95% CI 1.10–10.57) or having been bullied (aOR = 3.2 95% CI 1.08–9.53) were associated with first-onset of SI. Twelve-month mood at T2 either without (aOR = 13.92 95% CI 3.76–51.59) or with (aOR = 8.03 95% CI 2.13–30.29) were associated to T2 SI persistence.
University sense of membership was protective for overall 12-month SI at T2 (aOR = 0.25 95% CI 0.12–0.53 for middle tertile), first-onset SI (aOR = 0.1 95% 0.02–0.55 for middle tertile) and persistence (aOR = 0.3 95% CI 0.11–0.81 for middle tertile).
Limitations: Analysis was based on self-report data focusing on SI only, and conclusions about the direction of the associations are limited.
Conclusions: High proportion of SI suggests the need of suicide prevention strategies. The potential role of university sense of membership in reducing suicidal behaviour among university students deserves further investigation.
Abstract
Background
Although integrase inhibitor (INI)-based regimens are now the first-line choice for all people living with HIV, experience among children and adolescents is still scarce. We ...describe the characteristics and outcomes of a paediatric/adolescent cohort on INI-based ART.
Methods
Retrospective analysis of HIV-infected patients below 18 years of age who started an INI-based regimen from 2007 to 2019, enrolled in the Spanish National Adult (CoRIS) and Paediatric (CoRISpe) cohorts. Resistance mutations were identified by the Stanford HIV Drug Resistance Database.
Results
Overall, 318 INI-based regimens were implemented in 288 patients 53.8% female; median age at start of 14.3 years (IQR 12.0–16.3). Most were born in Spain (69.1%), vertically infected (87.7%) and treatment-experienced (92.7%). The most frequently prescribed INI was dolutegravir (134; 42.1%), followed by raltegravir (110; 34.6%) and elvitegravir (73; 23.0%). The median exposure was 2.0 years (IQR 1.1–3.0). The main reasons to start an INI-based therapy were treatment simplification (54.4%) and virological failure (34.3%). In total, 103 (32.4%) patients interrupted their regimen: 14.5% for simplification and 8.5% due to virological failure. Most subjects who received dolutegravir (85.8%) and elvitegravir (83.6%) did not interrupt their regimen and maintained undetectable viral load. There were only five virological failures with dolutegravir and three with elvitegravir. There were no interruptions related to adverse events. Seven patients with virological failure presented major resistance mutations to INIs; none of them were on dolutegravir.
Conclusions
INI-based regimens were effective and safe for HIV treatment in children and adolescents. Dolutegravir and elvitegravir presented an excellent profile, and most patients achieved and maintained viral suppression.
University stage is a risk period for development of mental disorders and major depression disorder (MDD) is one of the most prevalent disorders. There is increasing evidence about the influence of ...lifestyle factors on depression onset and maintenance, nevertheless there is a great heterogeneity between analyzed lifestyle factors and few longitudinal studies has been carried out. The current study aims to longitudinally assess the influence of lifestyle on MDD courses among first-year university students.
First-onset and persistence of MDD and lifestyle trajectories are measured using baseline and 12-months follow-up online surveys. Multivariate logistic regression analyses were performed to study longitudinal risk/protective associations between lifestyle factors and MDD.
1,292 participants were included. Mean age of included participants at baseline was 18.5 (SD= 1.16) and 75.7 % were female. First-onset and persistence of MDD at T2 were 10.3 % and 38.9 % respectively. Maintenance of healthy sleep (Adjusted Odds Ratio (aOR) = 0.26; 95 % CI =0.12–0.58) and physical activity (aOR = 0.24; 95 % CI = 0.10–0.58) were protectively associated against MDD first-onset. Adoption of healthy levels of social support showed a protective effect against MDD persistence (aOR = 0.17; 95 % CI = 0.07–0.44).
Lifestyle should be considered in order to improve depression prevention strategies among university students. Sleep, physical activity, and social support seem to have a crucial role in the onset and persistence of depression among this population.
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