Maria Elena Medina-Mora

Instituto Nacional de Psiquiatría | INP

The epicenter of fentanyl use in Mexico has been in Tijuana and Mexicali, two cities on the U.S. border characterized by drug use (Rafful et al., 2015; Goodman-Meza et al., 2022). In recent years, these cities have seen the largest seizures of fentanyl in the country (Comisión Nacional de Salud Mental y Adicciones, 2024a) as well as the exponential...

Introduction. The use of medical marijuana was legalized in Mexico in 2017. In June 2021, the Supreme Court authorized personal marijuana use, as well as its planting, cultivation, harvest, preparation, possession, and transportation for recreational purposes by persons aged 18 and over, decriminalizing its use. Objectives. 1) To determine which va...

Although COVID-19 vaccines have demonstrated efficacy, there is variability in health professionals’ attitudes towards these agents. Factors associated with mental health professionals’ attitudes towards COVID-19 vaccination are not well understood. We investigated these factors by administering a newly developed measure, the COVID-19 Vaccine Attit...

Background The use of stimulants and other substances with the purpose of enhancing, maintaining, and prolonging sexual activity is known as sexualized substance use. Also known as chemsex, this pattern of use has been mainly explored in high-income countries. The aim of this article was to assess the feasibility, acceptability, and usefulness of a...

Contemporary research on the genomics of Attention Deficit Hyperactivity Disorder (ADHD) often underrepresents admixed populations of diverse genomic ancestries, such as Latin Americans. This study explores the relationship between admixture and genetic associations for ADHD in Colombian and Mexican cohorts. Some 546 participants in two groups, ADH...

Objective: Interpersonal partner violence (IPV) is a pervasive social and public health problem worldwide. In the context of the response by the World Health Organization to this issue, proposals were developed to improve the usefulness of International Classification of Diseases (ICD-11) descriptions for helping clinicians to reliably identify rel...

Internationally, HIV-related stigma and crystal methamphetamine (meth) use have been described as barriers to treatment adherence among gay, bisexual, and other men who have sex with men (gbMSM). Crystal meth use has been increasing among gbMSM in the Metropolitan Area of Mexico City (MAMC). Therefore, this study aimed to determine the association...

Antecedentes: Los trastornos mentales constituyen una de las principales causas de años vividos con discapacidad, si bien no se dispone de estimaciones recientes sobre su magnitud. Objetivo: Reportar las tendencias de prevalencia de trastornos mentales, los años vividos con discapacidad y los años de vida saludables perdidos por sexo, edad y entid...

Objetivo. Describir los malestares emocionales y las estrategias de afrontamiento utilizadas, de un grupo de migrantes de la comunidad LGBTQ (lesbiana, gay, bisexual, transgénero y queer) en su país de origen y en los de tránsito y destino, y analizar la intersección con otras categorías como nacionalidad, clase social, género y orientación sexual,...

Background Perception of drug adulteration has increased in Mexico, but there is little research on adulterants and toxicity. The aim of this study was to identify drug composition in an electronic music outdoor festival nearby Mexico City. Methods The participants completed a questionnaire with demographic data, harm reduction strategies, drug-us...

Objective: Untreated mental disorders are important among low- and middle-income country (LMIC) university students in Latin America, where barriers to treatment are high. Scalable interventions are needed. This study compared transdiagnostic self-guided and guided internet-delivered cognitive behavioral therapy (i-CBT) with treatment as usual (TAU...

Background: Increased levels of occupational stress among health professionals during the COVID-19 pandemic have been documented. Few studies examined the effects of the pandemic on mental health professionals despite the heightened demand for their services. Method: A multilingual, longitudinal, global survey was conducted at three time points...

Objective: Cannabis use is increasingly normalized; psychosis is a major adverse health outcome. We reviewed evidence on cannabis use-related risk factors for psychosis outcomes at different stages toward recommendations for risk reduction by individuals involved in cannabis use. Methods: We searched primary databases for pertinent literature/data...

Purpose: This study examined if culturally and linguistically adapted versions of a US-developed adolescent substance use prevention intervention, keepin' it REAL (kiREAL), for Mexico increases the use of drug resistance strategies and if increased use of resistance strategies subsequently leads to a reduction in the frequency of substance use (i....

Summary Background Information on the frequency and timing of mental disorder onsets across the lifespan is of fundamental importance for public health planning. Broad, cross-national estimates of this information from coordinated general population surveys were last updated in 2007. We aimed to provide updated and improved estimates of age-of-o...

Background Major depressive disorder (MDD) contributes to a significant proportion of disease burden, disability, economic losses, and impact on need of treatment and health care in Brazil, but systematic information about its treatment coverage is scarce. This paper aims to estimate the gap in treatment coverage for MDD and identify key bottleneck...

En este capítulo abordaremos estudios realizados en México con respecto al consumo de sustancias psicoactivas en distintos grupos. A pesar de que aún no se cuenta con una encuesta nacional representativa de la población, pre- sentamos la información científica obtenida a través de diversas metodologías enfocadas en grupos poblacionales diversos. Co...

Importance: Guided internet-delivered cognitive behavioral therapy (i-CBT) is a low-cost way to address high unmet need for anxiety and depression treatment. Scalability could be increased if some patients were helped as much by self-guided i-CBT as guided i-CBT. Objective: To develop an individualized treatment rule using machine learning metho...

Alcohol is the most commonly consumed drug worldwide; for many, it begins before age 15. According to 2018 data from the World Health Organization, 43% of the world's population over 15 (2.35 million people) had used alcohol during the previous 12 months (current drinkers, see Note 1), a slight reduction from 2010 (45.5%). The regions with the high...

This article reports on effects of two earthquakes in Mexico on adolescents attending middle school. The earthquakes struck in close succession during the implementation of a school-based prevention program, providing an opportunity to assess emotional distress due to the earthquakes and whether the life skills taught in the program affected how st...

Background: Perception of drug adulteration has increased in Mexico, but there is little research on adulterants and toxicity. The aim of this study was to identify drug composition in an electronic music outdoor festival nearby Mexico City. Methods: The participants completed a questionnaire with demographic data, harm reduction strategies, drug-u...

Background: Posttraumatic stress disorder (PTSD) is associated with significant morbidity, but efficacious pharmacotherapy and psychotherapy are available. Data from the World Mental Health Surveys were used to investigate extent and predictors of treatment coverage for PTSD in high-income countries (HICs) as well as in low- and middle-income coun...

Aims: Mental disorders characterized by preoccupation with distressing bodily symptoms and associated functional impairment have been a target of major reconceptualization in the ICD-11, in which a single category of Bodily Distress Disorder (BDD) with different levels of severity replaces most of the Somatoform Disorders in ICD-10. This study com...

Migration exposes Central American migrants, particularly those who migrate without documents, to a range of incidents, dangers, and risks that increase their vulnerability to anxiety symptoms. In most cases, the poverty, conflict, and violence they experience in their countries of origin are compounded by the unpredictable conditions of their jour...

There is little recent information about the prevalence of symptomatology of mental health disorders in representative population samples in Mexico. To determine the prevalence of mental health symptoms in Mexico and its comorbidity with tobacco, alcohol, and drug use disorder (SUD), we used the 2016-17 National Survey of Drug, Alcohol, and Tobacco...

Objective: The COVID-19 pandemic has affected the mental health of populations around the world, but few longitudinal studies of its impact on suicidal thoughts and behaviors have been published especially from low- and middle-income countries. Methods: This is a prospective cohort study of 1,385 first-year students from 5 Universities in Mexico...

Gender-based violence (GBV) and cyber-aggression are growing problems in Mexico, but there is a dearth of information on their associated risks. We aimed to determine the prevalence of dating violence (DV) and cyber-aggression in a public campus and compared students’ acceptability of abusive DV based on their sex and sexual orientation. We employe...

Esta obra presenta de forma sintética los resultados de la reflexión colectiva que ofrece la colección La década COVID en México en sus catorce tomos. Aquí encontramos los hallazgos, análisis, interpretaciones, reflexiones y recomendaciones de política pública sobre cada temática abordada por las plumas expertas convocadas por las y los coordinador...

Este volumen ofrece estudios alrededor de las emociones, sentimientos y afectaciones psicológicas a consecuencia de la contingencia sanitaria. Reúne aportaciones de la psicología y la filosofía, cuyo común denominador es la comprensión del fenómeno y la btención de lecciones útiles para el futuro. En principio, presenta los retos enfrentados en rel...

Este volumen ofrece estudios alrededor de las emociones, sentimientos y afectaciones psicológicas a consecuencia de la contingencia sanitaria. Reúne aportaciones de la psicología y la filosofía, cuyo común denominador es la comprensión del fenómeno y la btención de lecciones útiles para el futuro. En principio, presenta los retos enfrentados en rel...

Este volumen ofrece estudios alrededor de las emociones, sentimientos y afectaciones psicológicas a consecuencia de la contingencia sanitaria. Reúne aportaciones de la psicología y la filosofía, cuyo común denominador es la comprensión del fenómeno y la btención de lecciones útiles para el futuro. En principio, presenta los retos enfrentados en rel...

Background Although gay, bisexual, and other cisgender men who have sex with men (MSM) and transgender women have the highest HIV burden in Latin America, pre-exposure prophylaxis (PrEP) implementation is poor. We aimed to assess the feasibility of same-day oral PrEP delivery in Brazil, Mexico, and Peru. Methods Implementation PrEP (ImPrEP) was a...

This chapter analyzes the living conditions of persons who inject drugs (PWIDs) in Tijuana, a border city in the northern part of Mexico, as an example of the adversities associated with drug use. The social and emotional problems of PWIDs include poverty, restricted access to health-care services, malnourishment, low education, and few job opportu...

This chapter describes the two sides of the opioid crisis: the unmet needs of opioids for pain management and the role of prescription and nonprescription opioids (heroin, fentanyl, and new synthetic opioids) in substance use disorders. It draws attention to the unfulfilled United Nations General Assembly (UNGASS) agreements to adopt a public healt...

A binational team of investigators culturally adapted, implemented, and tested the efficacy in Mexico of keepin' it REAL, a US-designed prevention intervention for youth. This article reports on the social validity of the adapted intervention by assessing its feasibility, acceptability, and utility, as perceived by participating middle school stude...

Purpose Lesbian, gay, and bisexual (LGB) individuals, and LB women specifically, have an increased risk for psychiatric morbidity, theorized to result from stigma-based discrimination. To date, no study has investigated the mental health disparities between LGB and heterosexual AQ1individuals in a large cross-national population-based comparison. T...

Background: Substance use disorders are among the most stigmatized conditions worldwide. People with substance use disorder (PWSUD) are often considered responsible for their use of drugs. The objectives are to analyze changes in Mexican attitudes toward PWSUD in the general population over the period 2011 to 2016 and to use the latest Mexican hou...

Aim: This study aimed to identify whether clinicians’ gender, clinical experience, and personal attitudes influenced their perception of criminality of specific sexual behaviours, their judgments about criminal liability if mentally disordered, and the need for treatment as part of criminal settings for those having ICD-11 paraphilic disorders. Met...

Aim Exposure to traumatic events (TEs) is associated with substance use disorders (SUDs). However, most studies focus on a single TE, and are limited to single countries, rather than across countries with variation in economic, social and cultural characteristics. We used cross-national data to examine associations of diverse TEs with SUD onset, an...

Introduction: The social service in palliative care aims for doctors in the last stage of training in the Bachelor of Medical Surgeon to integrate a vision of care towards people who face diseases that limit or threaten their lives. Coping with death represents emotional and existential challenges, however, improve training in palliative care can p...

Background Major depressive disorder (MDD) and generalized anxiety disorder (GAD) are highly prevalent among university students and predict impaired college performance and later life role functioning. Yet most students do not receive treatment, especially in low-middle-income countries (LMICs). We aim to evaluate the effects of expanding treatmen...

Patient‐reported helpfulness of treatment is an important indicator of quality in patient‐centered care. We examined its pathways and predictors among respondents to household surveys who reported ever receiving treatment for major depression, generalized anxiety disorder, social phobia, specific phobia, post‐traumatic stress disorder, bipolar diso...

Since the first report of a possible association between psycho-tropic drug exposure in utero and childhood neurological disorders , clinicians have faced a dilemma regarding the management of women with mental disorders during both the time that they are trying to conceive and pregnancy. Ongoing efforts have been made to enhance perinatal psychiat...

Background: Major Depressive Disorder (MDD) contributes to a significant proportion of disease burden, disability, economic losses, and impact on need of treatment and health care in Brazil, but systematic information about its treatment coverage is scarce. This paper aims to estimate the gap in treatment coverage for MDD and identify key bottlenec...

Durante el confinamiento por COVID-19 (de finales de marzo a junio del 2020), se encontraron variaciones en el consumo de alcohol entre la población. Aunque varias fuentes de información en México indicaron que hubo un decremento en su consumo, en aquellas personas que incrementaron su consumo se presentaron mayores sínto-mas de depresión y ansieda...

Durante el confinamiento por COVID-19 (de finales de marzo a junio del 2020), se encontraron variaciones en el consumo de alcohol entre la población. Aunque varias fuentes de información en México indicaron que hubo un decremento en su consumo, en aquellas personas que incrementaron su consumo se presentaron mayores síntomas de depresión y ansiedad...

Introduction. Complex diagnostic profiles (i.e., clusters of comorbid disorders) may be present in adolescence with long-lasting effects later in life. Little is known about their developmental transitions to adulthood as well as potential risk factors. This study aimed to identify the diagnostic profiles in adolescence and emerging adulthood, patt...

Objective: to estimate structural and attitudinal reasons for premature discontinuation of mental health treatment, socio-demographic and clinical correlates of treatment dropout due to these reasons, and to test country differences from the overall effect across the region of the Americas. Methods: World Health Organization-World Mental Health (WM...

Background Mental health treatment is scarce and little resources are invested in reducing the wide treatment gap that exists in the Americas. The regional barriers are unknown. We describe the barriers for not seeking treatment among those with mental and substance use disorders from six (four low- and middle-income and two high-income) countries...

Background The aim of the present study was to estimate the economic burden from the perspective of patients and their families and the associated variables. Methods Quantitative evaluative research with retrospective design of patients with schizophrenia diagnosis according to the International Classification of Diseases (ICD-10). Direct costs (m...

Background COVID-19 has profoundly affected the work of mental health professionals with many transitioning to telehealth to comply with public health measures. This large international study examined the impact of the pandemic on mental health clinicians’ telehealth use. Methods This survey study was conducted with mental health professionals, pr...

Introduction Studies in various countries have shown that adolescents with a history of parental use of alcohol have a greater risk of presenting alcohol problems of their own, including binge drinking, driving under the influence of alcohol, and alcohol dependence. A few studies in Mexico have also found this association, but these have been carri...

Abstract: Alterations in eating behavior characterized eating disorders (ED). The genetic factors shared between ED diagnoses have been underexplored. The present study performed a genome-wide association study in individuals with disordered eating behaviors in the Mexican population, blood methylation quantitative trait loci (blood-meQTL), summary...

Drug use and violence are two interconnected problems in violent urban contexts, leading to coercive drug offers. In this study, relationships between drug use, use of violence as a strategy for rejecting drug offers, and exposure to neighborhood violence were analyzed in Mexican students. Data were obtained through a self-report survey and focus g...

COVID-19 frontline healthcare workers (FHCW) are struggling to cope with challenges that threaten their wellbeing. We examine the frequency and predictors of the most frequent mental health problems (MHP) among FHCW during the first COVID-19 peak in Mexico, one of the most severely affected countries in terms of FHCW’s COVID-19 mortality. A cross-se...

Condom use is the most affordable method to prevent sexually transmitted infections (STIs). Anxiety, depression, and substance use have been used as covariates of condom use, but little is known about the possibility of synergistic effects. The objective of this study was to determine the synergist effect of depression, anxiety, and substance use i...

Aim We examined prevalence and factors associated with receiving perceived helpful alcohol use disorder (AUD) treatment, and persistence in help-seeking after earlier unhelpful treatment. Methods Data came from 27 community epidemiologic surveys of adults in 24 countries using the World Health Organization World Mental Health surveys (n = 93,843)....

Background/Objective: The most recent versions of the two main mental disorders classifications—the World Health Organization's ICD-11 and the American Psychiatric Association's DSM–5—differ substantially in their diagnostic categories related to transgender identity. ICD-11 gender incongruence (GI), in contrast to DSM-5 gender dysphoria (GD), is...

Aims Major depressive disorder (MDD) is characterised by a recurrent course and high comorbidity rates. A lifespan perspective may therefore provide important information regarding health outcomes. The aim of the present study is to examine mental disorders that preceded 12-month MDD diagnosis and the impact of these disorders on depression outcome...

AIM: This article describes the general characteristics of community-based mental healthcare in Mexico. METHODS: Data from national surveys, special studies and statistics from the national information system during the period 20012017 are used. Available information on health systems, new regulations and the innovations implemented are reviewed,...

Objective: ICD-11 clinical guidelines for mental and behavioral disorders must be tested in clinical settings to guarantee their usefulness worldwide. The purpose of this study was to evaluate interrater reliability and clinical utility of the ICD-11 guidelines for children and adolescents in assessing and diagnosing mood, anxiety, and fear-related...

Background: We report results of an internet-based field study evaluating the diagnostic guidelines for ICD-11 mood disorders. Accuracy of clinicians' diagnostic judgments applying draft ICD-11 as compared to the ICD-10 guidelines to standardized case vignettes was assessed as well as perceived clinical utility. Methods: 1357 clinician members o...

Background: Most research linking type of traumatic events to the incidence of alcohol and drug use disorders among adolescents are cross-sectional and no longitudinal research exists in low/middle income countries where violence is common. Studies on bidirectional associations are infrequent. Methods: We estimated prospective associations of 7...

In April 2016, at the 30th Special Session of the United Nations General Assembly, heads of state and government, together with ministers and representatives of the member states, convened to review progress in the implementation of the “Political Declaration and Plan of Action on International Cooperation in Favor of a Comprehensive and Balanced S...

Objective: ICD-11 clinical guidelines for mental and behavioral disorders must be tested in clinical settings to guarantee their usefulness worldwide. The purpose of this study was to evaluate interrater reliability and clinical utility of the ICD-11 guidelines for children and adolescents in assessing and diagnosing mood, anxiety, and fear-relate...

PurposeTo investigate the associations of childhood adversities (CAs) with lifetime onset and transitions across suicidal thoughts and behaviors (STB) among incoming college students.Methods Web-based self-report surveys administered to 20,842 incoming college students from nine countries (response rate 45.6%) assessed lifetime suicidal ideation, p...

Introduction PrEP awareness in Latin America has been poorly characterized, with studies in Brazil, Mexico, and Peru highlighting awareness of 65% among gay, bisexual and other men who have sex with men (MSM). We assessed the association between higher risk of HIV infection, indicative of PrEP eligibility, and PrEP awareness among MSM from these co...

Objective Limited research exists on the impact of type and number of traumatic events on the incidence of suicide ideation and attempts (suicidality) among adolescents in low/middle income countries where violence is common. Method We estimated prospective associations of 7 types of events on the new occurrence of suicidality from a follow-up con...

Background: Treatment guidelines for generalized anxiety disorder (GAD) are based on a relatively small number of randomized controlled trials and do not consider patient-centered perceptions of treatment helpfulness. We investigated the prevalence and predictors of patient-reported treatment helpfulness for DSM-5 GAD and its two main treatment pa...

Background Cannabis use is common, especially among young people, and is associated with risks for various health harms. Some jurisdictions have recently moved to legalization/regulation pursuing public health goals. Evidence-based ‘Lower Risk Cannabis Use Guidelines’ (LRCUG) and recommendations were previously developed to reduce modifiable risk f...