Background: Smartphones, internet access, and social media represent a new form of problematic behavior and can affect how teens sleep. Methods: A cross-sectional design was employed to examine the prevalence and association of problematic internet use and problematic smartphone use with sleep quality in a non-probability sample of 190 high school students in Mexico. The internet-related experiences questionnaire (IREQ), the mobile-related experiences questionnaire (MREQ), and the Pittsburgh Sleep Quality Index (PSQI) were used. Results: The study revealed that 66% of participants exhibited some form of problematic internet use, primarily in the form of social media use; 68% had some form of problematic smartphone use, and 84% reported poor sleep quality. The PSQI score was most accurately predicted by problematic smartphone use (MREQ), followed by enrollment in the morning school shift, participation in sports, the father’s education level, and knowledge that “smartphone use disturbs sleep”, which together explained 23% of the variation in sleep quality. Conclusions: Excessive smartphone use may negatively affect sleep quality in adolescents. We recommended that interventions be implemented to educate adolescents about appropriate and healthy use of technology, in parallel with the promotion of preventive sleep habits.

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 treatment using scalable and inexpensive Internet-delivered transdiagnostic cognitive behavioral therapy (iCBT) among college students with symptoms of MDD and/or GAD in two LMICs in Latin America (Colombia and Mexico) and to investigate the feasibility of creating a precision treatment rule (PTR) to predict for whom iCBT is most effective.Methods: We will first carry out a multi-site randomized pragmatic clinical trial (N= 1500) of students seeking treatment at student mental health clinics in participating universities or responding to an email offering services. Students on wait lists for clinic services will be randomized to unguided iCBT (33%), guided iCBT (33%), and treatment as usual (TAU) (33%). iCBT will be provided immediately whereas TAU will be whenever a clinic appointment is available. Short-term aggregate effects will be assessed at 90 days and longer-term effects 12 months after randomization. We will use ensemble machine learning to predict heterogeneity of treatment effects of unguided versus guided iCBT versus TAU and develop a precision treatment rule (PTR) to optimize individual student outcome. We will then conduct a second and third trial with separate samples (n= 500 per arm), but with unequal allocation across two arms: 25% will be assigned to the treatment determined to yield optimal outcomes based on the PTR developed in the first trial (PTR for optimal short-term outcomes for Trial 2 and 12-month outcomes for Trial 3), whereas the remaining 75% will be assigned with equal allocation across all three treatment arms.Discussion: By collecting comprehensive baseline characteristics to evaluate heterogeneity of treatment effects, we will provide valuable and innovative information to optimize treatment effects and guide university mental health treatment planning. Such an effort could have enormous public-health implications for the region by increasing the reach of treatment, decreasing unmet need and clinic wait times, and serving as a model of evidence-based intervention planning and implementation.Trial status: IRB Approval of Protocol Version 1.0; June 3, 2020. Recruitment began on March 1, 2021. Recruitment is tentatively scheduled to be completed on May 30, 2024.Trial registration: ClinicalTrials.gov NCT04780542. First submission date: February 28, 2021.

An elderly person who lives alone must often be autonomous and self-sufficient in daily living activities. We explored if living alone and marital status were associated with mild cognitive impairment and low cognitive reserve in a sample of Mexican women aged 60+ attending continuing education courses using a cross-sectional design. Objective cognitive functions were assessed using the MMSE and Blessed Dementia Scale. We administered the Cognitive Reserve Questionnaire. Independence skills were assessed with the Katz index and Lawton index. Multivariate logistic regression analysis was used. We recruited 269 participants ($\overline{\mathrm{x}}$ = 69.0 ± 5.8 years). Single, widowed, separated, and divorced women comprised 73% of the participants. A third lived alone and 84% had completed high school. Mild cognitive deficit was observed among 24.5–29.0%; the upper range for cognitive reserve was 61.7%. Living alone versus living with someone was associated with cognitive impairment (OR = 0.51, p = 0.04) and with low to medium cognitive reserve (OR = 0.51, p = 0.02) after adjusting for confounding variables. Living alone was an independent factor associated with a lower probability of displaying mild cognitive impairment and a higher probability of displaying high cognitive reserve. Women living alone in this study had a more robust cognitive framework and had built their own support networks.

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 employed a cross-sectional design to survey 964 first-year medical students attending a public university. We analyzed who found “acceptable” abusive behaviors from a dating partner and carried out descriptive analyses of sample characteristics by sex. We included 633 women and 331 men. Homosexual and bisexual orientation was lower among women (1.5%, 4.8%) vs. men (16.9%, 7.2%). Of women and men, respectively, 64.2% and 35.8% reported having been in a dating relationship. Experiencing abusive behaviors in the year prior to the study was associated with students’ level of “acceptability”. A total of 43.5% of the students who experienced cyber-aggression did not report any mental health consequences, 32.6% did not seek professional help, and 17.4% reported feeling depressed. Students that accepted emotionally abusive DV behaviors displayed a fourfold risk of experiencing physical abuse. Women and sexual minorities are more at risk of experiencing GBV and DV. More male students reported being victims of cyber-aggression.

The prevalence of eating disorders (ED) has grown in recent decades, associated with sociocultural pressures that partly stem from body stereotypes and increased stress in daily life. However, even though college constitutes a high-risk life stage, this group has received little attention, leaving a significant gap in prevention and early intervention. This cross-sectional and comparative study included 610 Mexican college students aged 18–30 enrolled in two public universities in Mexico: one sample comprised undergraduate students from Yucatan’s UADY (n = 457), and another one from Mexico City’s UNAM (n = 153). Screening tools included the EAT-26, BES, BSQ, DMS, HADS and AUDIT. We determined the frequency of ED symptomatology across both universities. Linear and multiple logistic regressions were conducted to identify factors associated with ED symptomatology. Overall, 19.8% of participants displayed significant ED symptomatology (UADY 15.5%, UNAM 32.7%). Significant ED symptomatology was more common among women (31.8%) than men (11.7%). Non-cisgender students (27.8%) showed a higher frequency than cisgender women (24.7%) and cisgender men (11.2%). High BD was the strongest predictor of significant ED symptomatology (OR = 13.35; 95% CI 6.79–26.26), followed by symptoms of anxiety (OR = 1.11, 95% CI 1.03–1.19). Our findings highlight the need for early screening and targeted interventions among college students in Mexico.

The world is aging and experiencing loneliness. Functional impairment in instrumental activities of daily living (IADL) in older people (OP) with mild neurocognitive disorder (MNCD) predicts loneliness. After the pandemic, there was an increase in perceived loneliness. We explored the association between loneliness, depression, deficits in IADL, and cognitive symptoms among OP. From February to December 2023, using a cross-sectional design, we interviewed probable cases with mild cognitive impairment and caregivers in two public facilities. We administered the UCLA Loneliness Scale v3, Lawton IADL Scale, Mini-Mental State Examination (MMSE), and Yesavage’s Geriatric Depression Scale. Samples were matched: 85 per group, 82.4% were women, married (52.95%), and mean age of 69.17 (±6.93) years. In our study, 30% displayed moderate to high levels of perceived loneliness. Multivariate analysis showed loneliness was associated with depression, low levels of IADL, and older age, but not with cognitive symptoms, which explained 22% of the total variance (F 165) = 16.99, (p < 0.001). Targeting symptoms and behaviors that could be modified (i.e., depression and functionality) can improve feelings of perceived loneliness and have an impact on morbidity and mortality with which it is associated.