Nikol Mayo-Puchoc

This study aimed to (1) determine the psychometric properties and reliability of the FACES‐IV and (2) evaluate the curvilinear hypotheses of the Circumplex Model. A total of 6245 Peruvian participants, aged 18–65 years ( M = 26.1; SD = 8.8), completed the Spanish version of the FACES‐IV. In addition, the complementary scales (PHQ‐9 and PSS) were administered for the evaluation of the Circumplex Model hypotheses. The six‐dimensional model, using an exploratory structural equation modeling (ESEM) approach, was robust. Reliability was acceptable for most dimensions ( ω > 0.70). Balanced dimensions were associated with prevalence depression symptoms by 10% to 31% lower. Furthermore, the Rigid and Enmeshment dimensions increased family communication or satisfaction) by up to 35% to 94%. This study provides relevant information on the validity of the FACES‐IV when modeled using ESEM and provides psychotherapists and families with a psychometrically sound tool with clinical utility in the Spanish‐speaking population of Peru and similar countries.

Background: Highly visual social media (HVSM) platforms such as Facebook (Meta Platforms, Inc), Instagram (Meta Platforms, Inc), TikTok (ByteDance Ltd), and Snapchat (Snap Inc) have become central to the digital lives of adolescents and young adults. While these platforms have been linked to body dissatisfaction, they are also increasingly used as vehicles for health promotion. However, the evidence on interventions delivered through HVSM to address body image issues remains fragmented. Objective: This review aimed to synthesize available evidence on interventions using HVSM platforms to reduce negative body image in adolescents and young adults. Methods: We conducted a systematic search across 5 electronic databases (Scopus, MEDLINE, APA Psynet, Embase, and Web of Science) for studies published between January 2012 and October 2025. Eligible studies included experimental or quasi-experimental designs evaluating the effect of an HVSM-based intervention on body image outcomes in individuals aged 13 to 35 years. Risk of bias was assessed using the Risk of Bias Tool 2.0 (Cochrane) and was conducted independently by 2 researchers. Results: Eight studies met the inclusion criteria with 4975 participants (2612 in intervention groups and 2363 in control groups). Most studies were conducted in high-income countries and had predominantly female participants. The interventions varied widely in format, duration, and theoretical basis. Microinterventions, brief interactive strategies such as gamified chatbots or short videos, were the most common and had moderate effects. Stimulus-based interventions using content with a positive body image or that did not focus on appearance were also identified, achieving moderate effects (ηp²<.07), as well as combined approaches that integrated digital and face-to-face components to reduce negative body image (P<.001). The use and functionality of interventions using social media platforms were also compared by gender. Conclusions: Body image management platforms offer an emerging avenue for implementing body image interventions in adolescents and young adults. While current evidence suggests modest benefits, the high heterogeneity among presentation formats and the variability in duration make comparisons between these studies difficult. This review synthesizes social media–delivered interventions for body image disturbance, going beyond broader digital approaches centered on websites or apps. It identifies cross-platform, putative mechanisms of action and common intervention formats, highlighting the potential of brief interventions for scalable reach and user empowerment via content curation. These findings define targets for optimization and underscore the need for platform safeguards and supportive policy and regulatory frameworks to enable safe real-world implementation, particularly for adolescents.

Introducción: Las internaciones prolongadas constituyen un problema para los sistemas de salud. En este trabajo se debate sobre las internaciones prolongadas en hospitales generales, considerando la importancia de la internación en estos servicios en el marco de los procesos de reforma psiquiátrica. El primer aspecto del debate es esclarecer la definición operacional de “internaciones prolongadas”. Método: Se realizó una revisión documental que incluyó artículos científicos y documentos técnicos. En el análisis se revisaron los términos utilizados para referirse a las internaciones prolongadas, y se buscó identificar si se precisaba un tiempo específico en tales definiciones. Resultados: Los resultados se organizaron en dos categorías de definiciones: una centrada en la dimensión temporal y otra en la dimensión de organización del cuidado. Conclusión: Se propone utilizar como término "alta demorada" y establecer una duración de 30 días para contabilizar los días de exceso de internación.

BACKGROUND Highly visual social media (HVSM) platforms such as Facebook (Meta Platforms, Inc), Instagram (Meta Platforms, Inc), TikTok (ByteDance Ltd), and Snapchat (Snap Inc) have become central to the digital lives of adolescents and young adults. While these platforms have been linked to body dissatisfaction, they are also increasingly used as vehicles for health promotion. However, the evidence on interventions delivered through HVSM to address body image issues remains fragmented. OBJECTIVE This review aimed to synthesize available evidence on interventions using HVSM platforms to reduce negative body image in adolescents and young adults. METHODS We conducted a systematic search across 5 electronic databases (Scopus, MEDLINE, APA Psynet, Embase, and Web of Science) for studies published between January 2012 and October 2025. Eligible studies included experimental or quasi-experimental designs evaluating the effect of an HVSM-based intervention on body image outcomes in individuals aged 13 to 35 years. Risk of bias was assessed using the Risk of Bias Tool 2.0 (Cochrane) and was conducted independently by 2 researchers. RESULTS Eight studies met the inclusion criteria with 4975 participants (2612 in intervention groups and 2363 in control groups). Most studies were conducted in high-income countries and had predominantly female participants. The interventions varied widely in format, duration, and theoretical basis. Microinterventions, brief interactive strategies such as gamified chatbots or short videos, were the most common and had moderate effects. Stimulus-based interventions using content with a positive body image or that did not focus on appearance were also identified, achieving moderate effects (ηp²<.07), as well as combined approaches that integrated digital and face-to-face components to reduce negative body image (P<.001). The use and functionality of interventions using social media platforms were also compared by gender. CONCLUSIONS Body image management platforms offer an emerging avenue for implementing body image interventions in adolescents and young adults. While current evidence suggests modest benefits, the high heterogeneity among presentation formats and the variability in duration make comparisons between these studies difficult. This review synthesizes social media–delivered interventions for body image disturbance, going beyond broader digital approaches centered on websites or apps. It identifies cross-platform, putative mechanisms of action and common intervention formats, highlighting the potential of brief interventions for scalable reach and user empowerment via content curation. These findings define targets for optimization and underscore the need for platform safeguards and supportive policy and regulatory frameworks to enable safe real-world implementation, particularly for adolescents.

Background: Experience sampling methods (ESMs) have been used in clinical research to collect data on emotional and behavioral states in real-life contexts among different populations. Although the use of ESMs in mental health has increased, it has not been applied to larger samples of young people in disadvantaged urban settings. Objective: This study aimed to determine the extent to which mood status scores (happiness and nervousness) vary during a week, as a function of having or not having symptoms of depression or anxiety, in a sample of adolescents and young adults in the cities of Buenos Aires, Bogotá, and Lima. A secondary objective was to identify factors associated with mood scores, including sociodemographics, quality of life, and daily activities. Methods: This study was part of the Building Resilience and Resources to Reduce Mental Distress in Young People in Latin America research program, which focuses on mental health resources for young people. Participants (n=143) aged 15‐24 years completed daily ESM assessments over a week using the mobile app, resulting in 5246 reports. Data were analyzed using descriptive analyses with 2-tailed t tests and c hi-square tests, and multilevel linear regression was used to examine associations between depressive or anxiety symptoms, mood variability, and factors influencing mean mood. Finally, Spearman correlation assessed the relationship between happiness and nervousness. Results: The analysis revealed that depressive or anxiety symptoms were not significantly associated with increased variability in mood scores (happiness P=.40 and nervousness P=.84). However, males exhibited greater variability in happiness and nervousness scores (P<.001) than females. Additionally, young people showed higher variability in nervousness than adolescents (P=.02). Regarding average happiness scores, young adults reported higher average happiness than adolescents (β=.604; P=.003). Engaging in structured activities (eg, sports, music lessons, and dance classes) was associated with increased happiness (β=.266; P=.01). In contrast, instrumental activities (eg, cleaning, shopping, meal preparation, or taking medication; β=−.144; P=.02) and work-related tasks (β=−.205; P=.01) were linked to lower happiness and higher nervousness (β=.387; P<.001). Quality of life was positively correlated with happiness (β=.486; P<.001) and negatively correlated with nervousness (β=−.273; P=.005). Finally, as for average scores, a strong negative correlation was found between happiness and nervousness (rs=−0.92; P<.001). The simple multilevel analysis showed that for each point of happiness, nervousness decreased by 0.45 points (95% CI −0.48 to −0.42; t₃=−41.7; P<.001; SE 0.01). Conclusions: Our study reveals that depressive and anxiety symptoms do not significantly affect the variability in predicted happiness and nervousness scores. However, we observed that demographic factors, such as gender and age, play a role in emotional variability.

Objetivo. Identificar la relación entre las estrategias de afrontamiento y la sobrecarga en padres de pacientes pediátricos con leucemia en un hospital pediátrico peruano. Métodos. Se realizó un estudio descriptivo, transversal y unicéntrico en un hospital pediátrico de Lima, Perú. La muestra incluyó padres cuidadores principales de pacientes pediátricos con leucemia. Se utilizó el Brief COPE y el Caregiver Burden Inventory. Se realizaron análisis de regresión lineal múltiple para examinar las relaciones ajustadas. Resultados. Se incluyeron 115 padres, con un promedio de sobrecarga de 49.5 puntos. Los estilos de afrontamiento como el afrontamiento activo (aβ = -3.14; p = 0.039), reenfoque positivo (aβ = -2.74; p = 0.002), aceptación (aβ = -2.50; p = 0.002) y auto-distracción (aβ = -1.58; p = 0.048) se asociaron con una menor sobrecarga del cuidador. En contraste, la negación (aβ = 2.58; p < 0.001) y la auto-culpabilización (aβ = 3.04; p < 0.001) se asociaron con una mayor sobrecarga. Conclusión. Las estrategias de afrontamiento como el afrontamiento activo, reenfoque positivo, aceptación y auto-distracción están asociadas con una menor sobrecarga, mientras que la negación y la auto-culpabilización están asociadas con una mayor sobrecarga, en los padres cuidadores de niños con leucemia. Se recomienda replicar el estudio en otros establecimientos y con un enfoque longitudinal para obtener resultados más robustos.

BACKGROUND Experience Sampling Methods (ESM) have been used in clinical research to collect data on emotional and behavioural states in real life contexts among different populations. Although the use of ESM in mental health has increased, it has not been applied to larger samples of young people in disadvantaged urban settings. OBJECTIVE This study aimed to determine the extent to which mood status scores (happiness and nervous) vary during a week as a function of having or not having symptoms of depression and/or anxiety in a sample of adolescents and young adults in the cities of Buenos Aires (Argentina), Bogotá (Colombia) and Lima (Peru). A secondary objective was to identify factors associated with mood scores, including socio-demographics, quality of life, and daily activities. METHODS The study was part of the OLA research programme, which focuses on mental health resources for young people. Participants (n=143) aged 15-24 completed daily ESM assessments over a week using the mobile App. Data were analysed using multilevel linear regression to evaluate associations between depressive/anxiety symptoms, mood status variability, and factors influencing mood average. RESULTS The analysis revealed that depressive and/or anxiety symptoms were not significantly associated with increased variability in mood scores. However, males exhibited greater variability in happiness and nervousness scores than females. Additionally, young people showed higher variability in nervousness than adolescents. Regarding average happiness scores, young adults reported higher average happiness than adolescents. Engaging in structured activities (e.g., sports, music lessons, dance classes) was associated with increased happiness. In contrast, instrumental activities (e.g., cleaning, shopping, meal preparation, taking medication) and work-related tasks were linked to lower happiness and higher nervousness. Quality of life was positively correlated with happiness and negatively correlated with nervousness. Finally, as for average scores, a strong negative correlation was found between happiness and nervousness. CONCLUSIONS Our study reveals that depressive and anxiety symptoms do not significantly affect the variability in predicted happiness and nervousness scores. However, we observed that demographic factors, such as gender and age, play a role in emotional variability. CLINICALTRIAL

Background: The COVID-19 pandemic led to a global reduction in health care accessibility for both infected and noninfected patients, posing a particular burden on those with chronic conditions, including mental health issues. Peru experienced significant devastation from the pandemic, resulting in a collapsed health care system and leading to the world’s highest per capita mortality rate as a result of COVID-19. Understanding the trends in health care utilization, particularly in mental health care, is crucial for informing pandemic response efforts and guiding future recovery strategies. Objective: This study aims to analyze the trends of outpatient medical and psychiatric consultations during the COVID-19 pandemic in a national hospital in Peru. Methods: This observational study was conducted at a national hospital in Lima, Peru. We analyzed data on user care across all services, including psychiatric services, from May 2019 to December 2022. The data were calculated for users served per month, including the number of users seen monthly in mental health services. Sociodemographic variables such as sex (female or male), age (≥0 years), type of medical appointment (regular or additional), and modality of care (in-person or teleconsultations) were taken into account. An interrupted time series regression model was conducted to assess the number of outpatient medical and psychiatric consultations. Subgroup analyses were performed based on service modality, including overall consultations, telemonitoring/teleconsultations only, or face-to-face only, for all service users and for mental health service users. Results: A total of 1,515,439 participants were included, with females comprising 275,444/484,994 (56.80%) of the samples. Only 345,605/1,515,439 (22.81%) visits involved telemedicine. The total monthly outpatient visits were significantly reduced compared with the expected projection (P<.001) at the beginning of the pandemic, followed by a later monthly increment of 298.7 users. Face-to-face interventions experienced a significant reduction at the beginning of the pandemic (P<.001), gradually recovering in the following months. By contrast, telemedicine use initially increased but subsequently declined toward the end of the pandemic. A similar trend was observed in mental health units. Conclusions: During the pandemic years, health care utilization in both general and psychiatric services experienced a significant decrease, particularly at the beginning of the pandemic (March 2020). However, no significant trends were observed in either case throughout the pandemic period. Telemedicine consultations witnessed a significant increase overall during this period, particularly among mental health users.

Background: Anxiety disorders are among the main mental health problems worldwide and are considered one of the most disabling conditions. Therefore, it is essential to have measurement tools that can be used to screen for anxiety symptoms in the general population and thus identify potential cases of people with anxiety symptoms and provide them with timely care. Our aim was to evaluate the psychometric properties of the General Anxiety Disorder-7 scale (GAD-7) in the Peruvian population.Method: Our study was a cross-sectional study. The sample included people aged 12 to 65 years in Peru. Confirmatory factor analysis, analysis of measurement invariance, convergent validity with the Patient Health Questionnaire-9 (PHQ-9) and internal consistency analysis were performed.Results: In total, 4431 participants were included. The one-factor model showed the best fit (CFI = 0.994; TLI = 0.991; RMSEA = 0.068; WRMR = 1.567). The GAD-7 score showed measurement invariance between men and women and between age groups (adults vs. adolescents) (ΔCFI < 0.01). The internal consistency of the one-factor model was satisfactory (ω = 0.90, α = 0.93). The relationship between depressive symptoms (PHQ-9) and anxiety symptoms (GAD-7) presented a moderate correlation (r = 0.77).Conclusions: Our study concluded that the GAD-7 score shows evidence of validity and reliability for the one-factor model. Furthermore, because the GAD-7 score is invariant, comparisons can be made between groups (i.e., by sex and age group). Finally, we recommend the use of the GAD-7 for the general population in the Peruvian context.

Governments globally deployed various non-pharmacological public health measures to respond to the COVID-19 pandemic (i.e. lockdowns and suspension of transportation, amongst others); some of these measures had an influence on society’s mental health. Specific mental health policies were therefore implemented to mitigate the potential mental health impact of the pandemic. We aimed to explore the implementation of mental health regulations adopted by the Peruvian health system by focusing on the care services at Community Mental Health Centres (CMHCs), based on the experiences of health workers. We conducted a phenomenological qualitative study to understand the implementation of mental health policies launched in Peru during the COVID-19 pandemic. Data were obtained from a document review of 15 national policy measures implemented during the pandemic (March 2020 to September 2021), and 20 interviews with health workers from CMHCs (September 2021 to February 2022). The analysis was conducted using thematic content analysis. Most implemented policies adapted CMHC care services to a virtual modality during the COVID-19 pandemic; however, various challenges and barriers were evidenced in the process, which prevented effective adaptation of services. Workers perceived that ineffective telemedicine use was attributed to a gap in access to technology at the CMHCs and also by users, ranging from limited access to technological devices to a lack of technological skills. Further, although mental health promotion and prevention policies targeting the community were proposed, CMHC staff reported temporary interruption of these services during the first wave. The disparity between what is stated in the regulations and the experiences of health workers is evident. Policies that focus on mental health need to provide practical and flexible methods taking into consideration both the needs of CMHCs and socio-cultural characteristics that may affect their implementation.