Introduction: The impact of public transportation on the human emotional well-being is certainly under-studied, especially in the developing countries. This study proposes and validates a questionnaire aimed to assess the emotional well-being in the context of public transportation use in Paraguay (as in any other Spanish country). Methods: We conducted an observational cross-sectional study using an online survey to address the relationship between the transport systems and mental health. The newly developed Questionnaire on the Use of Public Transportation and Well-Being (QUPTW) was evaluated for content and construct validity, criterion validity, and reliability. Results: Findings from 918 respondents have shown that the QUPTW reports strong psychometric properties, including validity and reliability. Participants, primarily young, university-educated women residing in Greater Asuncion, reported dissatisfaction with the public transportation services. Long commute times, discomfort, and poor hygiene and safety conditions are significant contributors leading to emotional distress. These findings underscore the potential impact of the inadequate public transportation systems on mental well-being, suggesting the need for policy interventions to enhance accessibility, comfort, and safety. Conclusions: This study contributes to the understanding of the relationship between the public transportation use and the emotional well-being and provides a valuable tool for further research and policy development.

Introduction: the mental health of medical students has been extensively researched, showing that they are part of a group vulnerable to the development of mental disorders. Aim: the aim of this research was to determine the frequency of NSSI and its associated factors in medical students in Paraguay. Methodology: this was a descriptive and cross-sectional study. An online survey was launched to assess depression, anxiety, and self-harm, the PHQ-2, the GAD-7 and SHQ scales were used, respectively. Results: we received responses from 330 medical students. Of the participants, 71.2 % were female. 46.4% of the participants were identified as having depression (PHQ-2 ≥ 3) and 37.3 % as having anxiety (GAD-7 ≥10). The frequency of NSSI was 27 % (n = 89). The main factors associated with NSSI were a previous diagnosis of a mental disorder (which increased the likelihood of NSSI by 3.76 times) and/ or a history of physical or sexual abuse (with a 3.75-fold increase). Conclusion: this research found the presence of NSSI in almost 3 out of 10 of the medical students surveyed. The main factors associated with self-injurious behavior were a previous diagnosis of a mental disorder and/or a history of physical or sexual abuse.

The COVID-19 pandemic has had a heavy impact on daily life, leading to physical and psychosocial consequences. Nowadays, clinicians and health researchers are particularly interested in describing and facing the long-term effects of COVID-19, also known as "long-COVID syndrome". Pandemic fatigue has been defined as a cluster of demotivation, tiredness, and psychological effects that emerge gradually over time after the infection or through the adoption of the recommended measures to combat it. In this study, we report the findings of a large survey conducted in South America involving 1448 participants (mean age: 33.9 ± 11.2 years old) from Argentina, Bolivia, Uruguay, Peru, and Paraguay. An online survey was launched through the common social media based on a specific assessment aimed to detect the prevalence of pandemic fatigue and associated factors. Socio-demographic characteristics, medical, and personal information were collected; the Pandemic Fatigue Scale (PFS) and the Coronavirus Anxiety Scale (CAS) were also administered. We found mid-levels of pandemic fatigue among respondents (21.7 ± 7.95 score at PFS) as well as significant anxiety related to the COVID-19 pandemic (1.56 ± 2.76 score at CAS). In addition, pandemic fatigue was significantly associated with the experience of the loss of a relative/friend due to COVID-19, anxiety related to the infection, and reliance on social media as a primary source of information on the pandemic. Vaccination significantly reduced the levels of fatigue among respondents. Our findings may add to the international debate regarding the long-term health consequences of the COVID-19 pandemic and strategies to manage them in the general population of South America.

BACKGROUND:Suicide and suicide attempts are impacting events for patients and their relatives, and these behaviors are still taboo among adults and may be even more traumatic when involving children and adolescents. AIM:In this study we aimed to describe suicide rates among children and adolescents in Paraguay over the last decades as well as associated factors such as sociodemographic characteristics and methods used for suicide. METHODS:This was an observational and exploratory study describing the frequency and characteristics of suicide among children and adolescents in Paraguay between 2004 and 2022. Official records of all deaths by suicide were reviewed, and statistical analyses were performed. In addition, an attempt was made to predict the number of suicides in the next 5 years using a mathematical model based on simple linear regression. RESULTS:In the 18-year period observed, 940 suicides among children and adolescents were recorded. The mean age was 15.05 ± 1.8 years old. Of these, 51.17% were male, 74.6% were from urban areas, and 22.2% were from the Greater Asunción and Central Department of Paraguay. The most frequently used method of suicide was intentional self-inflicted injury by hanging, strangulation, or suffocation, which all represented 75.3% of the cases. Our mathematical modeling based on simple linear regression determined that the expected yearly number of national suicides in the pediatric population for the following years, from 2023 to 2027, will range between 72 and 81. CONCLUSION:This study is the first large national epidemiological report on the emerging issue of suicide among children and adolescents in Paraguay. It may be a relevant source of information for mental health professionals, health authorities, and decision makers to develop national prevention strategies and actions against suicide among youths.

BACKGROUND:Positive mental health includes not only the absence of mental disorders but also the presence of subjective well-being, good coping strategies for life stress, and strategies for adapting to community life. It is well known that the COVID-19 pandemic has challenged mental health in general population worldwide. However, research has not measured protective factors for mental health in the general population after the declared end of pandemic by the World Health Organization. METHODS:This observational, cross-sectional study surveyed 591 Paraguayan participants aged ⩾18 years, who were recruited through an online survey. Demographic characteristics, socioeconomic status were collected as well as mental health and validated tools for hope, resilience, subjective happiness were administered. RESULTS:Of the participants, 81.6% were women, 54% were married or in a relationship and 90.7% reported an university education. The main source of stress was economic issues (30.3%). A total of 22.7% had been previously diagnosed with a mental disorder, 22.2% had consulted a mental health professional and 10.8% had consumed prescription drugs. 42.6% reported flourishing, 36.2% reported moderate and 21.2% reported languishing mental health. CONCLUSIONS:This large survey has shown that most of participants reported a flourishing mental health with high ratings at hope, resilience, and subjective happiness scales. Also, the main sources of stress were economic issues, not consequently related to the pandemic. This may add evidences to the international debate on the long term effects of the global pandemic and probably suggests that recovery processes have been collectively adopted in Paraguay.

Background: Paraguay has recently experienced an exponential increase in chikungunya cases, leading to psychological distress, particularly anxiety. Aim: To develop and validate the Chikungunya Anxiety Scale (CHIKAS). Materials and Methods: An initial scale of 18 items was used, which was subjected to validation by expert judgment to obtain 14 items. To determine construct validity, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) have been employed, and internal and convergent validity were determined. Demographic, socioeconomic, and health status data were also collected. Results: The study included 974 participants. The final scale consisted of 12 items with evidence of a two-factor model (psychological and physical). The internal validity was good (McDonald's omega = 0.882). The CFA showed good adjustment indices. Regarding participant characteristics, a relationship was found between anxiety due to chikungunya and gender, employment, mental diagnosis, medication use, and chikungunya infection. Conclusion: The final 12-item CHIKAS had strong psychometric properties and was a two-factor model.

Abstract Background Several authors have pointed out that the use of smartphones might have an impact on mental health in general. Most of the evidences are focused on the incorrect or overblown use of smartphones, videogame or Internet, particularly focusing on related addiction problems among adolescents. Objective The present study, although preliminary, aims to report the first evidence in Paraguay regarding the association between anxiety and addiction to social networks/internet as well as the use of smartphones among adolescents. Method Participants (100 adolescents, aged 12- 17 years old) were assessed in a school setting with the Beck Anxiety Inventory (BAI) and the Scale of risk of Addiction to Social Networks and Internet for adolescents (ERA-RSI). Categorical variables and associations were statistically assessed. Results The average smartphone use in boys rated 8.06 ±3.81 hours and in girls 9.46 ±4.4 hours. The BAI mean score was 20.71 ± 13.2. Of the participants, 27% reported moderate anxiety, and 36% severe anxiety and scores on this scale were not associated with hours of smartphone use. The ERA-RSI mean score was 1.94 ± 0.46 and anxiety was related to the symptoms-addiction, social-use, and nomophobia dimensions of the scale. Conclusion The misuse of smartphones in the Paraguayan pediatric population has been reported to be closely related to anxious symptoms. Our results suggest further research with an impact on possible public health policies aimed at preserving the mental health of children and adolescents exposed to internet and electronic devices.

Background Alopecia Areata (AA) is an autoimmune dermatological disease that could be influenced by psychological factors as part of the pathophysiology of the illness. Aims This review article aims to report on psychodermatological and psychopathological aspects involved in the etiopathogenesis and comorbidities of AA, as well as on the psychiatric and psychological management of affected patients. Methods We conducted a literature search on PubMed and Google Scholar from January 1980 to May 2021 employing the search terms of alopecia areata, psychological factors, psychological impact, psychodermatology, and psychopathology. All lists of references from the identified articles were screened for further relevant studies. The search was limited to English and Spanish language articles and was supplemented with themed books and book chapters. No specific quality criteria were used for the studies selection. Results Several authors have found a high comorbidity rate between AA and mental disorders, concluding that stress and psychological factors are involved in both the development and exacerbation of the illness. More evidences are needed in order to describe the associations between the immune response, stress, and the physiological factors observed in AA patients. Conclusion AA is a complex illness characterized by multifactorial etiology. An interaction between genetic, autoimmune, hormonal, neural, and psychological factors is supposed. Psychopathological aspects of illness need to be better described and considered in the clinical setting.

Background: Irritability, as a trans dimensional symptom, is present in several mental disorders. This study investigated the psychometric properties of the Spanish version of the Brief Irritability Test (BITe).

Introduction: This study aimed to investigate the psychometric properties of the Spanish version of the international Trauma Questionnaire (ITQ). Material and Methods: An online survey was launched to recruit participants. This survey was shared via social networks (Twitter, Facebook) and messaging applications (Telegram, WhatsApp) from November 15 to December 15, 2021. Participants were 141 individuals older than 18 years and with at least one self-reported lifetime traumatic event. ITQ was translated into Spanish and validated through a confirmatory factor analysis. Participants have been also scored with the trauma questionnaire (TQ) and the international trauma exposure measure. Results: The results of the Kaiser-Meyer-Olkin (KMO) test and the sphericity test were adequate (KMO=0.878) and significant (p<0.001), respectively. A two-dimensional scale was reported after confirmatory analysis. Fit indices reported that the model adjustment was good. Cronbach's alpha of the total scale was a=0.95, as well as for the PTSD symptoms and DSO clusters were alpha=0.91 and alpha=0.93, respectively. Good convergence (r=0.807; p<0.001) was shown by the scores between the two scales (ITQ and TQ). Conclusion: The Spanish version of the ITQ shows good psychometric properties and satisfactorily replicates the two-dimensional model of the original English version of the scale.

BACKGROUND:Although technologies (including information, e-learning, and communication) have been daily employed by University students in the last years, the COVID-19 pandemic has led to a considerable increase in their use. Technostress is a modern term referring to levels of stress caused by the prolonged exposure to technology.AIM:The aim of this study is to assess the technostress and related anxiety and depression among Paraguayan University students, describing their sociodemographic characteristics and relevant associations.METHODS:A cross-sectional and descriptive study has been conducted. Participants were recruited through an Internet-based survey. Technostress, anxiety, and depression have been assessed with the Technostress Questionnaire (TechQ), the Generalized Anxiety Disorder-7 (GAD-7) questionnaire, and the Patient Health Questionnaire-2 (PHQ-2), respectively.RESULTS:A total of 378 participants were included, 74.1% of whom were women. According to the TechQ scores, 47.4% of the participants reported a low/moderate level of technostress whereas 5.2% showed severe scores. About 58.5% of participants reported a GAD-7 score ⩾10, meeting diagnostic criteria for generalized anxiety. About 60.3% scored ⩾3 at the PHQ-2 reporting significant levels of depression. Technostress has been significantly associated with levels of anxiety (p < .001) as well as depression (p < .001).CONCLUSION:Our results suggest further research regarding the implications of technostress on the well-being of University students. Specific measures aimed to improve students' coping with the challenges of technology and technostress should be promoted.

Introduction: This study investigated the psychometric properties of the Spanish version of the body vigilance scale (BVS). The recruitment has been performed through an online survey launched through common social media. Material and Methods: All subjects were older than 18 years and affected by panic disorder as a self-reported diagnosis. 367 individuals were rated for the validation analysis. BVS has been translated into Spanish and validated through confirmatory factor analysis. Participants have been also scored with the self-report panic disorder severity scale (PDSS-SR). Kaiser-Meyer-Olkin (KMO) test was adequate (KMO=0.0887) and sphericity tested significantly (p<0.001). The confirmatory analysis confirmed that the scale is one-dimensional. Results: The model adjustment was good, according to all fit indices. Cronbach's alpha also confirmed an excellent internal consistency (alpha=0.985). Scores between the two scales (BVS and PDSS-SR) have shown a good convergence (r=0.898; p<0.001). Conclusion: The Spanish version of the BVS has shown good psychometric properties and adequately reproduce the one-dimensional model of the original English version.

Este estudio fue realizado con el objetivo de examinar e identificar la presencia de indicadores específicos de abuso sexual infantil (ASI) a través de test gráficos de niños y niñas de entre 5 y 12 años de edad, en base a los hallazgos de los 7 indicadores de Boscato. Fueron evaluados los dibujos de 40 niños y niñas con ASI y 40 niños y niñas sin ASI como grupo control, de sectores vulnerables del Departamento Central y Asunción, provenientes de instituciones que otorgan asistencia a niños y niñas, debido al contexto de pandemia por Covid-19. Los resultados mostraron una diferencia significativa e importante de presencia para 6 de los 7 indicadores gráficos de ASI (excepto el indicador registro somático) en el grupo de casos en comparación al grupo control, correlacionándose con el diagnóstico de abuso sexual infantil.

Abstract Objective: The aim of this study is to test the psychometric properties of the Spanish validation of the Fear of COVID-19 Scale (FCV-19S) in a Paraguayan population. Methods: Participants were recruited through an Internet-based survey. All participants whose scores in the Hospital Anxiety and Depression Scale (HADS) and The Fear Questionnaire (FQ) were greater than zero were included. 1245 subjects responded voluntarily: 1077 subjects, scoring >0, were considered. Results: To establish construct validity of the FCV-19S, an exploratory factor analysis was performed using the KMO test, which was adequate, and the Bartlett sphericity test, which was significant (p <.0001). The CFI, NFI, GFI, TLI and RMSEA indices were used to evaluate the model and showed good adjustment. Cronbach’s α showed valid internal consistency (α = 0.86). This validation was supported by significant correlation (p <.001) with the HADS scale for anxiety and depression and with the FQ scale for specific phobia. Conclusions: The Spanish version of the FCV-19S is a 7-item scale with two dimensions, psychological symptoms and physiological symptoms, which demonstrated robust psychometric properties in a Paraguayan population.

Introducción: Se ha notado un aumento de cuadros psicopatológicos (ansiedad, depresión) tras el inicio de la pandemia de COVID-19. El flujo constante de información relacionada con la pandemia puede contribuir a este hecho.

Introducción: los trastornos alimentarios y de la ingestión de alimentos están asociados con importantes efectos físicos y morbilidad psicosocial, así como con un impacto negativo en la calidad de vida de las personas.