Salud mental 2019;
ISSN: 0185-3325
DOI: 10.17711/SM.0185-3325.2019.033
Priorities in psychiatry for the next decade: Challenges for research
Francisco R. de la Peña1 , Norma Bernal-Santamaría2 , Jordan N. Villalobos-Montero2
1 Dirección de Servicios Clínicos. Instituto Nacional de Psiquiatría Ramón de la Fuente Muñíz, Ciudad de México, México.
2 Dirección de Enseñanza, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñíz, Ciudad de México, México.
Correspondence: Francisco R. de la Peña Dirección de Servicios Clínicos. Instituto Nacional de Psiquiatría Ramón de la Fuente Muñíz, Ciudad de México, México. 14370, Ciudad de México, México. Phone: +52 (55) 4160-5305 Email: adolesc@imp.edu.mx.
Salud Mental is the official Journal of the Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz (INPRFM), thereby reflects its mission of being a mean for divulgation of science around psychiatry and mental health in Mexico and Latin-America specifically and for worldwide generally. Recent year’s publications reflect the changes in trends and lines of research.
These changes for psychiatry priorities and challenges for research had been recently summarize by two different positions in Mexico and in the United States of America (USA). First, the national program for mental health for the period 2019 to 2024, implemented by the federal government in Mexico was presented by Dr. Juan Manuel Quijada Gaytan, general director of Servicios Nacionales de Atención Psiquiátrica, at the 40th Anniversary Ceremony of this INPRFM last November 21st. This program includes 10 priority areas: 1. Integration of mental health services in primary health care, 2. Prevention and attention for suicidal conduct, 3. Attention to the mental health of children and adolescents, 4. Prevention and treatment of depression, 5. Prevention and treatment of addictions, 6. Prevention and treatment of mental health for sexual minorities, 7. Perinatal and maternal and child mental health, 8. Mental health of the elderly, 9. Care for victims of violence and post-traumatic stress disorder (PTSD), 10. Mental health care in palliative care. Second, in the 2019 meeting of the American Academy of Child and Adolescent Psychiatry (AACAP), held in the city of Chicago, Illinois; Dr. Joshua A. Gordon, director of the National Institute of Mental Health (NIMH) of USA, delivered the conference “Lawrence A. Stone” with the theme “Progress and Priorities in Child and Adolescent Mental Health Research”, where he clearly established, which are the research priorities in the area of pediatric mental health: 1. Longitudinal studies, 2. Studies of people with autism spectrum disorders, 3. Early start psychosis, and 4. Suicide prevention.
These two positions show a renewed interest in researches with priority areas as violence, suicide, and vulnerable, or at-risk populations, in order to achieve an equitable access of opportunities, in special to reduce the mental health care gap. This principle is beyond national frontiers and political ideas, as reflect in Mexico, with the national program of mental health 2019-2024 and the NIMH strategic plan for research, in which researchers are encouraged to consider mental health disparities (NIMH, 2015).
Suicide in vulnerable or at risk populations has been a research emergent topic in the past two decades in Salud Mental. In 2004 was published an epidemiological study that concluded that in Guanajuato state, the phenomenon of suicide presented alarming peculiarities: more risk related to vulnerable groups like children, adolescents, and young people (Chavez, Macías, Palatto, & Ramirez, 2004). Social adversity, mental health problems in children, and adolescents had been associated with further adult suicide conduct, these findings make us question which prevention actions need to be implemented (Palacios, 2015). A study of suicide associated to violence and drug use in lesbian, gays, bisexual, transvestites, and transexual population was recently published; this research found that psychological and verbal violence were associated with the use of amphetamines, while physical violence was associated with a higher consumption of tranquilizers and anabolic steroids, suicide attempts were more common among participants who had suffered physical violence and who were users of substances such as ecstasy, cocaine, marijuana, and tranquilizers (Albuquerque et al., 2018).
Last decade investigations around violence have been carried out in different situations. It has been possible to demonstrate that the greater knowledge of violence in the hospital’s personal can be associated with attitudes modification that lead to less violence (Ramos Lira, Fuentes de Iturbe, Flores Celis, & Ruíz Cortés, 2014). Violence involves vulnerable groups, emotional, and behavioral problems in children affected by poverty and criminal groups activity on Mexico’s northern border have showed multiple mental illnesses including post-traumatic stress disorder (PTSD), substance use disorder, anxiety, and depression (Leiner et al., 2015). Abuse in any of its expressions, physical, sexual, or emotional, as a violence expression in girls, trigger depression, anxiety, and PTSD (Rizo Martínez, Guevara Pérez, Hernández González, & Sánchez Sosa, 2018).
Therefore, this issue of Salud Mental forms a set of specific research in at-risk populations (children, adolescents, and elderlies), standing out our vision of balance between epidemiological and clinical populations, passing through national and international multi-disciplinary teams and involving topics like violence, eating, neurocognitive, and neurodevelopmental disorders.
Dr. Veytia-López and her team present “Relationship between stressful life events and emotional intelligence in Mexican adolescents: male vs. female comparative study”. They evaluated 1417 adolescents (57% women and 43% men), with an average age of 15.90 years; their results showed high rates of stressful events experienced. Attention to emotions increases the perception of stress in both sexes, while clarity and emotional repair have a stress-reducing effect on women. “Family conflict, stress and coping as predictors of violence” from Dr. Gómez-Acosta, used structural- equations model to explore violence variance in a Colombian sample constituted of 291 young adults, and describe 68% variance is explained for average expressions of family violence, family conflict, perceived stress, and coping strategies.
We consider that instruments with optimal validity and reliability are fundamental in order to achieve a precise measure of researched phenomena specially in developing countries. Thus, Mejía and her collaborators consider the need for a test that evaluates current conduct disorders through criterion-related validation of the Antisocial Process Screening Device in a sample of Mexican adolescents within the national survey of drug consumption. Dr. Aguilar-Navarro from Instituto Nacional Ciencias Médicas y Nutrición Salvador Zubirán and her international team, described the validity of the “Five Words Test” for screening of neurocognitive disorder in Mexican eldiers, endorse the need to have adapted scales specifically to our population. Cortés-Ramírez et al., publish psychometric properties of scale for healthy nutrition, this instrument measures self-efficacy for healthy diet in people with obesity that allows associations with three types of self-efficacies profiles, proposed in a model to predict changes in eating behavior. We consider the importance because includes a variety of trajectories that have implications on public health care system through comorbidities.
Finally, consideration also needs to be given to advances in translational research like an objective to overcome challenges implicated in understanding psychiatric disorders. Thus, Dr. Humberto Nicolini from Instituto Nacional de Medicina Genómica and his national and international team presents a narrative review about FOXP2 gene and its participation in language alterations in some neurodevelopmental disorders and schizophrenia.
In conclusion, we can see new priorities for mental health in Mexico and USA, most of them have been include as new researches in previous numbers of Salud Mental Journal during the last years, this issue continuous the incorporation of these emerging topics and establish the path to follow new research priorities for the next decade.
REFERENCES
Albuquerque, G. A., dos Santos Figueiredo, F. W., da Silva Paiva, L., Moura de Araújo, M. F., da Silva Maciel, E., & Adami, F. (2018). Associaton between violence and drug consumption with suicide in lesbians, gays, bisexuals, transvestites, and transsexuals: cross-sectional study. Salud Mental, 41(3), 131-138. doi: 10.17711/SM.0185-3325.2018.015
Chávez, A. M., Macías, L. F., Palatto, H. & Ramírez, L. (2004). Epidemiología del suicidio en el estado de Guanajuato. Salud Mental. 27(2), 15-20.
Leiner, M., Villanos, M. T., Puertas, H., Peinado, J., Ávila, C., & Dwivedi, A. (2015). The emotional and behavioral problems of children exposed to poverty and/or collective violence in communities at the Mexico-United States border: A comparative study. Salud Mental, 38(2), 95-102. doi: 10.17711/SM.0185-3325.2015.013
National Institute of Mental Health (2015). National Institute of Mental Health Strategic Plan for Research. Bethesda, MD. Retrieved from: https://www.nimh.nih.gov/about/strategic-planning-reports/nimh_strategicplanforresearch_508compliant_corrected_final_149979.pdf
Palacios, L. (2015). Adversidad psicosocial, salud mental y suicidio en adolescentes: ¿estamos hacienda lo suficiente para attender a esta población?. Salud Mental, 38(5), 309-310. doi: 10.17711/SM.0185-3325.2015.042
Ramos Lira, L., Fuentes de Iturbe, P., Flores Celis, K., & Ruíz Cortés, E. (2014). Evaluación de una intervención en línea para prevenir la violencia en población juvenil y adolescente: Resultados preliminares sobre su efectividad con profesionales de la salud. Salud Mental, 37(3), 195-204.
Rizo Martínez, L. E., Guevara Pérez, M. Á., Hernández González, M., & Sánchez Sosa, J. J. (2018). A preliminary study of the prevalence of post-traumatic stress disorder, depression and anxiety symptoms in female adolescents maltreatment victims in Mexico. Salud Mental, 41(3), 139-144. doi: 10.17711/SM.0185-3325.2018.018