How do experts recognize schizophrenia: the role of the disorganization symptom

Objective: Research on clinical reasoning has been useful in developing expert systems. These tools are based on Artificial Intelligence techniques which assist the physician in the diagnosis of complex diseases. The development of these systems is based on a cognitive model extracted through the identification of the clinical reasoning patterns applied by experts within the clinical decision-making context. This study describes the method of knowledge acquisition for the identification of the triggering symptoms used in the reasoning of three experts for the diagnosis of schizophrenia. Method: Three experts on schizophrenia, from two University centers in Sao Paulo, were interviewed and asked to identify and to represent the triggering symptoms for the diagnosis of schizophrenia according to the graph methodology. Results: Graph methodology showed a remarkable disagreement on how the three experts established their diagnosis of schizophrenia. They differed in their choice of triggering-symptoms for the diagnosis of schizophrenia: disorganization, blunted affect and thought disturbances. Conclusions: The results indicate substantial differences between the experts as to their diagnostic reasoning patterns, probably under the influence of different theoretical tendencies. The disorganization symptom was considered to be the more appropriate to represent the heterogeneity of schizophrenia and also, to further develop an expert system for the diagnosis of schizophrenia.2815

Investigación en Salud Mental en América Latina y el Caribe: Enfoque en las Ciencias Básicas.

Objetivo: Evaluar el estado de la investigación en ciencias básicas (CB) dentro del ámbito de la salud mental (SM),en países de América Latina y el Caribe (pALC). Material y métodos: Se recopiló información de bases de datos depublicaciones (PubMed/PsycINFO), mediante buscadores de internet y muestreo bola de nieve, para identificarinvestigadores y otros actores involucrados en la gestión de la salud mental. Los 2 555 actores identificados recibieronun cuestionario dirigido a evaluar su capacidad personal/institucional para realizar investigación en SM. Tanto labase de datos de publicaciones como las respuestas al cuestionario fueron utilizadas para el análisis. Resultados: Seidentificó 2 397 publicaciones en SM, de las cuales 222 estuvieron vinculadas a las CB. Sólo 9 de los 30 pALC teníanpublicaciones en esta área. Uno de cada cuatro investigadores en SM de la región –la mayoría psiquiatras y neurólogosdeclarótener entrenamiento formal en CB. El 41% de los investigadores declaró contar con apoyo técnico para lainvestigación en CB en sus instituciones. Sólo 10% de los proyectos de investigación realizados en los últimos 5años estuvieron relacionados a las CB. De éstos, un 62% se realizó con colaboración local, y 30% con colaboradoresde países desarrollados. La financiación provino principalmente de fundaciones, ONGs y universidades. Las principalesmotivaciones de los investigadores de SM en el área de las CB fueron el interés personal (77%), y la carga deenfermedad (63%). La investigación en CB no fue considerada una prioridad por la mayor parte de los investigadores(55%) y tomadores de decisión (56%). Los investigadores con entrenamiento formal en CB tuvieron más publicacionesy accedieron a mayores fondos de investigación que el resto de investigadores. Conclusiones: La investigación enCB en el área de SM permanece relegada en la región. Es necesario que el papel de las CB como parte integral de l

The mental health system in Brazil: Policies and future challenges

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Improving mental and neurological health research in Latin America: a qualitative study

<p>Abstract</p> <p>Background</p> <p>Research evidence is essential to inform policies, interventions and programs, and yet research activities in mental and neurological (MN) health have been largely neglected, particularly in low- and middle-income countries. Many challenges have been identified in the production and utilization of research evidence in Latin American countries, and more work is needed to overcome this disadvantageous situation. This study aims to address the situation by identifying initiatives that could improve MN health research activities and implementation of their results in the Latin American region.</p> <p>Methods</p> <p>Thirty-four MN health actors from 13 Latin American countries were interviewed as part of an initiative by the Global Forum for Health Research and the World Health Organization to explore the status of MN health research in low- and middle-income countries in Africa, Asia and Latin-America.</p> <p>Results</p> <p>A variety of recommendations to increase MN health research activities and implementation of their results emerged in the interviews. These included increasing skilled human resources in MN health interventions and research, fostering greater participation of stakeholders in the generation of research topics and projects, and engendering the interest of national and international institutions in important MN health issues and research methodologies. In the view of most participants, government agencies should strive to have research results inform the decision-making process in which they are involved. Thus these agencies would play a key role in facilitating and funding research. Participants also pointed to the importance of academic recognition and financial rewards in attracting professionals to primary and translational research in MN health. In addition, they suggested that institutions should create intramural resources to provide researchers with technical support in designing, carrying out and disseminating research, including resources to improve scientific writing skills.</p> <p>Conclusion</p> <p>Fulfillment of these recommendations would increase research production in MN health in Latin American countries. This, in turn, will raise the profile of these health problems, and consequently will underscore the need of continued high-quality and relevant research, thus fostering a virtuous cycle in the decision-making process to improve MN health care.</p

Responsible Governance for Mental Health Research in Low Resource Countries

Blurb: Taghi Yasamy and colleagues identify challenges facing good research governance in low- and middle-income countries and provide suggestions for a way forward

Responsible Governance for Mental Health Research in Low Resource Countries

Blurb: Taghi Yasamy and colleagues identify challenges facing good research governance in low- and middle-income countries and provide suggestions for a way forward