From research methods to clinical practice in psychiatry: Challenges and opportunities in the developing world

From research methods to clinical practice in psychiatry: Challenges and opportunities in the developing world
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从精神病学的研究方法到临床实践:发展中国家的挑战和机遇

DOI:
10.1080/09540260701563536
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发表时间:
2007
影响因子:
2.8
通讯作者:
S. Seedat
S. Seedat
中科院分区:
医学4区
文献类型:
--
作者:
Dan J Stein;S. Seedat

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精神疾病是所有医学疾病中最普遍、最繁重和最昂贵的疾病之一。有几个因素使这成为研究这些疾病的令人兴奋的时刻;这些因素包括:(1)疾病学和流行病学的相关进展;(2)神经科学,包括神经遗传学,分子神经生物学,认知情感神经科学和脑成像;(3)精神药理学和精神治疗干预;(4)精神卫生系统研究,包括证据和成本评估;和(5)患者倡导和心理健康素养。与此同时,精神病学研究人员面临着重要的挑战;这些挑战包括:(1)目前诊断系统的局限性;(2)在吸引有才华的研究人员从事神经科学和为大量所需工作获得足够资金方面的问题;(3)相对缺乏在发达国家三级中心范围外进行的受控药理学和心理治疗研究;(4)系统研究方面的持续差距,包括相对缺乏对精神健康政策影响的研究;以及(5)社区中对精神病的污名化和反科学信仰。这些机会和挑战在发达世界和发展中世界都存在,但其范围可能在质量和数量上有所不同;在此,我们提出发展中世界的观点。最后,我们列出了前进道路的愿望清单。
Psychiatric disorders are amongst the most prevalent, burdensome, and costly of all medical disorders. Several factors make this an exciting time for research on these conditions; these include relevant advances in (1) nosology and epidemiology; (2) neuroscience, including neurogenetics, molecular neurobiology, cognitive-affective neuroscience, and brain imaging; (3) psychopharmacological and psychotherapeutic interventions; (4) systems research in mental health, including evaluation of evidence and of costs; and (5) patient advocacy and mental health literacy. At the same time, there are important challenges facing psychiatry researchers; these include (1) limitations of current diagnostic systems; (2) problems in attracting talented researchers to neuroscience and in obtaining sufficient funding for the vast amount of needed work; (3) a relative lack of controlled pharmacotherapeutic and psychotherapeutic studies undertaken outside the context of tertiary centres in the developed world; (4) ongoing gaps in systems research, including a relative lack of research on the effects of mental health policy; and (5) stigmatization of mental illness and anti-scientific beliefs in the community. These opportunities and challenges exist in both the developed and the developing world, but their scope may differ qualitatively and quantitatively; here we present a perspective from the developing world. We conclude with a wish list for the way forwards.
DOI: 10.1001/archpsyc.1993.01820180093010
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影响因子: --
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