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This quantitative study sought to compare beliefs about the manifestation, causes and treatment of mental illness and attitudes toward people with mental illness among health professionals from five countries: the United States, Brazil, Ghana, Nigeria, and China. A total of 902 health professionals from the five countries were surveyed using a questionnaire addressing attitudes towards people with mental illness and beliefs about the causes of mental illness. Chi-square and analysis of covariance (ANCOVA) were used to compare age and gender of the samples. Confirmatory factor analysis was employed to confirm the structure and fit of the hypothesized model based on data from a previous study that identified four factors: socializing with people with mental illness (socializing), belief that people with mental illness should have normal roles in society (normalizing), non-belief in supernatural causes (witchcraft or curses), and belief in bio-psycho-social causes of mental illness (bio-psycho-social). Analysis of Covariance was used to compare four factor scores across countries adjusting for differences in age and gender. Scores on all four factors were highest among U.S. professionals. The Chinese sample showed lowest score on socializing and normalizing while the Nigerian and Ghanaian samples were lowest on non-belief in supernatural causes of mental illness. Responses from Brazil fell between those of the U.S. and the other countries. Although based on convenience samples of health professional robust differences in attitudes among health professionals between these five countries appear to reflect underlying socio-cultural differences affecting attitudes of professionals with the greater evidence of stigmatized attitudes in developing countries.

Background Emerging researchers in low- and middle-income countries (LMIC) face many barriers, including inadequacies in funding, international exposure and mentorship. In 2012, the National Institute of Mental Health (NIMH) funded five research hubs aimed at improving the research core for evidence-based mental health interventions, enhancing research skills in global mental health, and providing capacity building (CB) opportunities for early career investigators in LMIC. In this paper emerging researchers contextualize their experiences. Case presentation Each of the five hubs purposively selected an emerging researcher who had experienced more than one hub-related CB opportunity and actively participated in hub-related clinical trial activities. The five ‘voices’ were invited to contribute narratives on their professional backgrounds, CB experience, challenges and successes as an emerging mental health researcher, and suggestions for future CB activities. These narratives are presented as case studies. CB activities provided broader learning opportunities for emerging researchers. Benefits included the receipt of research funding, hands-on training and mentorship, as well as exposure to networks and collaborative opportunities on a global scale. To overcome ongoing challenges of access to funding, mentoring, networking and global exposure, the emerging voices recommend making mentorship and training opportunities available to a wider range of emerging mental health researchers. Conclusions Investing in CB is not enough to ensure sustainability and leave a legacy unless it is accompanied by ongoing mentorship and international exposure. Financial investment in building research capacity, promotion of mentorship and supervision, and international networking are essential to yield well-prepared young investigators in LMIC as experienced by these rising stars. Governments and policymakers should prioritize educational policies to support the continuous development and international engagement of emerging researchers. This can advance strategies to deal with one of most important and costly problems faced by healthcare systems in LMIC: the mental health treatment gap.

resuMo objetivo: Realizar revisão sistemática para avaliar a adesão medicamentosa ao tratamento em pacientes do espectro esquizofrênico. Método: As buscas dos artigos foram conduzidas nas seguintes bases de dados: PubMed/Medline, Lilacs, SciELO e PePSIC, considerando artigos publicados entre 2001 e 2010. Na estratégia de busca, foram utilizados descritores de acordo com sua definição no DeCS e no MeSH: "schizophrenia" and "patient adherence" or "patient compliance" or "medication adherence". As correspondências em português e espanhol foram respectivamente "esquizofrenia/esquizofrenia" e "cooperação do paciente/ cooperácion del paciente" ou "adesão à medicação/cumplimiento de lá medicación". Também foram realizadas buscas manuais nas referências dos artigos selecionados. resultados: A busca bibliográfica resultou em 1.692 artigos. Contudo, apenas 54 preencheram os critérios para compor esta revisão. Conclusões: A maioria dos estudos sobre o tema foi realizada em países desenvolvidos, prejudicando a aplicação dos achados à nossa realidade. As taxas da adesão e os métodos utilizados para avaliação variaram bastante, porém os fatores associados à não adesão se repetiram, como falta de insight, comorbidade com uso de substâncias psicoativas, falta de apoio social, efeitos colaterais da medicação, comportamento violento, situação de rua, tentativa de suicídio, entre outros. Assim sendo, há necessidade da realização de mais estudos nacionais para investigar potenciais variáveis associadas a não adesão e suas consequências para a população estudada. aBstraCt objective: Carry out a systematic review to assess medication adherence among schizophrenic spectrum patients. Method: The searches were carried out in the following data-

Participation in a psychiatric clerkship was associated with greater social acceptance but not with improvement on other attitudinal factors. This may reflect ceiling effects in responses before the clerkship concerning supernatural and bio-psychosocial beliefs about causes of mental illness that left little room for change.

Negative attitudes toward people with mental illness are a widespread concern and may vary across countries. This study used a 36-item questionnaire to compare attitudes toward people with mental illness and beliefs about the causes of mental illness among medical students from the United States, Brazil, Ghana, Nigeria, and China (N = 1131). Exploratory factor analysis identified the underlying factor structure of the questionnaire, and analysis of covariance was then used to compare factors representing four nonstigmatized attitudes across students from the five countries. US Medical students scored highest on all four factors, followed by those from Brazil. Nigerian and Ghanaian students scored lowest on nonsupernatural etiology of mental illness, and Chinese students showed the lowest score on personal social acceptance and public policy acceptance of people with mental illness. Differences in medical student attitudes between these five countries suggest underlying sociocultural differences in attitudes with the more stigmatized attitudes in developing countries.

Foi realizada uma análise da incidência de exames realizados no Instituto Médico-Legal Afrânio Peixoto, Rio de Janeiro, Brasil, entre janeiro e julho de 2000. Foram selecionados 124 casos suspeitos de abuso sexual, envolvendo ambos os sexos em indivíduos com idade entre 0 e 17 anos. Os menores entre 0 e 14 anos representaram 81,45% da amostra, coincidindo com os índices observados em estudo anterior que abrangeu o primeiro trimestre do mesmo ano. O sexo masculino predominou nos casos suspeitos de atentado violento ao pudor - 20,97% do grupo, não havendo registro, em ambos os gêneros, entre 15 e 17 anos. O maior número de casos alegados de conjunção carnal (cópula vaginal) foi observado no grupo de menores do sexo feminino entre 10 e 17 anos. Dos alegados agressores, 44,36% eram relacionados às vítimas; os desconhecidos corresponderam a 13,71% do grupo estudado. Em 30,65% dos casos não havia informação sobre o agressor. A maior parte dos registros de ocorrências policiais diz respeito às Zonas Norte e Oeste da cidade. O perfil sócio-econômico-cultural dos indivíduos examinados não foi contemplado no presente estudo.

rESUMo objetivo: Avaliar a qualidade de vida e as características sociodemográficas e clínicas associadas em amostra de pacientes com transtorno do espectro esquizofrênico (CID-10 F20--F29) atendidos nos CAPS da área programática 3.0 da cidade do Rio de Janeiro. Métodos: Realizou-se estudo transversal em amostra de pacientes com diagnóstico pertencente ao espectro esquizofrênico, matriculados em 2008 nos CAPS da AP 3 da cidade do Rio de Janeiro. Foram utilizados instrumentos semiestruturados na avaliação da esquizofrenia e uso de álcool e drogas (MINIPLUS), sintomas psiquiátricos (PANSS) e qualidade de vida (QLS-BR). resultados: Foram entrevistados 79 pacientes, dos quais 74 (93,7%) tinham algum prejuízo na qualidade de vida. A área mais afetada foi o nível ocupacional. As variáveis que se mostraram significativamente associadas ao grave comprometimento da qualidade de vida foram: estado civil, raça, ocupação, com quem reside, situação de rua, ter filhos, internação psiquiátrica prévia, tipo sintomatológico negativo e não aplicável (sendo este caracterizado pela escassez dos típicos sintomas positivos e negativos). Conclusão: O conhecimento desses fatores é importante para a formulação de políticas de saúde e programas de reabilitação psicossocial voltados para a otimização da qualidade de vida dessa clientela.