Development of national capabilities in low and middle income countries for research in child mental health

Abstract

key to promote worldwide improvements [1,6]. The current issue of the European Child and Adolescent Psychiatry brings three examples of two upper middle income countries-Brazil and Mexico-where local research groups have been producing novel and relevant findings to the international community and influencing organization of local health systems and policymakers.In Brazil, the National Institute of Developmental Psychiatry for Children and Adolescents (http://inpd.org.br) congregates researchers from different universities who together have launched cross-sectional studies, a large community cohort with extensive phenotype data and neuroimaging and genomic information, a birth cohort, and a home-visiting intervention for high-risk pregnant youth. In this issue, two studies from the Brazilian Institute illustrate their work. Fortes et al. [8] studied prevalence and correlates of specific learning disorders (SLDs) in 1618 children and adolescents from four different cities, each one in a different geographic area of Brazil (which differs markedly between them in broad socioeconomic and cultural aspects). Prevalence estimates found were 7.6 % for SLD with global impairment, 5.4 % for SLD with impairment in writing, 6.0 % for SLD with impairment in arithmetic, and 7.5 % for SLD with impairment in reading. ADHD was the only comorbid mental disorder significantly more frequent in children with SLD with global impairment, and among other SLDs, only SLD with impairment in arithmetic presented higher rates of comorbidity, specifically of anxiety disorders. Rates of SLD with global impairment were associated with age, sex, SES, and the city, and estimates based on DSM-IV criteria were lower than those based on DSM-5 criteria. This study suggests that commonalities and specificities on SLDs are identified across different regions within the country and according to the literature, between countries. To further understand the nature of these findings Worldwide estimates indicate that 13 % of children and adolescents suffer from impairing mental disorders [14] and approximately 60 % of adolescents report significant levels of symptoms [10]. Most of what we know about these disorders come from high-income countries (HICs), home of only approximately 10 % of the total population of children in the world [12]. Despite only a partial picture of the global child mental health scenario, built with data from the more affluent environments [4], it is now possible to conclude that mental and substance use disorders are the leading cause of disability in children and adolescents [7]. The complete picture, with national data from low and middle income countries (LMICs) included, would certainly depict a more vulnerable scenario. In fact, due to population growth and under-resourced health care systems, the burden of mental health and substance-use disorders is expected to further increase worldwide in the next decades, and the steepest rise is predicted to occur in LMICs [7].Considering the evolving adverse scenario of child mental he...

Genetic Factors in Mental Health Disorders in adolescents in West Java: Experiencing it with Genomics

“…Although genomic research in mental health has primarily focused on adult populations, there is a growing recognition of the importance of studying adolescents. Adolescence is a critical developmental period characterized by significant biological and psychological changes [24]- [26].…”