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By its own nature psychiatry is a discipline devoted to embrace the most different perspectives, from philosophy to molecular genetics, from social to biological sciences. This is the only way of avoiding splitting human nature into small pieces, to confront the real needs of our patients. Research is one essential tool to understand human nature in its collectivity.

However, research in psychiatry is becoming an increasingly complex and expensive activity. The contents of our main scientific journals increasingly consist of sophisticated papers reporting on neuroimaging, genetic, or molecular biology research carried out in well-resourced academic departments of a limited number of Western countries.

On the other hand, the access of the average clinician to these sophisticated papers is becoming more and more problematic, because of the increasing cost of subscription to scientific journals, the lack of motivation in perusing articles, which do not have an obvious clinical relevance, and the objective difficulty in understanding the language, the concepts and the technical details.

Also, there are enormous gaps in transcultural and international research, in the promotion of young psychiatrists and in the design of research, which is relevant for the needs of patients worldwide. All this implies that the traditional gap between developed and developing countries in conducting and taking advantage of psychiatric research, and the traditional gap between the small circle of researchers and the multitude of psychiatric practitioners, are becoming wider and wider. All this led the WPA to adopt the stimulation of research and its support in its statutes in 1996.

The Role of the WPA in promoting psychiatric research globally and among its different components can be summarized along the following axes.

WPA sections

  1. Top of page
  2. WPA sections
  3. Improving communications among scientists
  4. Publications and research
  5. Research projects
  6. Development of ethical guidelines relevant to research
  7. Conclusion
  8. References

There are 54 scientific sections in the WPA, covering practically every single area of psychiatric knowledge. They include the most prominent researchers and professionals in their own field of interests, and most of them are active and present in many meetings throughout the world. Several of them publish their own journal or newsletter and are connected with independent and international scientific societies. One of the main tasks of the Secretary for Sections has been to strengthen intersection collaboration. More and more research is atomized and more and more there is a need for a broad and long-term perspective integrating different disciplines.

The role of the WPA Scientific Sections in Global research is potentially a very important one. Members of the Sections are actively engaged in research in their departments anyway, but more centralized intersectional research has also been attempted in recent years through intersectional research. Sections have been encouraged to form clusters on the basis of common interests and to work together.

Every 3 years a volume containing state-of- the-art papers by each of the sections, reflecting the progress achieved in the scientific area covered by each section will be published. The first of these volumes, entitled Advances in Psychiatry, has already been prepared and will be distributed to Sections' chairs and other WPA components. The book reflects the progress made in research carried out during the last triennium. Advances in Psychiatry will be edited periodically every 3 years. Each section should be in a position to single out and highlight the most important triennial developments in its sphere of expertise.

In addition, 14 of our sections produce journals (some indexed), Bulletins or Newsletters, nine sections have produced books, nine sections have produced educational programs and eight of our sections have produced consensus or position statements.

Improving communications among scientists

  1. Top of page
  2. WPA sections
  3. Improving communications among scientists
  4. Publications and research
  5. Research projects
  6. Development of ethical guidelines relevant to research
  7. Conclusion
  8. References

Between 1996 and 2002, 100 000 psychiatrists have participated in WPA meetings organized across the globe.

Furthermore WPA publications and website carry out dissemination of information concerning progress in research. The development of computers, relational data base technology and biomathematics provide possibilities for efficient and accessibility of handling of the vast amount of data being produced worldwide by the various research projects (1).

WPA took the initiative to supply 100 libraries in developing and emerging countries with periodicals, books and thanks are due to the member societies especially the APA and Royal College and others for offering this collaboration to raise the standard of knowledge and research in this area.

The WPA Educational Liaisons Network (WPA ELN), which has about 500 members from about 100 countries, is an important tool to develop any worldwide initiative because of the multicultural characteristic of our Association and of the ELN itself. Its members are very active and permanently in contact, and they have been cooperative in a number of surveys they have been asked to participate in, for example: Survey of the field for the building of the core curriculum for postgraduate training in psychiatry; survey on transcultural psychiatry, conducted by the pertinent WPA Sections; survey on urban mental health, also conducted by the corresponding WPA section. Consequently, the WPA ELN could become an invaluable agent to carry out worldwide research in most fields of the speciality.

The WPA Education Coordination Center is another structure that supports the realization of all WPA educational initiatives, many of which are strongly based on the educational contents of WPA ON LINE.

Professional Development of Young Psychiatrists is a program, which coordinates and develops further WPA efforts and activities in research, education and practice. The young colleagues participating in this WPA Program are very enthusiastic members of this educational network.

Publications and research

  1. Top of page
  2. WPA sections
  3. Improving communications among scientists
  4. Publications and research
  5. Research projects
  6. Development of ethical guidelines relevant to research
  7. Conclusion
  8. References

Publications are among the means used by the WPA to encourage, promote and exchange research.

This year, the Association has launched its new official journal, World Psychiatry. Mental health care is the main topic of the journal. Priority is given to contributions dealing with the organization of mental health services throughout the world, to international collaborative research on new models of mental health care, and to reports on innovative experiences in this field. A second priority is biological and psychopathological research, which appears solid and relevant to clinical practice. A specific request is made to the contributors to use a very clear and simple language, avoiding concepts and terms, which would not be understood by the majority of psychiatrists worldwide. Papers from both developed and developing countries are welcome: among the contributors to the first two issues of the journal, there were three researchers from Africa, five from Asia, six from Latin America and four from Eastern Europe.

The first message we are trying to convey by this initiative is that psychiatric research does not need to be complicated and expensive. Ideas are certainly a more important ingredient for psychiatric research than technology and money. Research focusing on mental health services is not less important than biological research, and may be more relevant to clinical practice and more attractive to the majority of clinicians. This kind of research can certainly be carried out also in developing countries (2). The second message is that we cannot expect that research exerts a significant impact on clinical practice, if clinical practice does not exert a significant impact on the conception and planning of research.

People from developing countries should be able to carry out top-quality research in their own country. Research conducted in a third world country also serves as a powerful antidote to the ‘burn-out’ syndrome so frequently observed when Third World investigators and technical assistants are compelled to work without appropriate feedback and under difficult conditions for many years (3).

The WPA is trying to convey the same messages by the most important of its book series, called ‘Evidence and Experience in Psychiatry’. Each book of this series focuses on a specific mental disorder and contains several reviews of currently available research evidence concerning various diagnostic and management issues, each followed by about 20 commentaries by expert psychiatrists from different countries. The first four volumes of the series, dealing, respectively, with depressive disorders, schizophrenia, obsessive-compulsive disorder and dementia, have sold out, and a second updated edition is in preparation. The fifth volume, dealing with bipolar disorder, has been published in May 2002, and volumes on eating disorders and phobias are in preparation.

World Psychiatry is sent free of charge to 20 000 psychiatrists of 114 countries, whose names and addresses are provided by the WPA member societies (i.e. the national psychiatric associations) and the WPA scientific sections. The journal does not contain advertisements and its distribution does not involve any drug company. In addition to the paper version, an electronic version of the journal is produced regularly, and sent by e-mail to the WPA member societies and scientific sections, which are allowed to include it in their own websites. Moreover, this electronic version of the journal is included in the WPA website. National translations of the journal are encouraged: a Chinese version is already produced, and Spanish and Portuguese versions are in preparation.

Research projects

  1. Top of page
  2. WPA sections
  3. Improving communications among scientists
  4. Publications and research
  5. Research projects
  6. Development of ethical guidelines relevant to research
  7. Conclusion
  8. References

A project ‘Unanswered Questions in Psychiatry and Mental Health’ was initiated by Prof. Driss Moussaoui, when Secretary for Meetings and was launched by the World Psychiatric Association, in order to provide all those in need with good research ideas. The problem here is to know what are the crucial questions that significantly could change the landscape of psychiatry and mental health, if all or part of them find satisfactory answers in the near future.

A letter was sent to hundreds of clinicians and investigators in psychiatry and in related sciences asking for questions that seem essential to them to address in the near future, in order to contribute to the progress of psychiatry and mental health. The unanswered questions address all kinds of fields in psychiatry and mental health. This publication collects the first set of these questions but it will definitely also create a movement, which will lead to bringing up more and more questions where the everyday experience of clinicians or the authority of leaders in the profession do not have scientific-enough criteria to solve the problems that patients bring to our offices and hospitals.

WPA conducted studies undertaken to facilitate the application of WPA guidelines and to improve mental health services.

The formulation of operational criteria for diagnostics and symptom evaluation represent suitable tools for large-scale psychiatric research projects (1).

Examples of such studies include the studies on the effects of guidelines on the practice of general practitioners, the development of the idiographic diagnostic guidelines and the assessment of current state of mental health services in Africa and Central Asia.

A WPA Special Program on Disasters undertakes research on the basic psycho-biological responses to stressful situations, with a view to enable us to understand how human beings struggle to adapt to severely adverse environments and to help them when this struggle fails. Research on prevention and treatment of the effects of disasters on people involved with disasters directly or indirectly (relatives, rescue personnel, witnesses) is important and requires cross-cultural inputs.

Development of ethical guidelines relevant to research

  1. Top of page
  2. WPA sections
  3. Improving communications among scientists
  4. Publications and research
  5. Research projects
  6. Development of ethical guidelines relevant to research
  7. Conclusion
  8. References

The Ethics that govern research and education in mental health should never differ between developed and developing countries. Any difference may reflect that citizens or patients in developing countries should not have the same human rights.

Principle 7 of the Madrid Declaration clearly states that Scientifically invalid research is unethical (4).

Among its specific guidelines the Madrid Declaration has several provisions that are directly or indirectly related to research.

Recognizing the novelty of the field of genetic research and counseling, the Madrid Declaration states that psychiatrists involved in genetic research or counseling shall be mindful of the fact that the implication of genetic information are not limited to the individual from whom it was obtained and that its disclosure can have negative and disruptive effects on the families and communities of the individuals concerned.

Also the Declaration calls on psychiatrists presenting research findings to the media to ensure the scientific integrity of the information given and to be mindful of the potential impact of their statements on the public perception of mental illness and on the welfare of people with mental disorders.

Among the specific guidelines endorsed by the WPA General Assembly in the Yokohama Congress is the possibility of conflict of interest in relationship with the industry. The relevance of that issue to research cannot be underestimated considering that drug firms sponsor much of the psychiatric research.

Conclusion

  1. Top of page
  2. WPA sections
  3. Improving communications among scientists
  4. Publications and research
  5. Research projects
  6. Development of ethical guidelines relevant to research
  7. Conclusion
  8. References

We are now in the era of evidence-based medicine. Unfortunately this is not an easy task because often research is not specifically designed to address all the problems that confront clinicians. An additional challenge faces professionals working in third world countries who must continue on the double track of devising health services and care patterns that can be put into operation even under conditions of extreme shortage of resources and at the same time pursue well-conducted research if at all possible with a bias towards problems of the third world and the researcher's own country (3).

Some members of the Operational Committee on Sections have been authorized to suggest a Strategy for more systematized and collaborative involvement of WPA sections in research. The possibility of organizing research initiated by the sections, particularly on an intersectional basis, has been discussed for implementation. Some members have suggested a secretary for research in the Executive Committee of the WPA.

References

  1. Top of page
  2. WPA sections
  3. Improving communications among scientists
  4. Publications and research
  5. Research projects
  6. Development of ethical guidelines relevant to research
  7. Conclusion
  8. References