Stein Dan J, He Yanling, Phillips Anthony, Sahakian Barbara J, Williams John, Patel Vikram
Department of Psychiatry, University of Cape Town, Cape Town, South Africa.
Department of Epidemiology, Shanghai Mental Health Center, Shanghai, People's Republic of China.
Lancet Psychiatry. 2015 Feb;2(2):178-85. doi: 10.1016/S2215-0366(15)00014-0. Epub 2015 Jan 28.
Global mental health has emerged as an important specialty. It has drawn attention to the burden of mental illness and to the relative gap in mental health research and services around the world. Global mental health has raised the question of whether this gap is a developmental issue, a health issue, a human rights issue, or a combination of these issues-and it has raised awareness of the need to develop new approaches for building capacity, mobilising resources, and closing the research and treatment gap. Translational neuroscience has also advanced. It comprises an important conceptual approach to understanding the neurocircuitry and molecular basis of mental disorders, to rethinking how best to undertake research on the aetiology, assessment, and treatment of these disorders, with the ultimate aim to develop entirely new approaches to prevention and intervention. Some apparent contrasts exist between these fields; global mental health emphasises knowledge translation, moving away from the bedside to a focus on health systems, whereas translational neuroscience emphasises molecular neuroscience, focusing on transitions between the bench and bedside. Meanwhile, important opportunities exist for synergy between the two paradigms, to ensure that present opportunities in mental health research and services are maximised. Here, we review the approaches of global mental health and clinical neuroscience to diagnosis, pathogenesis, and intervention, and make recommendations for facilitating an integration of these two perspectives.
全球精神卫生已成为一门重要的专业学科。它使人们关注到精神疾病的负担以及世界各地精神卫生研究与服务方面的相对差距。全球精神卫生引发了这样一个问题：这种差距是一个发展问题、健康问题、人权问题，还是这些问题的综合——并且它提高了人们对开发新方法以建设能力、调动资源以及缩小研究与治疗差距的必要性的认识。转化神经科学也取得了进展。它包含一种重要的概念性方法，用于理解精神障碍的神经回路和分子基础，重新思考如何以最佳方式对这些障碍的病因、评估和治疗进行研究，最终目标是开发全新的预防和干预方法。这两个领域之间存在一些明显的差异；全球精神卫生强调知识转化，从临床转向关注卫生系统，而转化神经科学强调分子神经科学，专注于从实验室到临床的转化。与此同时，这两种范式之间存在协同增效的重要机遇，以确保精神卫生研究与服务的当前机遇得到最大化利用。在此，我们回顾全球精神卫生和临床神经科学在诊断、发病机制及干预方面的方法，并就促进这两种观点的整合提出建议。
