Category: Mental Health

Trying to make a big decision while you're also preparing for a scary presentation? You might want to hold off on that. Feeling stressed changes how people weigh risk and reward. A new article published in Current Directions in Psychological Science, a journal of the Association for Psychological Science, reviews how, under stress, people pay more attention to the upside of a possible outcome.

It's a bit surprising that stress makes people focus on the way things could go right, says Mara Mather of the University of Southern California, who cowrote the new review paper with Nichole R. Lighthall. "This is sort of not what people would think right off the bat," Mather says. "Stress is usually associated with negative experiences, so you'd think, maybe I'm going to be more focused on the negative outcomes."

But researchers have found that when people are put under stress — by being told to hold their hand in ice water for a few minutes, for example, or give a speech — they start paying more attention to positive information and discounting negative information. "Stress seems to help people learn from positive feedback and impairs their learning from negative feedback," Mather says.

This means when people under stress are making a difficult decision, they may pay more attention to the upsides of the alternatives they're considering and less to the downsides. So someone who's deciding whether to take a new job and is feeling stressed by the decision might weigh the increase in salary more heavily than the worse commute.

The increased focus on the positive also helps explain why stress plays a role in addictions, and people under stress have a harder time controlling their urges. "The compulsion to get that reward comes stronger and they're less able to resist it," Mather says. So a person who's under stress might think only about the good feelings they'll get from a drug, while the downsides shrink into the distance.

Stress also increases the differences in how men and women think about risk. When men are under stress, they become even more willing to take risks; when women are stressed, they get more conservative about risk. Mather links this to other research that finds, at difficult times, men are inclined toward fight-or-flight responses, while women try to bond more and improve their relationships.

"We make all sorts of decisions under stress," Mather says. "If your kid has an accident and ends up in the hospital, that's a very stressful situation and decisions need to be made quickly." And, of course, big decisions can be sources of stress all by themselves and just make the situation worse. "It seems likely that how much stress you're experiencing will affect the way you're making the decision."

New research with monkeys sheds light on how the drug methylphenidate may affect learning and memory in children with attention deficit hyperactivity disorder.

The results parallel a 1977 finding that a low dose of the drug boosted cognitive performance of children with ADHD, but a higher dose that reduced their hyperactivity also impaired their performance on a memory test.

"Many people were intrigued by that result, but their attempts to repeat the study did not yield clear-cut results," says Luis Populin, an associate professor of neuroscience at the University of Wisconsin-Madison School of Medicine and Public Health.

Populin was senior author of the new study exploring the same topic, now available in the early access section of the Journal of Cognitive Neuroscience, published last week. In the study, three monkeys were taught to focus on a central dot on a screen, while a "target" dot flashed nearby. The monkeys were taught that they could earn a sip of water by waiting until the central dot switched off, and then looking at the location of the now-vanished target dot.

The system tests working (short-term) memory, impulsiveness and willingness to stick with the task, as the monkeys could quit "working" at any time, says Populin. The study used different doses of methylphenidate — the generic name for Ritalin — that were comparable to the range of clinical prescriptions for ADHD.

According to the Centers for Disease Control, almost 5 percent of American children are taking medications for ADHD.

Strikingly, dosage had a major and unexpected impact. "At a low dose, the performance scores improved because the monkeys could control their impulses and wait long enough to focus their eyes on the target. All three were calmer and could complete a significantly larger number of trials," says Populin, who collaborated with Jeffrey Henriques and graduate student Abigail Rajala on the study.

At the higher dose, "performance on the task is impaired," Populin says, "but the subjects don't seem to care, all three monkeys continued making the same errors over and over." The monkeys stayed on task more than twice as long at the higher dose, even though they had much more trouble performing the task.

Although ADHD drugs are commonly thought to improve memory, "If we take the accuracy of their eye movements as a gauge of working memory, memory was not helped by either dose," says Populin. "It did not get better at the lower dose, and there actually was a small negative effect at the higher dose."

Memory is at the root of many intellectual abilities, but it can be affected by many factors, says Bradley Postle, a professor of psychology at UW-Madison.

Postle, an expert on working memory who was not involved in the study, says methylphenidate affects the brain's executive function, "which can create an internal environment that, depending on the dose, is either more or less amenable to memory formation and/or retention. If you can concentrate, and are able to process information without being interrupted by distracting thoughts or distractions in your environment, you will perform much better on a memory test. Apparently, the lower dose of methylphenidate helped create the conditions for success without actually improving memory itself."

Monkeys are not people, but monkeys in the study still reminded him of school children, Populin says.

"They made premature movements, could not wait to look at the target before they could be rewarded for doing so. It's like a kid where the teacher says, 'When you complete the task, raise your hand.' But he can't wait, even if he knows that by responding prematurely he will not get rewarded," he says.

The study results had another parallel with daily life, Populin says. Drug dosages may be set high enough to reduce the characteristic hyperactivity of ADHD, "but some children say that makes them feel less creative and spontaneous; more like a robot. If learning drops off as it did in our study, that dose may not be best for them. Our monkeys actually did act like robots at the higher doses, keeping at it for up to seven hours even though their performance was so low."

The logical way forward would involve a similar study with people diagnosed with ADHD, Populin says. With millions of children, and an increasing number of adults, taking medicines for the condition, "We have to be very careful about finding the right spot on the dose curve, or we may get changes in behavior that we don't want. People think these drugs help improve memory, but our data say, 'No, your memory is not getting better.' At the higher dose, you get a behavioral improvement at a price, and that price is cognitive ability."

The number of American children leaving doctors' offices with an attention deficit hyperactivity disorder (ADHD) diagnosis has risen 66 percent in 10 years, according to a new Northwestern Medicine study. Over this same timeframe, specialists, instead of primary care physicians, have begun treating an increasing number of these young patients, the study found.

The study, which will be published in the March/April issue of the journal Academic Pediatrics, analyzed ADHD trends from 2000 to 2010 among children under the age of 18 who were diagnosed and treated by office-based physicians. Researchers analyzed changes in the diagnosis of ADHD and treatment of the disorder over this 10-year time period.

"ADHD is now a common diagnosis among children and teens," said Craig Garfield, M.D., first author of the study. "The magnitude and speed of this shift in one decade is likely due to an increased awareness of ADHD, which may have caused more physicians to recognize symptoms and diagnose the disorder."

Garfield is an assistant professor in pediatrics and medical social sciences at Northwestern University Feinberg School of Medicine and a pediatrician at Children's Memorial Hospital and Northwestern Memorial Hospital.

Symptoms of ADHD, such as trouble paying attention and controlling impulsive behaviors and being overly active, can affect children and teens both academically and socially, Garfield said.

In the past decade several important regulatory and clinical changes regarding ADHD and the medications used to treat it have occurred, yet it was unknown how these factors have affected ADHD management, Garfield said.

For the study, Garfield and his team of researchers quantified ADHD diagnosis and treatment patterns among people under 18 using the IMS Health National Disease and Therapeutic Index. This is a nationally representative sample of office-based visits and included 4,300 office-based physicians in 2010.

According to the study, in 2010, 10.4 million children and teens under age 18 were diagnosed with ADHD at physician outpatient visits, versus 6.2 million in 2000.

Researchers also found that psychostimulants have remained the most common medication prescribed to children with ADHD. Psychostimulants were used in 96 percent of treatments in 2000 and 87 percent in 2010. The exact reason for the decrease is unclear, but there was not an increase in treatment with other, substitute medications, Garfield said.

While the majority of children and teens with ADHD are still managed by primary physicians, the study found that there has been a substantial shift away from primary doctors and towards specialists, such as pediatric psychiatrists.

"Recently, there's been more public health advisories issued about problems or side effects of different ADHD medications," Garfield said. "It may be that general pediatricians are shying away from treating patients themselves and instead rely on their specialist colleagues to provide the treatment and management of these medications."

Given the short supply of psychiatrists specializing in pediatric ADHD, Garfield said this trend might make it difficult for many children to receive medical treatment of ADHD in the future.

This study was funded by the Agency for Healthcare Research and Quality and the Robert Wood Johnson Foundation.

 Children who experience the stress of separation at birth from biological parents and are brought up in orphanages undergo biological consequences such as changes in their genome functioning, Yale School of Medicine researchers report in a new study.

Published online in the current issue of Development and Psychopathology, the study reports differences in DNA methylation, one of the main regulatory mechanisms of gene expression, or genome functioning. The investigators compared two cohorts: 14 children raised since birth in institutional care and 14 children raised by their biological parents.

Senior author Elena Grigorenko, associate professor at the Yale Child Study Center, and her colleagues took blood samples from children aged 7 to 10 living in orphanages and children growing up in typical families in the northwest region of the Russian Federation. They then profiled the genomes of all the children to identify which biological processes and pathways might be affected by deprivation of parental attention and care.

The team found that in the institutionalized group, there was a greater number of changes in the genetic regulation of the systems controlling immune response and inter-cellular interactions, including a number of important mechanisms in the development and function of the brain.

"Our study shows that the early stress of separation from a biological parent impacts long-term programming of genome function; this might explain why adopted children may be particularly vulnerable to harsh parenting in terms of their physical and mental health," said Grigorenko. "Parenting adopted children might require much more nurturing care to reverse these changes in genome regulation."

Other authors on the study included Oksana Naumova, Maria Lee, Roman Koposov, Moshe Szyf, and Mary Dozier.

The study was funded by the Foundation for Child Development, the USA National Institute of Mental Health, and Edna Bennett Pierce.

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Journal Reference:

1. Oksana Yu. Naumova, Maria Lee, Roman Koposov, Moshe Szyf, Mary Dozier, Elena L. Grigorenko. Differential patterns of whole-genome DNA methylation in institutionalized children and children raised by their biological parents. Development and Psychopathology, 2011; DOI: 10.1017/S0954579411000605

— People who try to boost their self-esteem by telling themselves they've done a great job when they haven't could end up feeling dejected instead, according to new research published by the American Psychological Association.

High and low performers felt fine when they assessed themselves accurately, probably because the high performers recognized their strengths and low performers acknowledged their weaknesses and could try to improve their future performance, according to a study in the October issue of the APA journal Emotion^®.

"These findings challenge the popular notion that self-enhancement and providing positive performance feedback to low performers is beneficial to emotional health. Instead, our results underscore the emotional benefits of accurate self-assessments and performance feedback," said lead author Young-Hoon Kim, PhD, of the University of Pennsylvania. . The study involved experiments with four different groups of young people from the United States and Hong Kong. Three U.S. groups totaled 295 college undergraduates, with 186 women and a mean age of 19, and one Hong Kong group consisted of 2,780 high school students, with 939 girls, from four different schools and across grades 7-12.

In the first two experiments, one of the U.S. groups and the Hong Kong students took academic tests and were asked to rate and compare their own performances with other students at their schools. Following their assessments, all the participants completed another widely used questionnaire to assess symptoms of depression.

In the third and fourth experiments, researchers evaluated the other two sets of U.S. undergraduates with feedback exercises that made high performers think their performance was low and low performers think their performance was high. Control groups participated in both and received their scores with no feedback.

Across all the studies, results showed that those who rated their own performance as much higher than it actually was were significantly more likely to feel dejected. "Distress following excessive self-praise is likely to occur when a person's inadequacy is exposed, and because inaccurate self-assessments can prevent self-improvement," said co-author Chi-Yue Chiu, of Nanyang Technological University in Singapore.

The results also revealed cross-cultural differences that support past findings that Asians are more humble than Americans. The U.S. undergraduates had a higher mean response when rating their performance than the Hong Kong students, at 63 percent compared to 49 percent, the researchers found. Still, they found that excessive self-enhancement was related to depression for both cultures.

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Journal Reference:

1. Young-Hoon Kim, Chi-Yue Chiu. Emotional costs of inaccurate self-assessments: Both self-effacement and self-enhancement can lead to dejection.. Emotion, 2011; 11 (5): 1096 DOI: 10.1037/a0025478

A new University of British Columbia study finds that Black Canadians with darker skin are more likely to report poorer health than Black Canadians with lighter skin. The study also suggests that a mismatched racial identity can negatively affect health.

The study, published online in the current issue of Social Science & Medicine journal, provides the first Canadian evidence of the health effects of "colourism," discrimination targeted more strongly at darker-skinned than lighter-skinned people of colour, says the author.

Researchers surveyed the self-reported racial identities — Asian, Black, South Asian and White — of nearly 1,500 participants from Vancouver and Toronto across four key health indicators: high blood pressure, depression, mental health and overall health.

While some findings support existing research — that Black Canadians are more likely than others to report high blood pressure and that Asian Canadians are most likely to report poorer mental health — the study found that Black Canadians with darker skin were as much as four times more likely than Black Canadians with lighter skin to report poor overall health.

Although U.S. scholars have researched the wide-ranging effects of colourism for African Americans, including effects on health, the UBC study's author Prof. Gerry Veenstra, Dept. of Sociology, says this is the first study to suggest that colourism can affect the health of Canadians as well.

"The findings indicate that, for Black Canadians, levels of discrimination can depend on the relative darkness or lightness of their skin," says Veenstra. "For health researchers and policymakers, this means that the broad racial classifications typically used by health researchers may actually underestimate the magnitude of racial health inequalities in this country."

"This is a first step to understanding colourism's manifestations in Canada and the degree to which and for whom it affects health and well-being," adds Veenstra, who plans to study whether colourism affects other Canadian racial identities.

The study also finds that mistaking an individual's racial identity can have significant negative physical or mental impacts. Participants who reported higher levels of racial identity mismatches were found to be at greater risk of high blood pressure, poorer self-rated mental health and poorer self-rated overall health.

"For instance, people who considered themselves to be White but believed others tend to think they are something else — perhaps that they were of mixed race, for example — were at a higher risk of high blood pressure and poor mental health," Veenstra says.

While the study did not investigate the causes of this phenomenon, Veenstra says previous studies have suggested that people experience stress when the cues provided by others do not match their conceptions of themselves, a stress that can be strong enough to elicit adverse health outcomes.

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Journal Reference:

1. Gerry Veenstra. Mismatched racial identities, colourism, and health in Toronto and Vancouver. Social Science & Medicine, 2011; 73 (8): 1152 DOI: 10.1016/j.socscimed.2011.07.030

New research from the University of Montreal shows that inattention, rather than hyperactivity, is the most important indicator when it comes to finishing a high school education.

"Children with attention problems need preventative intervention early in their development," explained lead author Dr. Jean-Baptiste Pingault, who is also affiliated with Sainte-Justine Mother and Child University Hospital. The researchers came to their conclusion after looking at data collected from the parents and teachers of 2000 children over a period of almost twenty years.

In this study, attention problems were evaluated by teachers who looked for behaviour such as an inability to concentrate, absentmindedness, or a tendency to give up or be easily distracted. Hyperactivity was identified by behaviour such as restlessness, running around, squirming and being fidgety. The researchers found that only 29% of children with attention problems finished high school compared to 89% of children who did not manifest these inattention problems. When it came to hyperactivity, the difference was smaller: 40% versus 77%. After correcting the data for other influencing factors, such as socioeconomic status and health issues that are correlated with ADHD, inattention still made a highly significant contribution which was not the case for hyperactivity.

"In the school system, children who have attention difficulties are often forgotten because, unlike hyperactive kids, they don't disturb the class," said Dr. Sylvana Côte, who led the study. "However, we know that we can train children to pay attention through appropriate activities, and that can help encourage success at school."

The results of the study have been published as mental health experts have begun to debate whether or not it would be appropriate to separate hyperactivity and inattention problems in the next edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). "These two health issues have now been more precisely dissected, and we may now need to define a differentiated type of inattention that is independent from hyperactivity, to improve our understanding of the phenomenon and better tailor interventions," Pingault said.

The study will be published in the American Journal of Psychiatry on November 1, 2011. The research was funded in part by the Fonds Québécois de la recherche sur la société et la culture, the Social Sciences and Humanities Research Council of Canada, the Canadian Institutes of Health Research, the US National Science Foundation, the National Institute of Mental Health and the US National Consortium on Violence Research. The University of Montreal and Sainte-Justine Mother and Child University Hospital are known officially as Université de Montréal and Centre hospitalier universitaire Sainte-Justine, respectively.

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Journal Reference:

1. J.-B. Pingault, R. E. Tremblay, F. Vitaro, R. Carbonneau, C. Genolini, B. Falissard, S. M. Cote. Childhood Trajectories of Inattention and Hyperactivity and Prediction of Educational Attainment in Early Adulthood: A 16-Year Longitudinal Population-Based Study. American Journal of Psychiatry, 2011; DOI: 10.1176/appi.ajp.2011.10121732

Sexual orientation and 'gender conformity' in women are both genetic traits, according to new research from Queen Mary, University of London.

It is well recognised that there consistent differences in the psychological characteristics of boys and girls; for example, boys engage in more 'rough and tumble' play than girls do.

Studies also show that children who become gay or lesbian adults differ in such traits from those who become heterosexual — so-called gender nonconformity. Research which follows these children to adulthood shows that between 50 to 80 per cent of gender nonconforming boys become gay, and about one third of such girls become lesbian.

Writing in the online journal PLoS ONE, Dr Andrea Burri and Dr Qazi Rahman from Queen Mary's School of Biological and Chemical Sciences report that a shared set of genes and shared set of random environmental factors is partially responsible both for gender nonconformity and female sexual orientation.

The team followed a group of 4,000 British women who were one of a pair of twins. They were asked questions about their sexual attractions and behaviour, and a series of follow up questions about their gender nonconformity. In line with previous research, the team found modest genetic influences on sexual orientation (25 per cent) and childhood gender nonconformity (31 per cent).

Dr Qazi Rahman, co-author of the study, explains: "We found that there is a connection between these mental traits and how sexual orientation develops. One idea is that there is an association between these psychological traits and sexual orientation because they all develop under common biological drivers; like the development of brain regions under the influence of genes and sex hormones."

Dr Rahman adds: "We think environmental factors and genetics drive other mechanisms, like exposure to sex hormones in the womb, to shape differences in gender nonconformity and sexuality simultaneously."

Dr Rahman is mindful that the results may carry the risk of stereotyping, adding: "Stereotypes like 'sissy' or 'mannish' have not been helpful in promoting respect for gay people, and those who don't match those stereotypes may find it hard to accept they are gay or lesbian."

But he believes the team's findings are increasingly important to researchers concerned with the mental health of sexual minorities. Dr Rahman concludes: "We know that gay people who are strongly gender nonconforming report more anxiety and depression symptoms.

"Poor mental health in gay populations is partly due to societal stigma and victimisation. Our results suggest that being gender nonconforming and lesbian comes from 'within'; there is little you can do about it. So gender nonconformity does not cause mental health problems, but it may trigger negative reactions from other people (like parents and peers), leading to mental health problems."

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Journal Reference:

1. Andrea Burri, Lynn Cherkas, Timothy Spector, Qazi Rahman. Genetic and Environmental Influences on Female Sexual Orientation, Childhood Gender Typicality and Adult Gender Identity. PLoS ONE, 2011; 6 (7): e21982 DOI: 10.1371/journal.pone.0021982

Mental health experts are calling for a greater world focus on improving access to care and treatment for mental, neurological, and substance use (MNS) disorders, as well as increasing discoveries in research that will enable this goal to be met.

The Grand Challenges in Global Mental Health Initiative, led by the National Institutes of Health and the Global Alliance for Chronic Diseases, has identified the top 40 barriers to better mental health around the world. Similar to past grand challenges, which focused on infectious diseases and chronic, noncommunicable diseases, this initiative seeks to build a community of funders dedicated to supporting research that will significantly improve the lives of people living with MNS disorders within the next 10 years.

Twenty-five of the specific challenges and the process used to derive them are described in an article that will be published on July 7, 2011, in the journal Nature.

"Participating in global mental health research is an enormous opportunity, a means to accelerate advances in mental health care for the diverse U.S. population, as well as an extension of our vision of a world where mental illnesses are prevented and cured," said Thomas R. Insel, M.D., director of the National Institute of Mental Health (NIMH), the NIH institute heading this effort.

According to the paper's authors, the disorders targeted by the Grand Challenges in Global Mental Health — for example, schizophrenia, depression, epilepsy, dementia, and alcohol dependence — collectively account for more years of life lost to poor health, disability, or early death than either cardiovascular disease or cancer. Yet, compared to illnesses like cardiovascular disease and cancer, there are far fewer effective treatments or preventive methods. In addition, interventions are not widely available to those who need them most.

In recognizing the need to address this imbalance, Pamela Collins, M.D., M.P.H., of the NIMH Office for Research on Disparities and Global Mental Health, and colleagues assembled an international panel of experts to identify research priorities using the Delphi method, a widely accepted consensus-building tool. The panel consisted of 422 experts in fields such as neuroscience, basic behavioral science, mental health services, and epidemiology, and represented more than 60 countries.

Over the course of two months, NIMH staff pared the panel's initial list of 1,565 challenges down to 154, with input from a scientific advisory board. From this list, the expert panel selected the top 40, of which the top five challenges identified after the third and final round of ranking are:

• Integrate screening and core packages of services into routine primary health care
• Reduce the cost and improve the supply of effective medications
• Improve children's access to evidence-based care by trained health providers in low- and middle-income countries
• Provide effective and affordable community-based care and rehabilitation
• Strengthen the mental health component in the training of all health care personnel.

These top five challenges were ranked according to the ability to reduce the burden of disease, ability to reduce inequalities in health and health care, length of time until results can be observed, and the ability for the topic to be researched effectively.

"Addressing these challenges could have far-reaching effects, including increasing access to services and ultimately, reducing the treatment gap associated with these disorders," said Dr. Collins.

The Grand Challenges in Global Mental Health Initiative is led by NIMH and the Global Alliance for Chronic Diseases, in partnership with the Wellcome Trust, the McLaughlin-Rotman Centre for Global Health, and the London School of Hygiene and Tropical Medicine. Other NIH components participating in the Grand Challenges in Global Mental Health include the Fogarty International Center; the National Heart, Lung, and Blood Institute; and the National Institute of Neurological Disorders and Stroke.

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Journal Reference:

1. Pamela Y. Collins, Vikram Patel, Sarah S. Joestl, Dana March, Thomas R. Insel, Abdallah S. Daar, Isabel A. Bordin, E. Jane Costello, Maureen Durkin, Christopher Fairburn, Roger I. Glass, Wayne Hall, Yueqin Huang, Steven E. Hyman, Kay Jamison, Sylvia Kaaya, Shitij Kapur, Arthur Kleinman, Adesola Ogunniyi, Angel Otero-Ojeda, Mu-Ming Poo, Vijayalakshmi Ravindranath, Barbara J. Sahakian, Shekhar Saxena, Peter A. Singer, Dan J. Stein, Warwick Anderson, Muhammad A. Dhansay, Wendy Ewart, Anthony Phillips, Susan Shurin, Mark Walport. Grand challenges in global mental health. Nature, 2011; 475 (7354): 27 DOI: 10.1038/475027a

A Toronto-based researcher is at the helm of a massive, worldwide study that identifies the top global challenges in mental health.

The paper resulting from the study appears in the journal Nature.

Professor Abdallah S. Daar, senior scientist with the McLaughlin-Rotman Centre for Global Health at the University Health Network (UHN) and the University of Toronto, co-authored the historic study, "Grand Challenges in Global Mental Health." The study — the world's largest of its kind — brought together more than 400 international researchers, advocates, clinicians and other experts to identify the major obstacles to improving the lives of people with mental illness around the world. The paper in Nature also suggests priorities for research funding agencies.

"Mental illnesses are a problem for the whole of humanity — globally, they contribute a huge burden, and they are poorly dealt with in almost all countries. This is why we need to develop a global list of challenges and priorities," says Daar, the senior author on the paper.

The study took 18 months to complete, having begun in early 2010. With leadership from the McLaughlin-Rotman Centre for Global Health and the US National Institute for Mental Health, it applied the following criteria in the last round to identify the top global challenges: ability to reduce disease burden; impact on equity; immediacy of impact; and feasibility. It grouped the grand challenges into five goals that span discovery science, prevention, health care delivery, training, and policy.

Among the top grand challenges in global mental health identified:

• Integrate screening and core packages of services into routine primary health care
• Reduce the cost and improve the supply of effective medications
• Improve children's access to evidence-based care by trained health providers in low- and middle-income countries
• Provide effective and affordable community-based care and rehabilitation
• Strengthen the mental health component in the training of all health care personnel

"For the first time ever, we have provided a clear picture on where the greatest needs lie in terms of tackling global mental health problems. This will help scientists, advocates, clinicians and practitioners to focus their efforts and will also help global Ministries of Health and funding agencies to understand the whole picture, prioritize and identify appropriate entry points," says Daar, also a U of T Professor of Public Health Sciences and of Surgery. "Substantial progress in mental health research can be made over the next decade if research funding agencies focus on these priorities."

Dean Catharine Whiteside of U of T's Faculty of Medicine says Canadian researchers will continue to play a lead role in mental health research as they hone in on the study's grand priorities. "Scientific research into mental illness has long been a major focus at the University of Toronto, but a clearer vision for research that will have meaningful impact is emerging, thanks to the work of Professor Daar and his international colleagues. With these goals in mind, our top researchers will continue to work collaboratively with global partners to address the most pressing mental health challenges."

"This research is a remarkable achievement in scope, surveying many participants in different countries and covering such a wide range of illnesses," says Dr. Sidney H. Kennedy, Psychiatrist-in-Chief, University Health Network and Professor of Psychiatry, University of Toronto. "It has the potential to transform how we treat mental illness throughout the world by setting key priorities, researching and establishing the most effective treatment interventions, and building a community of researchers and funders who can cooperate internationally."

"Our previous studies had already identified global challenges and priorities for chronic diseases and infectious diseases. Mental health is the next frontier," concludes Daar.

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Journal Reference:

1. Pamela Y. Collins, Vikram Patel, Sarah S. Joestl, Dana March, Thomas R. Insel, Abdallah S. Daar, Isabel A. Bordin, E. Jane Costello, Maureen Durkin, Christopher Fairburn, Roger I. Glass, Wayne Hall, Yueqin Huang, Steven E. Hyman, Kay Jamison, Sylvia Kaaya, Shitij Kapur, Arthur Kleinman, Adesola Ogunniyi, Angel Otero-Ojeda, Mu-Ming Poo, Vijayalakshmi Ravindranath, Barbara J. Sahakian, Shekhar Saxena, Peter A. Singer, Dan J. Stein, Warwick Anderson, Muhammad A. Dhansay, Wendy Ewart, Anthony Phillips, Susan Shurin, Mark Walport. Grand challenges in global mental health. Nature, 2011; 475 (7354): 27 DOI: 10.1038/475027a