From research methods to clinical practice in psychiatry: Challenges and opportunities in the developing world

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Abstract
Psychiatric disorders are amongst the most prevalent, burdensome, and costly of all medical disorders. Several factors make this an exciting time for research on these conditions; these include relevant advances in (1) nosology and epidemiology; (2) neuroscience, including neurogenetics, molecular neurobiology, cognitive-affective neuroscience, and brain imaging; (3) psychopharmacological and psychotherapeutic interventions; (4) systems research in mental health, including evaluation of evidence and of costs; and (5) patient advocacy and mental health literacy. At the same time, there are important challenges facing psychiatry researchers; these include (1) limitations of current diagnostic systems; (2) problems in attracting talented researchers to neuroscience and in obtaining sufficient funding for the vast amount of needed work; (3) a relative lack of controlled pharmacotherapeutic and psychotherapeutic studies undertaken outside the context of tertiary centres in the developed world; (4) ongoing gaps in systems research, including a relative lack of research on the effects of mental health policy; and (5) stigmatization of mental illness and anti-scientific beliefs in the community. These opportunities and challenges exist in both the developed and the developing world, but their scope may differ qualitatively and quantitatively; here we present a perspective from the developing world. We conclude with a wish list for the way forwards.