Four reflections on the new global mental health priorities

Using the CES-D-7 as a Screening Instrument to Detect Major Depression among the Inmate Population

Major depression is one of the most prevalent mental health problems in the penitentiary context and has been related to different undesirable outcomes. The aim of the current research was to evaluate the utility of screening tools for major depression brief assessment in the jail context. We interviewed 203 male inmates and complimented the MCMI-III, the SCL-90-R, and the CES-D-7 self-informed scales. Major depression syndrome and disorder were determined based on MCMI-III criteria and the capability of SCL-90-R and CES-D-7 to identify true positives and true negatives when tested. SCL-90-R and CES-D-7 showed good sensitivity for major depression syndrome and disorder. The specificity of SCL-90-R was poor in all cases, but CES-D-7 showed good specificity depending on the cut-off score. Rigorous interviews are needed for better evaluation of major depression in jails, but screening tools like CES-D-7 are useful for rapid assessment considering the work overload of penitentiary psychologists.

[Situating atention deficit and hyperactivity in Portugal: social, historical, and ethical dimensions of an emerging global health issue]

Attention deficit and hyperactivity disorder (ADHD) is considered one of the most frequent behavioral and neurodevelopmental problems in school-age children and adolescents, both in Portugal and worldwide. The diagnostic categorization of ADHD and the prescription of psychostimulants as its first-line treatment have been the object not only of scientific research and clinical validation, but also of controversy and social critique, especially in light of the concept of medicalization. Despite its high profile and salience in such diverse fields as education, pharmaceuticals, mental health, and public policy, a significant gap remains in the characterization of social-historical, ethical, and institutional dimensions of ADHD outside English-speaking countries. Combining historical and ethnographic research with document and media analysis, the article addresses that challenge by tracing the social trajectory of ADHD in Portugal, from the emergence of "hyperactivity" in the 1970s and 1980s to the current public and political debates on psychostimulant treatments and prescribing trends. From this interdisciplinary perspective and based on the Portuguese case study, the aim of this article is to contextualize the definition, validation, and expansion of ADHD as part of a dynamic and socially situated process in which global diagnostic and pharmaceutical systems intersect with institutional and socioeconomic contingencies, as well as local specificities and needs. More broadly, the article discusses how the case study of ADHD contributes to the development of interdisciplinary research that helps rethinking the social scope of mental health across local and global health contexts.

Global Mental Health: Interdisciplinary challenges for a field in motion

In recent years, efforts in Global Mental Health (GMH) have evolved alongside critical engagement with the field's claims and interventions. GMH has shifted its agenda and epistemological underpinnings, increased its evidence base, and joined other global policy platforms such as the Sustainable Development Goals. This editorial introduction to a thematic issue traces the recent shifts in the GMH agenda and discusses the changing construct of "mental health" as GMH moves away from a categorical biomedical model toward dimensional and transdiagnostic approaches and embraces digital technologies. We highlight persistent and emerging lines of inquiry and advocate for meaningful interdisciplinary engagement. Taken together, the articles in this special issue of Transcultural Psychiatry provide a snapshot of current interdisciplinary work in GMH that considers the socio-cultural and historical dimensions of mental health important and proposes reflexive development of interventions and implementation strategies.