Francisco Ortega

Imaginamos este libro, como una contribución a una reflexión que recupere lo mejor de la tradición crítica, problematizadora e historizante de la medicalización de la sociedad, pero que ofrezca múltiples panoramas actualizados, rigurosos y exhaustivos para observar estos procesos en la Argentina y en los países que
componen el sur de América Latina.
Esperamos sinceramente que la lectura de este volumen se constituya en un disparador que ofrezca claves de diferente índole para aproximarse a los problemas relacionados con la medicalización de las infancias. Claves teóricas, fundadas en reflexiones profundas acerca de los límites y posibilidades analíticas que pueden ofrecer las ciencias sociales para pensar estos temas. Claves metodológicas, que permitan poner de relieve la importancia de diseños de investigación flexibles y que abreven a la comprensión de los complejos fenómenos medicalizadores. Claves, en todos los casos, que resulten útiles para aproximarse al análisis de problemáticas empíricas.
Postulamos la relevancia de realizar estudios basados en el análisis de fenómenos empíricos en la región, que abran posibilidades no sólo de comprensión de tales fenómenos, sino que contribuyan a delinear contornos específicos y posibilidades analíticas propias de América Latina. En función de ello, consideramos que es necesario alentar la construcción de diálogos fructíferos que conduzcan al mutuo enriquecimiento de los estudios provenientes de diversas regiones incorporando referentes insoslayables en la perspectiva considerada. En este sentido, la participación de integrantes de nuestro equipo en el libro "Global perspectives on ADHD. Social dimensions of diagnosis and treatment in sixteen countries", compilado por Meredith Bergey, Angela Filipe, Peter Conrad e Ilina Singh, constituyó un punto de partida que nos permitió poner en diálogo lo sucedido en Argentina con países de los cinco continentes. También, y como resultado de las experiencias investigativas, refrendamos nuestra propuesta de profundizar y recentrar las investigaciones en el análisis de algunos desprendimientos de la perspectiva de la medicalización, tales como la biomedicalización, la farmacologización y la sociología del diagnóstico, que el libro aborda a partir de algunas sistematizaciones de lecturas realizadas en dichas claves. Así fue que, como parte del contenido, y poniendo en diálogo con nuestra investigación de Argentina, invitamos a equipos que estudian diferentes experiencias nacionales sobre medicalización de la infancia en el sur de nuestro continente, una región relevante en América Latina no sólo por su extensión, sino por el hecho de que tiene valores elevados en algunos de los principales indicadores de desempeño social y económico. Se considera la región macro más próspera de América Latina, con una alta esperanza de vida, el índice de desarrollo humano más elevado y un alto nivel de vida, así como con una participación significativa en los mercados mundiales. Pero, a la vez, una zona que tiene profundas desigualdades, y en ese contexto el sistema de salud en general y de salud mental en particular es muy representativo de dichas inequidades. Creemos que la contribución de los investigadores en este campo es un hito relevante y establecerá ricos intercambios a futuro con otras producciones.

Being Brains offers a critical exploration of one of the most influential and pervasive contemporary beliefs: “We are our brains.” Starting in the “Decade of the Brain” of the 1990s, “neurocentrism” became widespread in most Western and many non-Western societies. Formidable advances, especially in neuroimaging, have bolstered this “neurocentrism” in the eyes of the public and political authorities, helping to justify increased funding for the brain sciences.

The human sciences have also taken the “neural turn,” and subspecialties in fields such as anthropology, aesthetics, education, history, law, sociology, and theology have grown and professionalized at record speed. At the same time, the development of dubious but successful commercial enterprises such as “neuromarketing and “neurobics” have emerged to take advantage of the heightened sensitivity to all things neuro. Skeptics have reacted to the hype, warning against neuromythology, neurotrash, neuromania, and neuromadness.

While this neurocentric view of human subjectivity is neither hegemonic nor monolithic, it embodies a powerful ideology that is at the heart of some of today’s most important philosophical, ethical, scientific, and political debates. Being Brains critically explores the internal logic of such ideology, its genealogy, and its main contemporary incarnations.

Neurocultures offers «glimpses» into an expanding universe of knowledge, beliefs and practices characterized by the conviction that human activity is governed by the structure and functioning of the brain. The 1990s were the Decade of the Brain, and the first hundred years of the new millennium have been proclaimed its Century. Described as the most complex of all organs, the brain has become a major icon of contemporary culture. Brain imaging technologies are used in a large number of disciplines, and are increasingly applied in settings of potential social and legal relevance. It is often proclaimed that the neurosciences will bring about major transformations in notions and practices of the human in areas as diverse as spirituality and self-help, marketing, the law, education, or the classification and treatment of mental disease. Neurocultures explores these expectations, their history, their contexts, and the debates they raise, in a broad range of fields, including enhancement, meditation, neuroethics, the «social brain», psychedelic research, psychoanalysis, psychiatric and neurological conditions, and cinema and literature.

's Being Brains: Making the Cerebral Subject is a fine-grained account of the "neuro-" in a range of disciplines, and, importantly––crucially––, takes stock of the history and scope of this prefix. But more than this the book is an exploration, a critical engagement with the surge of brain-centered approaches to behavior, to physiology, to mind, to subjectivity, to art and creative enterprises and products––Being Brains is an invaluable appraisal of where those waves (many waves, different waves) crash and what they at times wash away. Vidal and Ortega ask (simply, provocatively), "How did the idea that humans are essentially their brains become thinkable?" (1) The commentaries that follow offer broad and diverse readings of the book. We hope you enjoy.

Since the 1990s, several disciplines have emerged at the interface between neuroscience and the social and human sciences. For the most part, they aim at capturing the commonalities that underlay the heterogeneity of human behaviors and experiences. Neuroanthropology and cultural neuroscience, or the “neurodisciplines of culture,” appear different, since their goal is to understand specificity rather than commonality and to address how cultural differences are inscribed in the
brain. After offering an overview of these disciplines, and of their relation to endeavors such as cultural psychology and social neuroscience, this article discusses some of the most representative studies in the area in order to explore in which ways they are relevant for an understanding of culture.

Since the 1990s, several disciplines, from neuroanthropology to neurotheology, have emerged at the interface between neuroscience and the social and human sciences. These “neurodisciplines” share basic assumptions about the brain/mind relationship, a preference for neuroimaging methodology, and the goal of establishing the neurobiological foundations of mind and behavior. A neural turn has also been taken in some quarters within the literary field. The neurosciences have provided writers of literature with resources for depicting characters and psychological processes and states; at the same time, they have inspired new interpretive approaches within literary studies. A twofold motif structures what might be called the neuroliterary field: brains in literature/literature in the brain. There has been a certain convergence between the rise of “neuronovels,” on the one hand, and the neurologization of literary analysis, on the other. This article studies that twofold motif. It first sketches how neuronovels fit into the history of neurological fiction and fictional elaborations of brain-related issues. It then examines three aspects of several major neuronovels: narrativity, solipsism and sociality, and memory. The article concludes by underlining the difference between incorporating “brains in literature” and placing “literature in the brain.”

The research reported here aims at mapping the “cerebral subject” in contemporary society. The term “cerebral
subject” refers to an anthropological figure that embodies the belief that human beings are essentially reducible to
their brains. Our focus is on the discourses, images and practices that might globally be designated as “neuroculture.”
From public policy to the arts, from the neurosciences to theology, humans are often treated as reducible to
their brains. The new discipline of neuroethics is eminently symptomatic of such a situation; other examples can be
drawn from science fiction in writing and film; from practices such as “neurobics” or cerebral cryopreservation; from
neurophilosophy and the neurosciences; from debates about brain life and brain death; from practices of intensive
care, organ transplantation, and neurological enhancement and prosthetics; from the emerging fields of neuroesthetics,
neurotheology, neuroeconomics, neuroeducation, neuropsychoanalysis and others. This research in progress
traces the diversity of neurocultures, and places them in a larger context characterized by the emergence of somatic
“bioidentities” that replace psychological and internalistic notions of personhood. It does so by examining not only
discourses and representations, but also concrete social practices, such as those that take shape in the politically
powerful “neurodiversity” movement, or in vigorously commercialized “neuroascetic” disciplines of the self.

as a concept to approach the
actual subjectivity processes and also the emergence of biotechnologies instruments to approach mental disorders,
behaviors and human attitudes. It analyses the use of neuroimages and the new issues they bring to psychological
research field that has to face the biologization of mind.

Somatosphere Presents A Book Forum on Tracing Autism: Uncertainty, Ambiguity, and the Affective Labor of Neuroscience by Des Fitzgerald

Contributions from:
Elizabeth Fein - Duquesne University; Matthew Wolf--Meyer - Binghampton University; M. Ariel Cascio - McGill  University; Michael Orsini - University of Ottawa; Francisco Ortega - State University of Rio de Janeiro
Reply - Des Ftizgerald - Cardiff University

This  article  approaches  the  claims  of  two  main 
parent-activists groups – Light Blue and Sky Blue –
in the struggle for the “right to treatment” of autism
in the state of Rio de Janeiro. It focuses mainly on
the forms of discourses and tensions about care and
treatments provided by the Unified Health System
(SUS).  Therefore,  our  purpose  is  to  understand  to 
what extent their claims about forms of treatments
approach  the  broader  context  of  national  health 
policies for autistic individuals. The laws drawn up
by parent-activists along with political figures are
highlighted, as well as the positioning and vocalizations  that  consider  the  assistance  offered  by  the 
Network for Psychosocial Care (Raps) “insufficient”
and/or “inadequate”. Our research methodology
involved ethnographic research, conducted between
2012 and 2013 in events, meetings, and demonstrations  organized  by  the  two  mentioned  groups  of 
autistic parents, as well as in-depth interviews with
qualified informants (activist parents and relatives).

In this paper we explore how our cultural contexts give rise to di erent kinds of knowledges of autism and examine how they are articulated, gain currency, and form the basis for policy, practice and political movements. We outline key tensions for the development of critical autism studies as an international, critical abilities approach. Our aim is not to o er a cross-cultural account of autism or to assume a coherence or universality of ‘autism’ as a singular diagnostic category/ reality. Rather, we map the ways in which what is experienced and understood as autism, plays out in di erent cultural contexts, drawing on the notion of ‘epistemic communities’ to explore shifts in knowledge about autism, including concepts such as‘neurodiversity’, and how these travel through cultural spaces. The paper explores two key epistemic tensions; the dominance of‘neuro culture’and dominant constructions of personhood and what it means to be human.

Although autism is not a contagious
disease, the term “autism epidemic” is
used in allusion to the dramatic increase in
the number of new cases in only a short
period of time. This paper provides an
overview of the socially shared conceptions
surrounding autism in Brazil, through the
narratives that have given visibility to this
topic in the Brazilian press between 2000
and 2012. We regard these narratives
not as representations of a reality a priori,
but through their function of structuring
human experience. On the one hand,
such narratives shape and give content
to the issues and controversies that
surround autism in Brazil, while on the
other hand, they also actively contribute
to such debates, given that they affect the
meaning that readers place on them.

The paper aims to offer a systematic analysis of some
results from investigations conducted in Argentina
and Brazil relating on the use of methylphenidate, its
prescription and sale’s regulation. We also examined
the discussions among researchers and professionals
assisting individuals diagnosed with ADHD in both
countries. The article integrates two research fields. In
Argentina, newspaper articles, official and professional
organizations’ numeric data, and individual and
group health professionals semi structured interviews
conducted between 2007 and 2011 were analyzed. In
Brazil scientific journals, participant observation and
school teachers and health professionals were analyzed.
Conclusions include that social movements in both
countries have been organized and articulated, in an
attempt to promote discussion on the medicalization of
childhood and its deployment in society.

Desde un análisis crítico de los estudios de la medicalización, y como un aporte a estas perspectivas, describimos y analizamos los modos en que la industria farmacéutica transnacional penetra en diversos espacios sociales, con diferentes estrategias de marketing, interviniendo en la consolidación de procesos medicalizadores en Argentina y Brasil. Se analizan dos modalidades de expansión de los procesos de medicalización, y se desarrollan aspectos y tendencias
específicas del diagnóstico y tratamiento del TDAH en ambos países: la incidencia de la industria farmacéutica en los grupos de apoyo en Brasil y las estrategias de marketing farmacéutico orientadas a actores no médicos en Argentina. Estas dos modalidades se caracterizan por no involucrar sólo al profesional médico. La metodología incluye datos de
investigaciones conducidas en Argentina y Brasil entre 1998 y 2014, con sede en la Universidad de Buenos Aires y la Universidade Estadual do Rio de Janeiro, orientadas al estudio de los procesos de diagnóstico y
tratamiento del TDAH y el consumo de metilfenidato en ambos países. Se emplearon técnicas de entrevista semiestructurada individual y grupal a profesores y profesionales de salud, estadísticas oficiales y de organizaciones profesionales, y revisión de bibliografía general y especializada nacional e internacional. Concluimos que los fenómenos documentados en Argentina y Brasil ponen de relieve la importancia de efectuar investigaciones que contemplen aspectos singulares de los casos empíricos, y sus múltiples vinculaciones con entramados más amplios y en tensión de saberes, dispositivos, normativas y actores involucrados en la medicalización en el siglo XXI.

Medicalización más allá de los médicos: marketing farmacéutico en torno al trastorno por déficit de atención e hiperactividad en Argentina y Brasil (1998-2014) Abstract From a critical analysis of medicalization studies, and as a contribution to these perspectives, we describe and analyze the ways in which the transnational pharmaceutical industry penetrates diverse social spaces, with different marketing strategies, to consolidate medicalized processes in Argentina and Brazil. We analyzed two expansion methods of medicalization processes and specific ADHD diagnostic and treatment aspects and trends were developed in both countries: the impact of the pharmaceutical industry on advocacy groups in Brazil and pharmaceutical marketing strategies aimed at non-medical actors in Argentina. These two methods are characterized by involving other actors than medical professionals. The methodology includes data from research conducted in Argentina and Brazil between 1998 and 2014, based in the University of Buenos Aires and in the State University of Rio de Janeiro, focused on the study of ADHD diagnostic and treatment processes and methylphenidate consumption in both countries. We used individual and group semi-structured interview techniques with professors and health professionals, official and professional organization statistics, and national and international

The article aims to present the outcome of the
investigation of social representations of 20 university
students on the use of methylphenidate to
improve cognitive performance in healthy people.
In this qualitative and exploratory research, 20
university students between 18 and 25 years from
health and humanities courses were divided into
3 focus groups to discuss about Pharmacological
Cognitive Enhancement. Data analysis revealed that
these students had greater tolerance to methods
that alter neurobiology in favor of the social ideal
of improving the performance of people. However,
respondents expressed great concern about this
procedure intensifying injustices and inequalities
between people, especially in societies where there
are already significant social differences. Thus,
although the subject is little studied in Brazil, the
analysis of data from this research suggests that
Pharmacological Cognitive Enhancement is an
important and relevant topic. Not only because this
practice is related to construction and maintenance
of individuals’ subjectivity in a society that prioritizes
the improvement in cognitive performance, but
also because of the risk that this practice interferes
in matters of social justice and equality.

The aim of this paper was to present
ongoing research on the social
representations relating to ritalin in Brazil
between 1998 and 2008. Over this
period, there was a considerable increase
in ritalin usage and expansion of its use
to purposes other than therapeutic use.
Ritalin has been used not only for treating
attention disorders, but also to enhance
cognitive functions in healthy individuals.
The research has developed through
two fields of investigation with different
methodologies. In the first field, Brazilian
scientific and popular publications have
been investigated, with analysis on the
arguments justifying ritalin usage and how
scientific results are disseminated to the lay
public in large-circulation newspapers. In
the second field, focus groups have been
used to explore the social representations
that university students, students’ parents
and healthcare professionals have in
relation to the use of ritalin for enhancing
cognitive performance.

O objetivo do artigo é apresentar
uma pesquisa em andamento sobre as
representações sociais da ritalina no Brasil
entre 1998 e 2008. Nesse período, houve
um incremento considerável do uso da
medicação e sua expansão para outros
fins além dos terapêuticos. A ritalina
tem sido usada tanto para o tratamento
de patologias da atenção como para
melhoria de funções cognitivas em
pessoas saudáveis. A pesquisa se desdobra
em dois campos de investigação, com
metodologias diferenciadas. O primeiro
campo investiga as publicações brasileiras,
científicas e em mídia popular, sobre
a ritalina, analisando os argumentos
que justificam seu uso e a difusão dos
resultados científicos para o público
leigo nos jornais de grande circulação.
O segundo campo de investigação usa a
metodologia de grupos focais para explorar
as representações sociais de universitários,
pais de universitários e profissionais de
saúde, acerca do uso da ritalina para o
aprimoramento do desempenho cognitivo

This paper presents a theoretical analysis on the integration of mental health within primary care from the perspective of the objectives and strategies of Global Mental Health (GMH). This task is divided into two parts. The first part is dedicated to international review studies on the subject and the second deals with Brazilian regulatory and scientific publications about the issue. The international studies corroborate the integration of mental health within primary health care (PHC) as a fundamental strategy for reaching the goals of GMH. In the Brazilian scenario, this topic is important for policies and research within mental health, but the objective of this integration and the ways in which it is put into operation require better definition. We conclude by pointing out some obstacles that prevent PHC from occupying a strategic role regarding mental health actions within the Brazilian National Health System (SUS).

Biological Psychiatry emerged in the 1980s in the
United States with the publication of DSM-III
(Diagnostic and Statistical Manual of Mental Disorders).
This manual intends to be a-theoretical and to provide
objective descriptions of "mental disorders" by using
diagnostic criteria that do not include discussions about
the aetiology of these "disorders". Hence and despite the
“biological” label conferred to this branch of psychiatry,
there is no explicit concern to ascertain the possible
biological origins of "mental disorders" in DSM-III. In
this paper we intend to examine the modifications in
North American Psychiatry following the introduction
of the first psychotropic medications and the subsequent
role played by the pharmaceutical industry in this
process. Thus, what is under analysis in our article is
that, by appropriating psychotropic drugs as the first
therapeutic option, Biological Psychiatry creates an
alliance with the pharmaceutical industry that inserts
it into a technoscientific network that makes it difficult
to know the limits between Biological Psychiatry,
Psychopharmacology and the Pharmaceutical industry.

The term medicalization in the studies
by Illich and Foucault was analyzed,
in order to provide conceptual tools
for studying movements that contest
medicalization. Illich addressed
hypertrophy of medicalization in modern
life by emphasizing the effect of reductions
of subjects’ autonomy, especially through
the fact that medical institutions take
on the responsibility of treating pain,
thus turning its intimate and personal
meaning into a technical problem. Foucault
approaches medicalization from the notion
of biopower, and in examining the concept
of governmentality, he made it possible
to analyze individuals’ ways of resisting
the wielding of that power. Both works
were concerned with proposing forms of
exercising freedom, although Foucault
did this in a more detailed and diversified
manner. They both seem appropriate
for reflecting on the current process of
demedicalization or situations in which the
medical diagnosis is rejected by the patient
or members of his family.
Analisa-se o termo medicalização nos
estudos de Illich e Foucault, com vistas a
oferecer ferramentas conceituais para o
estudo dos movimentos contestatórios à
medicalização. Illich aborda a hipertrofia
da medicalização na modernidade,
ressaltando o efeito de redução da
autonomia dos sujeitos, sobretudo pelo
fato de as instituições médicas assumirem
a responsabilidade de cuidar da dor,
transformando seu significado íntimo e
pessoal em um problema técnico. Foucault
aborda a medicalização a partir da noção
de biopoder, e, quando trabalha a noção
de governamentalidade, abre espaço para
a análise das formas de resistência dos
indivíduos ao exercício do poder. Ambos
os trabalhos, que têm como preocupação
propor formas de exercício da liberdade
– apesar de Foucault o fazer de forma
mais detalhada e diversificada – parecem
apropriados para se pensar o processo
atual de desmedicalização ou recusa do
diagnóstico médico por parte de seus
portadores ou familiares.

Um panorama sobre as variações em torno do conceito de medicalização entre 1950-2010 An overview of the variations surrounding the concept of medicalization between 1950 and 2010 Resumo Este artigo analisa a pertinência do con-ceito de medicalização, para a análise sóciocultu-ral, partindo de críticas na literatura internacio-nal surgidas na década de 2000. Essas críticas apon-tam a excessiva generalidade do termo, que pas-sou a abranger situações diversas, perdendo parte de sua acurácia analítica. Analisaremos alguns dos sentidos possíveis do termo medicalização, tais como: 1) as estratégias massivas de sanitarização da população; 2) a transformação de comporta-mentos considerados desviantes em doenças; 3) a ação do controle e imperialismo médico; 4) a par-ticipação de atores fora do campo da medicina. A partir desses diferentes usos, apontaremos a ne-cessidade de uma transitividade do conceito, ou seja, que se especifiquem os sentidos que são a ele atribuídos por ocasião de sua utilização – do con-trário, haveria uma perda de precisão teórica que retiraria do conceito sua possível utilidade para a análise social. Abstract This article examines the pertinence of the concept of medicalization for socio-cultural analysis. The study is based on the criticism which emerged in the international literature between 2000 and 2010. The criticism stressed the excessive generality of the expression that encompasses different situations and thereby loses its analytical precision. The main meanings of the term medicalization are examined, namely 1) the major strategies of hygienization of the population; 2) the transformation of behavior considered deviant into disorders; 3) control strategies and the medical imperative; 4) the participation of non-medical actors. Based on the different meanings of the notion of medicalization, the transient nature of the concept needs to be stressed, i.e. the need to specify the different meanings attributed to the notion depending on the different contexts in which it is used. If this is not done, the concept will lose its theoretical accuracy and will possibly no longer be useful for social analysis.

In psychiatry, the possibilities of intervention in the risk for development of mental disorders are now receiving greater attention, motivating researches and causing controversies. Among the several investigations about risk and psychiatric categories that have been conducted in the international scenario, proposals intended to previously detect and intervene in the development of psychosis stand out. Programs for early detection of psychosis have two objectives: to reach patients living the first psychotic break and patients considered to be at risk mental state. Despite the controversy about the at risk mental state, with the preparation of a new version of the DSM, the possibility of creating a specific category that could identify the risk for psychosis was pondered. This article analyzed the path of the early intervention in psychosis, starting with the emergence of the actions within the context of clinical enhancement in the first break, going through the controversial systematization of the notion of at risk mental state, finally coming to the formalization of the proposal of a new diagnostic category during the preparation of the DSM-5. RESUMO. No campo psiquiátrico, as possibilidades de prevenir o risco de desenvolver transtornos mentais começam a reunir interesse, motivar pesquisas e provocar controvérsias. Entre as diversas investigações sobre risco e categorias psiquiátricas que vêm sendo conduzidas no cenário internacional destacam-se as propostas destinadas a detectar e intervir precocemente no desenvolvimento da psicose. Os programas de detecção precoce da psicose têm como objetivo atingir duas categorias de pacientes: os que vivem o primeiro surto psicótico e aqueles considerados em estado mental de risco ou pré-psicóticos. Apesar da controvérsia em torno do estado mental de risco, com a elaboração de uma nova versão do DSM aventou-se a possibilidade de criar uma categoria específica que identificasse o risco para a psicose. Neste artigo analisamos as propostas de intervenção precoce na psicose de estratégia clínica dividindo essa análise em três etapas: 1-a do surgimento das ações no contexto de refinamento da clínica do primeiro surto; 2-a da sistematização controversa da noção de estado mental de risco; 3-a da formalização da proposta de nova categoria diagnóstica durante a elaboração do DMS-5.. Palavras-chave: Intervenção precoce; psicose; psiquiatria. INTERVENCIÓN TEMPRANA EN LA PSICOSIS: DE LA ESTRATEGIA CLÍNICA A UNA POSIBLE CATEGORÍA DIAGNÓSTICA RESUMEN. En el campo de la psiquiatría, las posibilidades de intervención sobre el riesgo de desarrollar trastornos mentales comienzan a provocar interés, motivar la investigación y causar controversias. Entre las muchas investigaciones sobre riesgo y categorías psiquiátricas que se han realizado a nivel internacional, se destacan las propuestas para detectar e intervenir tempranamente en el desarrollo de la psicosis. Los programas para la detección temprana de la psicosis tienen doble objetivo: llegar a los pacientes que viven el primer episodio psicótico y a los pacientes considerados en el estado mental de riesgo o pre-psicóticos. A pesar de la

Paralelos entre a produção científica sobre saúde mental no Brasil e no campo da Saúde Mental Global: uma revisão integrativa Parallels between research in mental health in Brazil and in the field of Global Mental Health: an integrative literature review Paralelismos entre la producción científica sobre salud mental en Brasil y el campo de la Salud Mental Global: una revisión integradora Resumo A Saúde Mental Global é um campo de ensino, pesquisa e prática, cuja priori-dade é melhorar o acesso e assegurar a equidade no cuidado em saúde mental para todas as pessoas do mundo, propondo ações especialmente em países de média e baixa renda, como o Brasil. Diante desse panorama mundial e con-siderando o avanço local dos processos das reformas sanitária e psiquiátrica, torna-se importante investigar o estado atual da literatura brasileira e sua relação com a Saúde Mental Global, descrevendo como a produção nacional aborda assuntos enfatizados nesse campo. Assim, adotando abordagem quali-tativa e perspectiva descritiva, foi realizada revisão integrativa da literatura do período de 2014-2015, por meio de pesquisa bibliográfica em português e inglês, utilizando os termos saúde mental e Brasil combinados a palavras-chave correspondentes aos principais tópicos discutidos por autores da Saúde Mental Global. Foram encontrados 88 artigos apreciados segundo sua auto-ria, periódicos e regiões de publicação, metodologia e de acordo com as catego-rias de análise e acesso; atenção primária; atenção psicossocial; determinantes sociais da saúde; direitos humanos; e equidade. Constatou-se haver na pro-dução científica nacional um conjunto de estudos muito rico e diversificado com paralelos com a literatura da Saúde Mental Global, mas apresenta um baixo índice de sistematização. Esses achados revelam, portanto, que, apesar dos esforços para a geração de conhecimento local, existem barreiras que, pos-sivelmente, comprometem a participação brasileira no debate internacional. Este é um artigo publicado em acesso aberto (Open Access) sob a licença Creative Commons Attribution, que permite uso, distribuição e reprodu-ção em qualquer meio, sem restrições, desde que o trabalho original seja corretamente citado.

Resumen El trabajo tiene como objetivo ofrecer un análisis sistemático de algunos resultados de investigaciones realizadas en Argentina y Brasil relacionadas con el uso del metilfenidato, su prescripción y la regulación de la venta. También examinamos las discusiones entre investigadores y profesionales que asisten a personas diagnosticadas con TDAH en ambos países. El artículo integra dos campos de investigación. En Argentina se analizaron artículos de prensa, datos numéricos de organizaciones oficiales y profesionales y entrevistas semiestructuradas de profesionales de salud individuales y grupales realizadas entre 2007 y 2011. En Brasil se analizaron las revistas científicas, la observación participante y los profesores de las escuelas y los profesionales de la salud. Las conclusiones incluyen que los movimientos sociales en ambos países se han organizado y articulado, en un intento de promover el debate sobre la medicalización de la infancia y su despliegue en la sociedad.
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El trabajo tiene como objetivo ofrecer un análisis sistemático de algunos resultados de investigaciones realizadas en Argentina y Brasil relacionadas con el uso del metilfenidato, su prescripción y la regulación de la venta. También examinamos las discusiones entre investigadores y profesionales que asisten a personas diagnosticadas
con TDAH en ambos países. El artículo integra dos campos de investigación. En Argentina se analizaron artículos de prensa, datos numéricos de organizaciones oficiales y profesionales y entrevistas semiestructuradas de profesionales de salud individuales y grupales realizadas entre 2007 y 2011. En Brasil se analizaron las revistas
científicas, la observación participante y los profesores de las escuelas y los profesionales de la salud. Las conclusiones incluyen que los movimientos sociales en ambos países se han organizado y articulado, en un intento de promover el debate sobre la medicalización

Attention deficit−hyperactivity disorder (ADHD) has been a common psychiatric diagnosis in both children and adults since the 1980s and 1990s in the United States. But the diagnosis was much less common—even unknown—in other parts of the world. By the end of the twentieth century, this was no longer the case, and ADHD diagnosis and treatment became an increasingly widespread global phenomenon. As the diagnosis was adopted around the world, the definition and treatment of ADHD often changed in the context of different psychiatric professions, medical systems, and cultures.
Global Perspectives on ADHD is the first book to examine how this expanding public health concern is diagnosed and treated in 16 different countries. In some countries, readers learn, over 10% of school-aged children and adolescents are diagnosed with ADHD; in others, that figure is less than 1%. Some countries focus on medicating children with ADHD; others emphasize parent intervention or child therapy. Showing how a medical diagnosis varies across contexts and time periods, this book explains how those distinctions shape medical interventions and guidelines, filling a much-needed gap by examining ADHD on an international scale.

ORTEGA, F. J. G.; ZORZANELLI, RAFAELA TEIXEIRA ; GONÇALVES, VALÉRIA PORTUGAL . Academic and Professional Tensions and Debates around ADHD in Brazil.In: Meredith R. Bergey; Angela M. Filipe; Peter Conrad; Ilina Singh. (Org.). Global Perspectives on ADHD: Social Dimensions of Diagnosis and Treatment in Sixteen Countries. 1ed.Baltimore: Johns Hopkins University Press, 2017, v. , p. 306-329.

The conceptual and practical work done by social medicine and global
health have often overlapped. In this paper, we argue that new efforts
to apprehend ‘the social’ in social medicine offer important insights to
global health along five lines of critical analysis: (1) reconfigurations of
the state and new forms of political activism, (2) philanthrocapitalism
and the economisation of life, (3) The economy of attention, (4)
anthropogenic climate change, and (5) the geopolitics of North and South.