Desafios estratégicos para a Marinha do Brasil na área de saúde mental: foco na psiquiatria operativa: uma proposta de diretrizes para a saúde mental operativa

Abstract

This monograph has the purpose of reviewing the history and the evolution of military psychiatry since the beginning of the first structured reports of neuropsychiatric disturbances in individuals exposed to combat stress until the present day, reinforcing its relevance and to propose directions to the operational psychiatry sector of the Brazilian Navy in terms of cooptation, recruitment, development and maintenance of human resources in this strategic area. The historical evolution of the de phenomenological descriptions since World War I and its posterior development towards the current diagnostic categories now on use, that reflects the appraisal of the epidemiological relevance of the mental disorders related to the exposure to combat stress and other operational stressors supports the assumption that the recent findings in the field of behavioral neurosciences applied to the study of trauma-related stress turns it in one of the most interesting fields of current scientific research, furthermore, the usefulness of the recently published findings goes beyond the traditional view of the military mental health only in terms of assistance and evaluation of work capacity and readiness. Behavioral neurosciences brings potential utility to the selection, training of warfighters, using methods of cognitive psychology, genetics, structural and functional neuroimaging, as well as potential biomarkers of stress vulnerability. These advances will be useful in pre-deployment prevention, early diagnosis end rehabilitation of warfighters experiencing stress related disorders. The abilities necessary to the psychiatrists who wishes to work in this main strategic area for the multiple and highly heterogeneous missions of the Brazilian Navy are reviewed, and the motivational factors linked to personal development in this unique scientific field discussed, as a singular opportunity to mental health professionals interested in personal and scientific growing, with some features that allow immediate practical applications of cutting edge knowledge, as well as promising future perspectives.