Importance: The worldwide scarcity of psychiatrists makes the identification of the factors associated with the intention to choose this specialty an important issue. Psychiatrists are the doctors with the lowest rates of religious affiliation. However, whether religious affiliation is a factor associated with choosing this specialty has not been studied. Objective: To evaluate the relationship between religious affiliation and the intention to choose psychiatry as a specialty among medical students in 11 Latin American countries. Design, setting and participants: A cross-sectional, multi-sited study that included 8308 first- and fifth-year students at 63 medical schools in 11 Latin American countries between 2011 and 2012. Main outcome and measures: Intention to pursue psychiatry as a specialty over other specialties (yes/no); religious affiliation (without: atheist/agnostic; with: any religion). Results: A total of 53.6% of the participants were women, and the average age was 20.4 (s.d. 2.9) years. A total of 36% were fifth-year students, and11.8% were not affiliated with any religion. Only 2.6% had the intention to choose psychiatry, whereby the highest percentage was among students in Chile (8.1%) and the lowest among students in Mexico (1.1%). It was found that those who had no religious affiliation had a higher probability of reporting the intention to become a psychiatrist [OR: 2.92 (95%CI: 2.14-4.00)] after adjusting for demographic, family, academic as well as personal and professional projection variables. Conclusions and relevance: There is a strong connection between not having a religious affiliation and the intention to be a psychiatrist. According to this logic, interventions could be implemented to incentivize those students who practice a religion to become mental-health professionals as well as other interventions to increase the probability that those who are not affiliated with a religion choose the specialty. However, the possible factors that influence this phenomenon must be evaluated in greater depth, ideally through longitudinal research. / Objetivo: Evaluar la asociación entre la afiliación religiosa y la intención de optar por la especialidad de psiquiatría en estudiantes de medicina de 11 países de Latinoamérica. Diseño, parámetros y participantes: Estudio de corte transversal, multicéntrico que incluyó a 8308 estudiantes de primer y quinto año de 63 escuelas de medicina de 11 países latinoamericanos entre 2011 y 2012. Outcome principal y medidas: Intención de hacer la especialidad de psiquiatría frente a otras especialidades (sí/no); afiliación religiosa (sin: ateo/agnóstico; con: participe de cualquier religión). Resultados: El 53.6% de los participantes eran mujeres y su media de edad fue 20.4 (s.d. 2.9) años. El 36% fueron estudiantes de quinto año. El 11.8% no estaban afiliados a ninguna religión. La intención de ser psiquiatra fue de 2.6%, siendo mayor en estudiantes de Chile (8,1%) y menor en México (1,1%). Se encontró que quienes no estaban afiliados a alguna religión tenían más probabilidad de haber reportado tener intención de ser psiquiatra [OR:2.92 (IC95%:2.14-4.00)], ajustado por variables demográficas, familiares, académicas y de perspectivas profesionales y personales. Conclusiones y Relevancia: Existe una fuerte asociación entre no tener una afiliación religiosa y la intención de ser psiquiatra. Bajo esta lógica, se podrían implementar intervenciones para incentivar a los estudiantes que profesan una religión a convertirse en profesionales de salud mental, así como otras para aumentar aún más la probabilidad de que los no afiliados a ninguna religión opten por la especialidad. Sin embargo, se debe evaluar más a profundidad los posibles factores que influyen en este fenómeno, idealmente a través de estudios longitudinales.

Trata-se de uma pesquisa teórica que verifica as relações existentes entre saúde mental e saúde pública a partir da identificação dos principais problemas referentes à infância em recomendações divulgadas pela Organização Mundial da Saúde nos seguintes momentos históricos: início da década de 1950, meados da década de 1970 e primeiros anos do século XXI. Apresenta a diversidade presente na construção do campo da saúde mental, as principais perspectivas teóricas e o lugar da clínica psiquiátrica e psicanalítica nesse processo. Ações dirigidas à infância pelo movimento da Higiene Mental, nas primeiras décadas do século XX, também são analisadas. Verifica-se que a prevenção se instaura como principal modelo de assistência. A saúde materno-infantil, a escola e a família são os principais componentes das medidas preventivas propostas. Nestas recomendações, evidencia-se uma relação de quase equivalência entre psiquiatria e saúde mental. A diversidade deste campo é substituída por um discurso relativamente hegemônico, no qual a noção de adaptação ocupa lugar central. Nas recomendações da OMS, deste início de século, observa-se a influência das neurociências, da psiquiatria biológica e das terapias cognitivo-comportamentais. / This is a theoretical research aiming at detecting the main problems concerning children on the intersection of mental and public health, and based upon the World Health Organization’s commendations at the following historical moments: the 1950s and 1970s, as well as the early 21st century. The foundations of such commendations were checked, keeping in mind the diversity of orientations in the field of mental health. The theoretical frame presents the origins of psychiatric and psychoanalytical clinics with children, and their fundamentals. Actions aiming at children by the Mental Hygiene Movement in the early 20th century were also analyzed. It can be observed that prevention imposes itself as the main assistance pattern. The health of both mothers and children, schools and families are the main components of the proposed prevention measures. In these commendations it can also be noticed an almost equivalent relationship between psychiatrist and mental health. Diversity in this field is substituted for a relatively hegemonic speech, in which the notion of adaptation plays a crucial role. In the World Health Organization’s commendations in this early century, it can be detected the influence of neurosciences, biological psychiatry, and behaviorist-cognitive therapies.

Trata-se de uma pesquisa teórica que verifica as relações existentes entre saúde mental e saúde pública a partir da identificação dos principais problemas referentes à infância em recomendações divulgadas pela Organização Mundial da Saúde nos seguintes momentos históricos: início da década de 1950, meados da década de 1970 e primeiros anos do século XXI. Apresenta a diversidade presente na construção do campo da saúde mental, as principais perspectivas teóricas e o lugar da clínica psiquiátrica e psicanalítica nesse processo. Ações dirigidas à infância pelo movimento da Higiene Mental, nas primeiras décadas do século XX, também são analisadas. Verifica-se que a prevenção se instaura como principal modelo de assistência. A saúde materno-infantil, a escola e a família são os principais componentes das medidas preventivas propostas. Nestas recomendações, evidencia-se uma relação de quase equivalência entre psiquiatria e saúde mental. A diversidade deste campo é substituída por um discurso relativamente hegemônico, no qual a noção de adaptação ocupa lugar central. Nas recomendações da OMS, deste início de século, observa-se a influência das neurociências, da psiquiatria biológica e das terapias cognitivo-comportamentais. / This is a theoretical research aiming at detecting the main problems concerning children on the intersection of mental and public health, and based upon the World Health Organization’s commendations at the following historical moments: the 1950s and 1970s, as well as the early 21st century. The foundations of such commendations were checked, keeping in mind the diversity of orientations in the field of mental health. The theoretical frame presents the origins of psychiatric and psychoanalytical clinics with children, and their fundamentals. Actions aiming at children by the Mental Hygiene Movement in the early 20th century were also analyzed. It can be observed that prevention imposes itself as the main assistance pattern. The health of both mothers and children, schools and families are the main components of the proposed prevention measures. In these commendations it can also be noticed an almost equivalent relationship between psychiatrist and mental health. Diversity in this field is substituted for a relatively hegemonic speech, in which the notion of adaptation plays a crucial role. In the World Health Organization’s commendations in this early century, it can be detected the influence of neurosciences, biological psychiatry, and behaviorist-cognitive therapies.