Psiquiatria e conflito global: uma revisão dos impactos psicológicos relacionados à guerra, dilemas éticos e direções futuras
DOI:
https://doi.org/10.25118/2763-9037.2025.v15.1473Palavras-chave:
psiquiatria e guerra, guerra psicológica, dinâmica de conflito global, saúde mental na guerra, psicologia e terceira guerra mundial, terceira guerra mundialResumo
A intrincada relação entre psiquiatria e conflitos globais continua sendo uma área de estudo pouco explorada, porém crítica, particularmente no contexto de uma potencial Terceira Guerra Mundial. Esta revisão bibliográfica investiga as raízes psicológicas dos conflitos, examinando como as psicopatologias individuais e coletivas contribuem para a dinâmica e a escalada da guerra. Destaca os dilemas éticos enfrentados por profissionais de saúde mental ao equilibrar responsabilidades clínicas com influências geopolíticas, incluindo o uso do conhecimento psiquiátrico na guerra psicológica. A revisão também explora as implicações para a saúde mental de tensões globais prolongadas e avanços tecnológicos, como o aumento da guerra cibernética e seu impacto psicológico nas populações. Enfatizando o papel da psiquiatria na promoção da paz, este trabalho propõe estratégias inovadoras para alavancar intervenções de saúde mental a fim de mitigar conflitos e promover a resiliência em sociedades que enfrentam ameaças existenciais. Os resultados ressaltam o potencial da psiquiatria para desempenhar um papel transformador na prevenção e no gerenciamento das dimensões psicológicas de futuros conflitos globais.
Downloads
Métricas
Referências
1. Kloocke R, Schmiedebach HP, Priebe S. Psychological injury in the two World Wars: changing concepts and terms in German psychiatry. Hist Psychiatry.2005;16(61 Pt 1):43-60. https://doi.org/10.1177/0957154X05044600 PMid:15981365 DOI: https://doi.org/10.1177/0957154X05044600
2. Freis, D. Central European Psychiatry: World War I and the Interwar Period. Oxford Research Encyclopedia of Psychol. 2021. https://doi.org/10.1093/acrefore/9780190236557.013.836 DOI: https://doi.org/10.1093/acrefore/9780190236557.013.836
3. Kurapov A, Kalaitzaki A, Keller V, Danyliuk I, Kowatsch T. The mental health impact of the ongoing Russian-Ukrainian war 6 months after the Russian invasion of Ukraine. Front Psychiatry. 2023; 14:1134780. https://doi.org/10.3389/fpsyt.2023.1134780 PMid:37575573 PMCid:PMC10412819 DOI: https://doi.org/10.3389/fpsyt.2023.1134780
4. Abudayya A, Bruaset GTF, Nyhus HB, Aburukba R, Tofthagen R. Consequences of war-related traumatic stress among Palestinian young people in the Gaza Strip: A scoping review. Ment Health Prev. 2023; 32: 200305. https://doi.org/10.1016/j.mhp.2023.200305 DOI: https://doi.org/10.1016/j.mhp.2023.200305
5. McFarlane AC. The impact of war on mental health: lest we forget. World Psychiatry. 2015;14(3):351-3. https://doi.org/10.1002/wps.20253 PMid:26407792 PMCid:PMC4592659 DOI: https://doi.org/10.1002/wps.20253
6. Krueger KL, Diabes MA, Weingart LR. The psychological experience of intragroup conflict. Res Organ Behav. 2022; 42:100165. https://doi.org/10.1016/j.riob.2022.100165 DOI: https://doi.org/10.1016/j.riob.2022.100165
7. Govrin A. The Cognition of Severe Moral Failure: a Novel Approach to the Perception of Evil. Front Psychol. 2018;9:1-9. https://doi.org/10.3389/fpsyg.2018.00557 PMid:29731732 PMCid:PMC5920199 DOI: https://doi.org/10.3389/fpsyg.2018.00557
8. Gebert D, Heinitz K, Buengeler C. Leaders' charismatic leadership and followers' commitment: the moderating dynamics of value erosion at the societal level. Leadersh Q. 2016;27(1):98-108. https://doi.org/10.1016/j.leaqua.2015.08.006 DOI: https://doi.org/10.1016/j.leaqua.2015.08.006
9. Roche P, Shimmin C, Hickes S, Khan M, Sherzoi O, Wicklund E, Lavoie JG, Hardie S, Wittmeier KDM, Sibley KM. Valuing All Voices: refining a trauma-informed, intersectional and critical reflexive framework for patient engagement in health research using a qualitative descriptive approach. Res Involv Engagem. 2020;6:1-13. https://doi.org/10.1186/s40900-020-00217-2 PMid:32699647 PMCid:PMC7370500 DOI: https://doi.org/10.1186/s40900-020-00217-2
10. Mawson AR. Understanding mass panic and other collective responses to threat and disaster. Psychiatry. 2005;68(2):95-113. https://doi.org/10.1521/psyc.2005.68.2.95 PMid:16247853 DOI: https://doi.org/10.1521/psyc.2005.68.2.95
11. Mejia CR, Alvarez-Risco A, Chamorro-Espinoza S, Castillón-Lozano JA, Paucar MC, Padilla-F VJ, Armada J, Vilela-Estrada MA, Serna-Alarcón V, Del-Aguila-Arcentales S, Yáñez JA. Crisis due to war: anxiety, depression and stress in the population of 13 Latin American countries. Front Psychiatry. 2023;14:1218298. https://doi.org/10.3389/fpsyt.2023.1218298 PMid:37547209 PMCid:PMC10398955 DOI: https://doi.org/10.3389/fpsyt.2023.1218298
12. Wirkner J, Brakemeier E. The crisis is over, long live the crisis: mental health in emerging adulthood during the course of the COVID-19 pandemic. Front Psychol. 2024;15:1283919. https://doi.org/10.3389/fpsyg.2024.1283919 PMid:38356763 PMCid:PMC10864646 DOI: https://doi.org/10.3389/fpsyg.2024.1283919
13. Coulombe S, Pacheco T, Cox E, Khalil C, Doucerain MM, Auger E, Meunier S. Risk and Resilience Factors During the COVID-19 Pandemic: A Snapshot of the Experiences of Canadian Workers Early on in the Crisis. Front Psychol. 2020;11:580702. https://doi.org/10.3389/fpsyg.2020.580702 PMid:33343455 PMCid:PMC7744587 DOI: https://doi.org/10.3389/fpsyg.2020.580702
14. Sharma M, Alemayehu M, Girma E, Milkias B, Stevenson A, Gelaye B, Koenen KC, Teferra S. The cumulative impact of trauma, chronic illness, and COVID-19 stress on mental health in a case-control study of adults with psychotic disorders in Ethiopia. Compr Psychiatry. 2024;134:152508. https://doi.org/10.1016/j.comppsych.2024.152508 PMid:38917710 DOI: https://doi.org/10.1016/j.comppsych.2024.152508
15. Schwarzer R. Stress, resilience, and coping resources in the context of war, terror, and migration. Curr Res Behav Sci. 2024; 57: 101393. https://doi.org/10.1016/j.cobeha.2024.101393 DOI: https://doi.org/10.1016/j.cobeha.2024.101393
16. Sukiasyan S. The Mental Health of Refugees and Forcibly Displaced People: a narrative review. Consort Psychiatr. 2024;5(4):78-92. https://doi.org/10.17816/CP15552 PMid:39980620 PMCid:PMC11839216 DOI: https://doi.org/10.17816/CP15552
17. Stoffel JM, Cain J. Review of Grit and Resilience Literature within Health Professions Education. Am J Pharm Educ. 2018;82(2):6150. https://doi.org/10.5688/ajpe6150 PMid:29606705 PMCid:PMC5869747 DOI: https://doi.org/10.5688/ajpe6150
18. Moore MJ, Shawler E, Jordan CH, Jackson CA. Veteran and military mental health issues [Internet]. StatPearls; 2023. https://www.ncbi.nlm.nih.gov/books/NBK572092/
19. World Health Organization. Infodemics and misinformation negatively affect people's health behaviours, new WHO review finds [Internet]. Geneve: WHO; 2022 Sep 1. https://www.who.int/europe/news-room/01-09-2022-infodemics-and-misinformation-negatively-affect-people-s-health-behaviours--new-who-review-finds
20. Jahn FS, Skovbye M, Obenhausen K, Jespersen AE, Miskowiak KW. Cognitive training with fully immersive virtual reality in patients with neurological and psychiatric disorders: A systematic review of randomized controlled trials. Psychiatry Res. 2021;300:113928. https://doi.org/10.1016/j.psychres.2021.113928 PMid:33857847 DOI: https://doi.org/10.1016/j.psychres.2021.113928
21. Cohen TR, Insko CA. War and Peace: Possible Approaches to Reducing Intergroup Conflict. Perspect Psychol Sci. 2008;3(2):87-93. https://doi.org/10.1111/j.1745-6916.2008.00066.x PMid:26158875 DOI: https://doi.org/10.1111/j.1745-6916.2008.00066.x
22. González I, Moyano M, Lobato RM, Trujillo HM. Evidence of Psychological Manipulation in the Process of Violent Radicalization: An Investigation of the 17-A Cell. Front Psychiatry. 2022;13:789051. https://doi.org/10.3389/fpsyt.2022.789051 PMid:35280161 PMCid:PMC8905186 DOI: https://doi.org/10.3389/fpsyt.2022.789051
23. Barman D, Guo Z, Conlan O. The Dark Side of Language Models: Exploring the potential of LLMs in multimedia disinformation generation and dissemination. Mach Learn Appl. 2024;16: 100545. https://doi.org/10.1016/j.mlwa.2024.100545 DOI: https://doi.org/10.1016/j.mlwa.2024.100545
24. Arincorayan D, Applewhite L, Almeida V, DiJoseph E, Romero C. The psychosocial challenges of conducting counterinsurgency operations. US Army Med Dep J. 2014 Oct-Dec:14-21. PMID: 25830794.
25. Hoffman DH, Carter DJ, Lopez CRV, Benzmiller HL, Guo AX, Latifi SY, Craig DC. Independent review relating to APA ethics guidelines, national security interrogations, and torture: Final report of the Independent Reviewer. Chicago: Sidley Austin LLP; 2015 Jul 2. https://www.psychiatry.org/File%20Library/About-APA/Meet-Our-Organization/DB-SA/scope/Hoffman-APA-Report.pdf
26. Warner CH, Appenzeller GN, Grieger TA, Benedek DM, Roberts LW. Ethical considerations in military psychiatry. Psychiatr Clin North Am. 2009;32(2):271-81. https://doi.org/10.1016/j.psc.2009.02.006 PMid:19486813 DOI: https://doi.org/10.1016/j.psc.2009.02.006
27. Samochowiec J, Frydecka D, Skonieczna-Żydecka K, Schouler-Ocak M, Carpinello B, Chkonia E, Dom G, Falkai P, Misiak B, Pinto da Costa M, Wise J, de Picker L, Vahip S, Wasserman D, Galderisi S, Bieńkowski P. Ethical dilemmas in contemporary psychiatry: Findings from a survey of National Psychiatric Associations in Europe. Eur Psychiatry. 2023;66(1):e94. https://doi.org/10.1192/j.eurpsy.2023.2470 PMid:37909413 PMCid:PMC10755573 DOI: https://doi.org/10.1192/j.eurpsy.2023.2470
28. Quinn M, Dickinson S, Shukla S. Training Military Psychiatrists to Adapt and Overcome: How COVID-19 Highlighted the Unique Flexibility of Military Psychiatry in Training and in the Fleet. Curr Psychiatry Rep. 2022;24(8):369-374. https://doi.org/10.1007/s11920-022-01342-3 PMid:35699916 PMCid:PMC9192931 DOI: https://doi.org/10.1007/s11920-022-01342-3
29. Yang S, Schneider B, Wynn GH, Howe E3rd. Ethical Considerations in the Treatment of PTSD in Military Populations. Focus. 2017;15(4):435-440. https://doi.org/10.1176/appi.focus.20170035 PMid:31975876 PMCid:PMC6519518 DOI: https://doi.org/10.1176/appi.focus.20170035
30. Kosenko O, Steger F. Politicization of psychiatry and the improvement of ethical standards in the 1970s. Front Psychiatry. 2023;14:1151048. https://doi.org/10.3389/fpsyt.2023.1151048 PMid:37351001 PMCid:PMC10282144 DOI: https://doi.org/10.3389/fpsyt.2023.1151048
31. Keepers GA, Fochtmann LJ, Anzia JM, Benjamin S, Lyness JM, Mojtabai R, Servis M, Walaszek A, Buckley P, Lenzenweger MF, Young AS, Degenhardt A, Hong SH. The American Psychiatric Association Practice Guideline for the Treatment of Patients With Schizophrenia. Am J Psychiatry. 2020;177(9):868-872. https://doi.org/10.1176/appi.ajp.2020.177901 PMid:32867516 DOI: https://doi.org/10.1176/appi.ajp.2020.177901
32. Alavi S. The evolution of cyber conflicts and its impact on international security: a comprehensive analysis [Master's thesis Internet]. Pádua: Università degli Studi di Padova; 2024. https://thesis.unipd.it/retrieve/9ecfb519-e683-4fb6-8a26-a8d1d129bc21/Thesis-SeyedhamidrezaAlavi.pdf
33. Marukhovskа-Kartunova O, Marukhovskyi O, Aleksandrova M, Ivanova I, Lebedenko N. Digital journalism and the role of social media in shaping public perception of Russian aggression in Ukraine. Rev Amazon Investig. 2023;12(69):143-153. https://doi.org/10.34069/ai/2023.69.09.12 DOI: https://doi.org/10.34069/AI/2023.69.09.12
34. Alonso-Martín-Romo L, Oliveros-Mediavilla M, Vaquerizo-Domínguez E. Perception and opinion of the Ukrainian population regarding information manipulation: a field study on disinformation in the Ukrainian war. Prof Inf. 2023;32(4)1-13. https://doi.org/10.3145/epi.2023.jul.05 DOI: https://doi.org/10.3145/epi.2023.jul.05
35. Valeriano B, Jensen BM, Maness RC. Cyberattacks, psychological distress, and military escalation: an internal meta-analysis. Journal of Global Security Studies. 2023;8(1):1-19. https://doi.org/10.1093/jogss/ogac042 DOI: https://doi.org/10.1093/jogss/ogac042
36. Danyk Y, Briggs C. Modern Cognitive Operations and Hybrid Warfare. Journal of Strategic Security. 2023;16(1):35-50. https://doi.org/10.5038/1944-0472.16.1.2032 DOI: https://doi.org/10.5038/1944-0472.16.1.2032
37. Mazepus H, Osmundsen M, Bang Petersen M, Toshkov D, Dimitrova A. Information battleground: Conflict perceptions motivate the belief in and sharing of misinformation about the adversary. PloS one. 2023; 18(3): e0282308. https://doi.org/10.1371/journal.pone.0282308 PMid:36947501 PMCid:PMC10032542 DOI: https://doi.org/10.1371/journal.pone.0282308
38. Baggiarini B. Algorithmic war and the dangers of in-visibility, anonymity, and fragmentation. Australian Journal of International Affairs. 2024;78(2): 257-65. https://doi.org/10.1080/10357718.2024.2333824 DOI: https://doi.org/10.1080/10357718.2024.2333824
39. Austin B, Fischer M. Transforming war-related identities individual and social approaches to healing and dealing with the past. Berlin: Berghof Foundation; 2016.
40. Judt, T. Postwar: A history of Europe since 1945. Londres: Penguin Books; 2005.
41. Hughes J, Kostovicova D. Introduction: rethinking reconciliation and transitional justice after conflict. Ethn Racial Stud. 2018;41(4): 617-23. https://doi.org/10.1080/01419870.2017.1406129 DOI: https://doi.org/10.1080/01419870.2017.1406129
42. O'Connor C, Chatwin C. The role of technology in post-conflict reconstruction. J Peacebuilding & Development. 2021;16(2):217-32. https://doi.org/10.1177/15423166211012345
43. Rawat A, Witt E, Roumyeh M, Lill I. Advanced Digital Technologies in the Post-Disaster Reconstruction Process: A Review Leveraging Small Language Models. Buildings. 2024;14(11):3367. https://doi.org/10.3390/buildings14113367 DOI: https://doi.org/10.3390/buildings14113367
44. Betancourt TS, Khan KT. The mental health of children affected by armed conflict: Protective processes and pathways to resilience. Int Rev Psychiatry. 2008;20(3):317-28. https://doi.org/10.1080/09540260802090363 PMid:18569183 PMCid:PMC2613765 DOI: https://doi.org/10.1080/09540260802090363
45. Carpiniello B. Psychopathological consequences of war and armed conflicts. Eur Psychiatry. 2023;66(Suppl 1):S49. https://doi.org/10.1192/j.eurpsy.2023.178 PMCid:PMC10417663 DOI: https://doi.org/10.1192/j.eurpsy.2023.179
46. Graham KR. British subversive propaganda during the Second World War: Germany, National Socialism and the Political Warfare Executive. Londres: Palgrave Macmillan; 2021. https://doi.org/10.1007/978-3-030-71664-6 DOI: https://doi.org/10.1007/978-3-030-71664-6
47. Khujumi IJ, Kour P. Psychological Wellbeing, Social support, And Resilience Among Population in Areas of Conflict. Educational Administration: Theory and Practice. 2024;30(4):8661-71. https://doi.org/10.53555/kuey.v30i4.2795 DOI: https://doi.org/10.53555/kuey.v30i4.2795
48. Gross ML, Canetti D, Vashdi DR. The psychological effects of cyber terrorism. Bull At Sci. 2016;72(5):284-91. https://doi.org/10.1080/00963402.2016.1216502 PMid:28366962 PMCid:PMC5370589 DOI: https://doi.org/10.1080/00963402.2016.1216502
49. Staub E. Building a peaceful society: Origins, prevention, and reconciliation after genocide and other group violence. Am Psychol. 2013;68(7):576-89. https://doi.org/10.1037/a0032045 PMid:24128319 DOI: https://doi.org/10.1037/a0032045
50. Christodoulou G. Preservation of peace as a target of mental health promotion. Psychiatriki. 2016;27(4):241-42. https://doi.org/10.22365/jpsych.2016.274.241 PMid:28114087 DOI: https://doi.org/10.22365/jpsych.2016.274.241
51. Christy S, Siriwardhana C, Lohmann J, Roberts B, Smith S. Quality of mental health questionnaires in conflict-affected adult populations in low and middle income countries: a systematic review. J Migr Health. 2021;4,100068. https://doi.org/10.1016/j.jmh.2021.100068 PMID:34901899 PMCID:PMC8640451 DOI: https://doi.org/10.1016/j.jmh.2021.100068
52. WHO EPI-WIN Webinar: Global Health and Peace Initiative webinar series: WHO's Global Health and Peace Initiative (GHPI): overview and case study from Cameroon. Geneve: WHO; 2024,Oct. 8. https://www.who.int/news-room/events/detail/2024/10/08/default-calendar/who-epi-win-webinar-global-health-and-peace-initiative-webinar-series-who-s-global-health-and-peace-initiative-ghpi-overview-and-case-study-from-cameroon#:~:text=To%20respond%20to%20the%20complex,health%20needs%20in%20fragile%2C%20conflict%2D
53. Pallavicini F, Argenton L, Toniazzi N, Aceti L, Mantovani F. Virtual reality applications for stress management training in the military. Aerosp Med Hum Perform. 2016;87(12):1021-30. https://doi.org/10.3357/AMHP.4596.2016 PMid:28323588 DOI: https://doi.org/10.3357/AMHP.4596.2016
54. Yuan Q, Chen Y, Liu S, Huang Q, Liao M, Zhou J, Li Z, Li Y. UN peacekeeper health and risk factors: a systematic scoping review. Glob Health Res Policy. 2024;9(1):13. https://doi.org/10.1186/s41256-024-00351-4 PMid:38600572 PMCid:PMC11005225 DOI: https://doi.org/10.1186/s41256-024-00351-4
55. Fritsche I, Jonas E, Kessler T. Collective reactions to threat: Implications for intergroup conflict and for solving societal crises. Soc Issues Policy Rev. 2011;5(1):101-36. https://doi.org/10.1111/j.1751-2409.2011.01027.x DOI: https://doi.org/10.1111/j.1751-2409.2011.01027.x
56. Aggarwal NK. Roles That Psychiatrists Can Play in International Negotiations to Reduce Conflict. JAMA Psychiatry. 2024;81(8):745-46. https://doi.org/10.1001/jamapsychiatry.2024.1379 PMid:38865143 DOI: https://doi.org/10.1001/jamapsychiatry.2024.1379
Downloads
Publicado
Como Citar
Edição
Seção
Licença
Copyright (c) 2025 Kirolos Eskandar
Este trabalho está licenciado sob uma licença Creative Commons Attribution-NonCommercial 4.0 International License.
Debates em Psiquiatria permite que o (s) autor (es) mantenha(m) seus direitos autorais sem restrições. Atribuição-NãoComercial 4.0 Internacional (CC BY-NC 4.0) - Debates em Psiquiatria é regida pela licença CC-BY-NC
