Paper on JAMA Psychiatry Unveils Interaction of Biological, Psychological and Social Factors in Mental Health

October 16, 2019

On October 9, 2019,JAMA psychiatrypublished a paper entitled “Implications of the Association of Social Exclusion with Mental Health" by Professor ZHAO Xudong, School of Medicine of Tongji University, jointly with Professor Andreas Heinz of Charité Universitätsmedizin Berlin and Dr. LIU Shuyan. This collaborative accomplishment was made by the newly established Sino-German Institute of Mental Health under the School of Medicine of Tongji University.

Basedon a review of the quintessential literature available, including results and conclusions of large-scale epidemiological surveys, clinical researches, longitudinal cross-cultural researches, experimental researches and systematic reviews, the authors discuss the relationship between the inter-group barriers formed by culture, race, class and other factors and mental health.

Among them, from the perspective of social and cultural changes, the paper discusses the mental health status of ethnic groups in a rapidly changing society, citing the results of a three-decade diachronic study in China, namely, a research on the mental health of Jinuo people initiated by Professor WAN Wenpeng in 1979. From the perspective of urbanization development, this paper analyzes the interactions between the gap between the rich and the poor, the low social status, the influence and circular causality between the adaptation mode of migrant groups and mental health indicators. It interprets the interaction among individual psyche and psychological factors of mental health from individual subjective happiness, sense of attainment and expectations (failure expectation). Finally, from the perspective of public health (international community-country-community-medical care), measures for promoting mental health are put forward, including adjusting national macro policies, regional economic development and community construction, as well as individualized intervention by psychiatric and psychotherapy professionals.

Against the background of China's promotion of Healthy China Action, this paper is especially relevant to China's development strategy in the process of modernization, which focuses on the overall well-being of the people, elimination of poverty and imbalance in development, greater sense of belonging, well-being and fairness. It has also implicants for professionals who wish to delve further into the interaction of biological, psychological and social factors in the future cause of mental health and hygiene.


About the journal:

JAMA Psychiatry is an international peer-reviewed journal for clinicians, scholars, and research scientists in psychiatry, mental health, behavioral science, and allied fields. It is a subsidiary of ——JMAM, one of the world's four major medical journals. The editor-in-chief is Dost Öngür (Harvard University, McLean Hospital). According to the Journal Citation Reports, the journal has a 2018 impact factor of 15.916, ranking it 3rd out of 146 journals in the category "Psychiatry".

About the authors:

ZHAO Xudong, corresponding author of the paper, M.D. ofHeidelberg University, is a full professor and chief physician of Tongji University. As a prolific author and assiduous researcher in cultural psychiatry, psychosomatic medicine and psychotherapy, he has published over 200 papers in Chinese, English and German, over 40 books. He won three Second Prizes at the provincial and ministerial level and four Third Prizes for scientific and technological progress for his extensive research.

Andreas Heinz, first author of the paper, has been the director of the Department of Psychiatry and Psychotherapy Campus Charité Mitte Berlin since 2002. From 2010 to 2014, he was the president of the German Society for Biological Psychiatry (DGBP). He is also member of the Akademie der Wissenschaften und der Literatur Mainz (since 2013); member of the Leopoldina – National Academy of Sciences (since 2015). Heinz is the editor of 13 books including the Practice of Intercultural Psychiatry and Psychotherapy,Migration and Mental Healthand the author of many scientific publications including studies focusing on psychiatry in national socialism, critical neuroscience and the neurobiology of psychotic and addictive disorders. Prof. Heinz also serves as Honorary Director of Sino-German Institute of Mental Health of Tongji University. He made field trips to the Mosuo people in Yunnan to study the mental health of locals, outcomes of which were reflected in this paper. When invited to contribute to JAMA Psychiatry, he invited Prof. ZHAO to co-author this paper, hoping to spread China’s contributions to mental health to the international community.

Full-text paper “Implications of the Association of Social Exclusion with Mental Health” is available at

Source (in Chinese):