A Call for Greater Diversity and Representativity Within Countries in Psychiatric Research: Lessons and Challenges from a Systematic Review of Schizophrenia Research in Brazil

Objective: This article aims to systematically review the studies on schizophrenia in Brazil, addressing geographical coverage as an indicator of sampling representativeness, essential to infer results' generalization. It also highlights the variation in research funding across different regions.

Methods: We searched for studies carried out until July 2023. Inclusion criteria encompassed studies of patients diagnosed with schizophrenia (or its spectrum) recruited in Brazil. Data extraction comprised geographic region of first and last authors, place recruitment, research subfield, and funding sources. The review followed PRISMA guidelines for systematic reviews and meta-analyses.

Results: Out of 296 studies reviewed, most (63.18%) took place in the Southeast, particularly São Paulo (48.98%). Clinical trials comprised the majority (41.6%), with genetic studies primarily conducted in the Southeast or South (81.5%). Funding was reported in 64% of papers. The Northeast region was less likely to receive study funding compared to the Southeast.

Conclusion: Schizophrenia research in Brazil shows a clear geographic concentration, with significant disparities in funding allocation and underrepresentation of certain regions. Broadening research coverage through equitable distribution of funding opportunities and fostering collaborations with local institutions are of utmost importance to enhance the understanding and treatment of schizophrenia within Brazil's diverse socio-economic and ethnic landscape.