Could you give us a glimpse into your personal history, emphasizing the pivotal moments that first kindled your passion for science?

I knew I wanted to become a physician from a very early age. My father, a psychiatrist, served as a role model for me. It was common for my father to bring some of his patients, who were sometimes depressive or psychotic, to our ranch. This provided me with a unique opportunity to observe their recovery as they lived with us. I did what I could to help and was struck by how rewarding these experiences were to my father and me. Thus, my decision to become a doctor was strongly associated with this fulfilling feeling of helping patients. Later, I enrolled in the Faculty of Medicine at the University of São Paulo (FMUSP), the top medical school in Brazil. There, I engaged in several academic activities, including serving as President of the student sports club (Associação Atlética Acadêmica Oswaldo Cruz). The experience of representing students to the Dean and leading in finding ways to pursue common goals was very significant for me, fostering a solid attachment to my medical school. After completing my residency in Psychiatry, I was sure I wanted to become a future leader at FMUSP. This ambition meant becoming a full professor, which required pursuing an academic career, including obtaining a PhD, postdoctoral training abroad, and developing my research skills. Teaching became my passion during this time, especially as I recognized that teaching is the best way to learn. In turn, I realized that conducting research was the best way to develop critical thinking, which allowed me to prepare better lectures. In this way, research became a means to achieve my goals. During this process, I also discovered that conducting high-quality research and gaining deep knowledge in a specific area alongside colleagues was very rewarding and greatly enjoyed.

We would like to know more about your career trajectory leading up to your most relevant leadership role. What defining moments channeled you toward that leadership responsibility?

When I finished my PhD, I was the Chief of the Consultation Psychiatric Service at our Institute of Psychiatry. I chose to do my postdoctoral training at Massachusetts General Hospital primarily because it has one of the area's most renowned departments. However, upon my arrival, I realized that their focus was much more on teaching and clinical care than on research, which was the primary purpose of my scholarship. During this period, I had the opportunity to participate in the OCD Clinic led by Michael Jenike. Although OCD was not an area of interest for me at that time, I saw this as the best opportunity available. To begin in an area where I had no prior background, I started a study group with Scott Rauch and Lee Baer (both from the OCD Clinic), Katherine Phillips, and Barbara Coffey, who was at McLean Hospital nearby. With their help, I developed a project focused on the clinical phenomenology of OCD and Tourette Syndrome. During the project's development, I learned that the Child Study Center at Yale was the most productive institution in Tourette Syndrome, with James Leckman being one of the leading figures in this field. I visited Yale to present my project to him and his colleagues (David Pauls and Donald Cohen), and they soon became part of my project, providing the methodological refinement I needed. Several papers resulted from this fruitful partnership, and we have continued our collaborations to this day. Back in Brazil, I helped create a competitive OCD Research group that was one of the most productive in the world for many years. In 2009, a position for Full Professor at FMUSP was announced, and I submitted my application, along with several other colleagues. The opportunity was in Child and Adolescent Psychiatry, although I was an adult psychiatrist. Therefore, my strategy was to propose an innovative project focused on identifying individuals at risk for psychiatric disorders and interventions to mitigate or prevent symptom expression. A few months before the open selection process, Brazil's two main research foundations (CNPq and FAPESP) launched a significant grant opportunity. I applied for that grant with my colleagues Luiz Rohde and Jair Mari (with whom I have been collaborating for more than 25 years) and successfully created the National Institute for Developmental Psychiatry for Children and Adolescents www.inpd.org.br, focusing on the early identification and intervention of mental health disorders in individuals at risk. This grant provided the credentials I needed to become a full, tenured Professor of Child and Adolescent Psychiatry at the Department of Psychiatry at FMUSP – where I have been consistently elected Chair (or Vice-Chair) of the department for the past 15 years. Therefore, I believe that the defining moments that made all this possible involved making the most of the situations I encountered by adapting my skill sets to match available opportunities, choosing the right people to work with, and fostering these relationships for life.

Please share with us what initially piqued your interest in your favorite research or professional focus area.

What piqued my interest were the opportunities that arose during my career that allowed me to deliver care to those in need in a way that made sense within the larger goal of serving my institution as a leader.

What impact do you hope to achieve in your field by focusing on specific research topics?

To provide new evidence-based treatments that will make a difference in the lives of patients with OCD and their families, and to implement a few tested interventions in mental health care delivery that can be transformed into public policies.

Please tell us more about your current scholarly focal points within your chosen field of science.

I continue to invest in the area where I have published the most, which involves Obsessive-Compulsive Disorder (OCD). My work is mainly focused on clinical phenotypes, their underlying neurobiological signatures, and how this knowledge can be transformed into treatments that provide some relief for individuals with OCD and their families. More recently, I have redirected my focus to the early identification and intervention of mental health disorders in individuals at risk for such disorders. In 2023, we created the National Center for Science and Innovation in Mental Health (CISM) (www.cism.org.br). Through this grant, which receives public and private funding, we aim to identify modifiable risk and protective factors in a cohort study involving individuals at risk for mental health disorders. A fascinating part of this project is the development of scalable digital mental health solutions based on these risk factors that we are testing in pragmatic clinical trials to promote improved mental health. Additionally, other interventions are being tested in individuals who have already been diagnosed but do not have access to treatment. Once their effectiveness is demonstrated, these interventions will be implemented in two separate cities in Brazil, providing evidence for the creation of public policies with the potential to transform the lives of people with mental health disorders and their families.

What habits and values did you develop during your academic studies or subsequent postdoctoral experiences that you uphold within your research environment?

Leadership is built not through authoritarianism but by addressing the needs of each team member and fulfilling agreed-upon commitments. This approach recognizes that knowledge is universal and should be shared, which, in turn, produces a team that grows together, leading to greater success.

At Genomic Press, we prioritize fostering research endeavors based solely on their inherent merit, uninfluenced by geography or the researchers' personal or demographic traits. Are there particular cultural facets within the scientific community that warrant transformative scrutiny, or is there a cause within science that deeply stirs your passions?

More than a specific cause, what captivates me are values, such as the idea of seeking, in the most honest way possible, a truth that is only provisional but offers new models that help us move beyond current limitations – even if this provisional truth ultimately proves to be an illusion.

What do you most enjoy in your capacity as an academic or research leader?

I find being able to bring people together around common goals, develop the best in each of them, and act according to previously made agreements keeps people working together for long periods. In short, to inspire an atmosphere of trust.

Outside professional confines, how do you prefer to allocate your leisure moments, or conversely, in what manner would you envision spending these moments given a choice?

My mother, Maria Lydia, is 93 years old. My father passed away 15 years ago. I have four children, who are now adults. Three of them are married (Helena, Alice, and André), to my two sons-in-law (Arthur and Luli) and my daughter-in-law (Luciana), respectively. Gustavo, my youngest son, is 17 years old. I have four grandchildren (Tomás, Noah, Dudu, and Laila), with one more grandson expected by the end of 2024. There is nothing I enjoy more than spending time with all of them, if possible, along with my wife, Maria Lúcia. I also enjoy spending time with my close friends. Individually, my main hobby is equestrianism, and I love participating in horse jumping competitions.

What is your idea of perfect happiness?¹

I do not believe in perfect happiness. For me, happiness consists of instants. These instants of happiness occur more frequently when I am close to and interacting with significant people in my life.

What is your greatest fear?

Making wrong choices and losing significant time in my life, especially now that I do not have much left.

Which living person do you most admire?

There are so many: I cannot choose just one.

What is your greatest extravagance?

Practicing equestrianism.

What are you most proud of?

The family and friends I have built over my life.

What is your greatest regret?

I have several. I cannot name the greatest, but I hope I have learned from each one.

What is the quality you most admire in people?

Transparency and generosity.

What is the trait you most dislike in people?

Dishonesty or insincerity.

What do you consider the most overrated virtue?

Gratitude.

What is your favorite occupation (or activity)?

Being a doctor caring for patients.

Where would you most like to live?

In my current home.

What is your most treasured possession?

My family.

When and where were you happiest? And why were you so happy then?

I am happiest when I am gathered around a big table with my wife, my children, their significant others, and my grandchildren – just hanging around. These moments of togetherness and the joy of being surrounded by my loved ones bring me immense fulfillment.

What is your current state of mind?

Unsettled, in a constant search for wisdom.

What is your most marked characteristic?

Energetic, determined, and resilient.

Among your talents, which one(s) give(s) you a competitive edge?

I am good at bringing people together to work towards common goals over extended periods, ensuring that agreements and commitments are fulfilled.

What do you consider your greatest achievement?

That I have a family that choses to be with me when they do not have to be.

If you could change one thing about yourself, what would it be?

I want to be more present and available, particularly to significant people in my life.

What do you most value in your friends?

Genuine warmth and acceptance, allowing me to truly be myself.

Who are your favorite writers?

I do not have a favorite writer. This may be because I do not consider myself an intellectual. Everything I read is associated with practical application, including my research work. Thus, I read extensively on topics related to my profession. I enjoyed novels and suspense books in the past, but now I seek out books that offer wisdom, often recommended by people I admire.

Who are your heroes of fiction?

I have a profound admiration for heroes, both real and fictional. When I was younger, I often imagined myself as a hero. As I got older, the prospect of a heroic death or gaining prestige at the expense of doing something detrimental to myself became less appealing to me. So, I transformed this admiration into a desire to take on leadership roles guided by the principle of leading to serve. This idea was likely instilled in me by the Jesuits during my time at Colégio São Luiz.

Who are your heroes in real life?

My numerous mentors. Among them, I highlight my father, whose example inspired me to become a psychiatrist; during my medical studies, Paulo Vaz de Arruda, who exemplified a loving attitude in the relationship between a professor and a student and whose influence had a transgenerational effect on me; Valentim Gentil Filho, my role model as a physician, demonstrating methodological rigor in research and care for public responsibilities in leadership roles; and James Leckman, who is an example of generosity in sharing knowledge and pursuing projects with social relevance.

What aphorism or motto best encapsulates your life philosophy?

The poem ‘Dreams’ by Langston Hughes best encapsulates my life philosophy:

Hold fast to dreams

For if dreams die

Life is a broken-winged bird

That cannot fly.

Hold fast to dreams

For when dreams go

Life is a barren field

Frozen with snow.

Hughes, a leading voice of the Harlem Renaissance, captured profound truths in accessible language. This poem reminds us that our aspirations give life meaning and propel us forward. Throughout my career, I have often returned to these lines when facing challenges, finding in them the strength to persevere.