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SEEING, BELIEVING AND DELVING
Most things are never quite what they seem and one of the tasks of every mental health professional is to look below the surface of a problem and make sense of what lies underneath. This issue is a good one for digging and delving. Maughan & Kim-Cohen (pp. 301–303) expose the advantages of the developmental perspective in understanding continuing child and adult psychopathology, and Green et al (pp. 306–313) reinforce the evidence highlighted by an earlier paper (Arseneault et al, 2004) that cannabis, whether taken currently or in the past, is associated with higher odds of developing schizophrenia and related disorders. Digging deeper below psychological layers, a well-recognised pathogen in medicine, the streptococcus, is suggested by Dale et al (pp. 314–319) as the potential cause of at least some cases of obsessive–compulsive disorder through autoimmune responses in the central nervous system. Adshead & Bluglass (pp. 328–333) identify a completely different pathology for another apparent compulsion, abnormal illness behaviour by proxy in mothers, in which insecure attachment behaviour is often a precursor; not an easy problem to treat (Murray et al, 2003), but clearly an early marker for later psychopathology.
There is, therefore, enough uncertainty in the honest presentation of illness to question what appears to be obvious, but this is added to by deliberate deceit, or lying. How gratifying to read from Yang et al (pp. 320–325) that we now may have the beginnings of a test for the ‘veracity of mendacity’ by examining the amount and proportion of prefrontal white matter with structural magnetic resonance imaging. There must be more subtle changes going on as well, but this is an excellent start. Perhaps it might be considered unfair to expose the novelist, Sebastian Faulks, to this test, but he has incurred the ire of one frequent contributor to the Journal, Tim Crow, by attributing Crow’s theory of the origin of psychosis, linking language, genetic mutation and cerebral independence, first published with us 10 years ago and developed subsequently (Crow, 1995; Ceccherini-Nelli & Crow, 2003), to his fictional psychiatrist, Thomas Midwinter, in his latest book, Human Traces (Faulks, 2005). The midwinter of Crow’s discontent is partly that in 1910, when the action in Human Traces takes place, there could be no possible way in which a psychiatrist, even of Crow’s equivalent inventive stature, could have developed such a complex theory. However, Crow is also concerned about the primacy of his theory. People in future may come to believe that he plagiarised Midwinter’s theory in 1995, or that it was around for years in one form or another, when it was, as I know from personal discussions, the outcome of genuinely original thought. The trouble is, as Goebbels once famously said, when a lie is repeated often enough it becomes the truth. Despite my attempts to widen the appeal of the Journal (Tyrer, 2003), it is likely that more people will read Human Traces than volume 167 of the British Journal of Psychiatry, and so the word that Crow is a plagiariser might get around. The importance that every journal now attaches to declarations of interest has not yet extended to fiction but it might well do so. However, even this declaration has its down side. It is a sad fact that almost every psychiatrist has received some degree of support, overt or covert, from the pharmaceutical industry, and this is rightly declared in our pages, but the assumption that this necessarily creates a conflict of interest is sometimes unwarranted, as, for example, in Calton’s recent letter to the journal (Calton, 2005), an apology for which appears in this issue (p. 390).
So please be assured that we at the Journal will continue to make every attempt to be fair and accurate in our reporting and to steer a successful path around the obstacles of fiction, fancy and fraud, and, on the few occasions when we stray and collide, that we will admit these errors openly.
OPEN ACCESS OPTION FOR AUTHORS
In the spirit of increasing openness we are allowing the option of immediate general dissemination of articles published in the Journal. As a new initiative to maximise access to original research, authors now have the option to make their papers freely available online from the time of publication, on payment of an open access charge. This charge is currently £2500 (or US$4500) per article. The text of other articles will become freely available after 12 months (as at present).
REFERENCES
Arseneault, L., Cannon, M., Witton, J., et al
(2004) Causal association between cannabis and psychosis:
examination of the evidence. British Journal of
Psychiatry, 184, 110
–117.
Calton, T. (2005) Who pays the piper (letter)?
British Journal of Psychiatry,
187, 195.
Ceccherini-Nelli, A. & Crow, T. J. (2003)
Disintegration of the components of language as the path to a revision of
Bleuler’s and Schneider’s concepts of schizophrenia: linguistic
disturbances compared with first-rank symptoms in acute psychosis.
British Journal of Psychiatry,
182, 233
–240.
Crow, T. J. (1995) A Darwinian approach to the
origins of psychosis. British Journal of Psychiatry,
167, 12
–25.
Faulks, S. (2005) HumanTraces. London: Hutchinson.
Murray, L., Cooper, P. J., Wilson, A., et al
(2003) Controlled trial of the short- and long-term effect of
psychological treatment of post-partum depression: 2. Impact on the
mother–child relationship and child outcome. British Journal
of Psychiatry, 182, 420
–427.
Tyrer, P. (2003) Entertaining eminence in the British Journal of Psychiatry. British Journal of Psychiatry, 183, 1 –2.
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  A. J. D. Macdonald Financial support and conflict of interest The British Journal of Psychiatry, March 1, 2006; 188(3): 294 - 294. [Full Text] [PDF]
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