© 2006 The Royal College of Psychiatrists
COLUMNS |
A SPREADING PSYCHIATRIC ISSUE
There is a special delicacy in Mallorca called sobrasada, a combination of selected minced pork carefully seasoned with paprika, salt and spices. It is an onomatopoeic word as sobrasada spreads easily and can cover a great deal. This is an example of one of our sobrasada issues, as here psychiatry is spread easily across the panoply of existence. Thus, we range from the rediscovery of the word ‘recovery’ for those with severe mental illness (a word that must not be allowed to become lost in the mists of spin) (Lester & Gask, pp. 401–402), a similar re-affirmation of the value of the polygraph as a test of deception in sex offenders (Grubin & Madsen, pp. 479–483), and two large epidemiological surveys in Nigeria (Gureje et al, pp. 465–471) and the UK (Coid et al, pp. 423–431) showing rather lower prevalences of generalised anxiety disorder and personality disorder respectively compared with previous surveys, accompanied by an urgent plea for international guidelines on euthanasia, particularly when mental suffering is present (Naudts et al, pp. 405–409). It was the News of the World that first boasted the slogan ‘all human life is there’, but I should like to think that we represent more accurately that position now. Come to think of it, we deal with the same type of material as the News of the World – where else can you read about sex offenders, sexual harassment and bullying (Mezey et al, 2005), stalkers, whose pathology has been shown in recent Journal issues to have widespread impact across society (McIvor & Petch, pp. 403–404; Dressing et al, 2005; Purcell et al, 2005), professionals’ degree of physical contact with children (Blower et al, pp. 486–487), the awful handicaps of Tourette syndrome (Ludolph et al, pp. 484–485), predicting which criminals will reoffend (Buchanan & Leese, pp. 472–478), and the suffering of Gulf War veterans (Fiedler et al, pp. 453–459), and all in measured prose without a single prurient comment or photograph in sight.
We also deal with highly relevant and important issues for ordinary psychiatric practice. Quality of life in dementia (Hoe et al, pp. 460–464), which drug therapy is best for psychotic depression (Wijkstra et al, pp. 410–415) and its place and cost-effectiveness in conjunction with other treatments (Chisholm et al, 2004; Proudfoot et al, 2005; Schneider et al, 2005), and how agoraphobia relates to panic longitudinally (Bienvenu et al, pp. 432–438) are all current subjects of clinical debate that are moved forward by this issue of the Journal. This brings us back to ‘recovery’. When everything is done well and properly in clinical practice we can indeed conclude with Lester & Gask (p. 401) that ‘hope and restoration of a meaningful life are possible despite a diagnosis of serious mental illness’. I wish they would publish that in the News of the World.
ETHICS OF RESEARCH WORLDWIDE
Although we are trying to make a contribution to improving the publication of papers from low- and middle-income countries (Tyrer, 2005) the correspondence on pages 489–492 shows another side of the coin. Global research requires common standards of methodology, procedure and ethics, but these are difficult to achieve in settings where there is much local variation that is dependent on culture, long-established practice and very large differences in attitudes towards our service users. We are pleased to be able to contribute to this debate, already stimulated by the BMJ (Mudur, 2006; Patel, 2006), and hope that the responsible and constructive airing of the issues will move us towards a better balance. We thank our colleagues from the Indian Journal of Medical Ethics for stimulating us to action.
REFERENCES
- Chisholm, D., Sanderson, K., Ayuso-Mateos, J. L., et al
(2004) Reducing the global burden of depression:
population-level analysis of intervention cost-effectiveness in 14 world
regions. British Journal of Psychiatry,
184, 393
-403.
[Abstract/Free Full Text] - Dressing, H., Kuehner, C. & Gass, P. (2005)
Lifetime prevalence and impact of stalking in a European population:
epidemiological data from a middle-sized German city. British
Journal of Psychiatry, 187, 168
-172.
[Abstract/Free Full Text] - Mezey, G., Hassell, Y. & Bartlett, A.
(2005) Safety of women in mixed-sex and single-sex medium
secure units: staff and patient perceptions. British Journal of
Psychiatry, 187, 579
-582.
[Abstract/Free Full Text] - Mudur, G. (2006) Indian study sparks debate on
the use of placebo in psychiatry trials. BMJ,
332, 566.
[Free Full Text] - Patel, V. (2006) Commentary on placebo controlled trials in severe mental illness. Indian Journal of Medical Ethics, 3, 11 -12.
- Proudfoot, J., Ryden, C., Everitt, B., et al (2005) Clinical efficacy of computerised cognitive-behavioural therapy for anxiety and depression in primary care: randomised controlled trial. British Journal of Psychiatry, 185, 46 -54.
- Purcell, R., Pathé, M. & Mullen, P.E.
(2005) Association between stalking victimisation and
psychiatric morbidity in a random community sample. British Journal
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[Abstract/Free Full Text] - Schneider, F., Härter, M., Brand, S., et al
(2005) Adherence to guidelines for treatment of depression in
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[Abstract/Free Full Text] - Tyrer, P. (2005) Combating editorial racism in
psychiatric publications. British Journal of
Psychiatry, 186, 1
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[Free Full Text]
Related articles in BJP:
- Delivering medical care for patients with serious mental illness or promoting a collaborative model of recovery?
- HELEN LESTER and LINDA GASK
BJP 2006 188: 401-402.[Abstract] [Full Text] - Stalking of mental health professionals: an underrecognised problem
- RONAN J. McIVOR and EDWARD PETCH
BJP 2006 188: 403-404.[Abstract] [Full Text] - Euthanasia: the role of the psychiatrist
- KRIS NAUDTS, CAROLINE DUCATELLE, JOZSEF KOVACS, KRISTIN LAURENS, FREDERIQUE VAN DEN EYNDE, and CORNELIS VAN HEERINGEN
BJP 2006 188: 405-409.[Abstract] [Full Text] - Pharmacological treatment for unipolar psychotic depression: Systematic review and meta-analysis
- JAAP WIJKSTRA, JEROEN LIJMER, FERDI J. BALK, JOHN R. GEDDES, and WILLEM A. NOLEN
BJP 2006 188: 410-415.[Abstract] [Full Text] - Prevalence and correlates of personality disorder in Great Britain
- JEREMY COID, MIN YANG, PETER TYRER, AMANDA ROBERTS, and SIMONE ULLRICH
BJP 2006 188: 423-431.[Abstract] [Full Text] - Agoraphobia in adults: incidence and longitudinal relationship with panic
- O. JOSEPH BIENVENU, CHIADI U. ONYIKE, MURRAY B. STEIN, LI-SHIUN CHEN, JACK SAMUELS, GERALD NESTADT, and WILLIAM W. EATON
BJP 2006 188: 432-438.[Abstract] [Full Text] - Military deployment to the Gulf War as a risk factor for psychiatric illness among US troops
- NANCY FIEDLER, GOZDE OZAKINCI, WILLIAM HALLMAN, DANIEL WARTENBERG, NOEL T. BREWER, DRUE H. BARRETT, and HOWARD M. KIPEN
BJP 2006 188: 453-459.[Abstract] [Full Text] - Quality of life of people with dementia in residential care homes
- J. HOE, G. HANCOCK, G. LIVINGSTON, and M. ORRELL
BJP 2006 188: 460-464.[Abstract] [Full Text] - Lifetime and 12-month prevalence of mental disorders in the Nigerian Survey of Mental Health and Well-Being
- OYE GUREJE, VICTOR O. LASEBIKAN, LOLA KOLA, and VICTOR A. MAKANJUOLA
BJP 2006 188: 465-471.[Abstract] [Full Text] - Quantifying the contributions of three types of information to the prediction of criminal conviction using the receiver operating characteristic
- ALEC BUCHANAN and MORVEN LEESE
BJP 2006 188: 472-478.[Abstract] [Full Text] - Accuracy and utility of post-conviction polygraph testing of sex offenders
- DON GRUBIN and LARS MADSEN
BJP 2006 188: 479-483.[Abstract] [Full Text] - Grey-matter abnormalities in boys with Tourette syndrome: magnetic resonance imaging study using optimised voxel-based morphometry
- ANDREA G. LUDOLPH, FREIMUT D. JUENGLING, GERHARD LIBAL, ALBERT C. LUDOLPH, JÖRG M. FEGERT, and JAN KASSUBEK
BJP 2006 188: 484-485.[Abstract] [Full Text] - Views of child psychiatrists on physical contact with patients
- AILEEN BLOWER, RODDY LANDER, ANNA CRAWFORD, RUTH ELLIOT, CLARE McNULTY, CHRISTOPHER HOLMES, PAVAN SRIREDDY, MICHELLE MULCAHY, and HELEN MINNIS
BJP 2006 188: 486-487.[Abstract] [Full Text] - Trial of risperidone in India – concerns
- S. Srinivasan, S. A. Pai, A. Bhan, A. Jesani, and G. Thomas
BJP 2006 188: 489.[Full Text]
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