© 2007 The Royal College of Psychiatrists
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DINING AT THE SLOW FOOD RESTAURANT
I have recently returned from a summer school in Denmark, where they not only enjoy their lifestyle but are more than happy to promote it. So we were reminded that Danes tend to start work ‘half an hour later than most other nations and, to compensate for this, finish half an hour earlier’. This gives them plenty of time for the delectable task of eating, and so, like the tortoise and the hare, slow food restaurants – indeed they are advertised as such – are catching up inexorably on the faster ones. In this issue I would like you to imagine you are eating at the slow food British Journal of Psychiatry restaurant and implore you to give a little more time to relish the articles and dwell on their messages.
In this context it is worth reminding our readers that one of the best known Danish specialities is smørrebrød, or the open sandwich. The Danes believe it is best to see exactly what you are eating and in the same way the Journal wants you to dwell on its pages and digest each dish precisely and slowly. You might start with support for the statement that the best tranquilliser in the world is a good square meal, as it is the Danes and the Swedes (please forget all that nonsense about every Swede being about as optimistic as Ingmar Bergman) who have the least affective disturbance in old age (Castro-Costa et al, pp. 393–401). If you then move to the topical issue of cannabis and schizophrenia, we see each element of the smørrebrød exposed, with three genes separately examined for their role in the link. The answer appears to be ‘no’ for all three (Zammit et al, pp. 402–407), so spiking the claims that if you lack the Val158Met polymorphism you can smoke cannabis indefinitely without risk of psychosis. Moving onto the next course from that flamboyant master chef Stefan Priebe and his European cooking team, you will see that, far from computers replacing good doctor–patient communication, they can enhance it (Priebe et al, pp. 420–426). Perhaps it is not surprising that focused patient-oriented interaction does so well, as other research we have recently published supports this (Johnson et al, 2005; Garety et al, 2006; Kendrick et al, 2006), but we still need to hammer home that our services should be focused on patient rather than manager satisfaction (Shipley et al, 2000) and that this offers an opportunity for outcomes to be used positively in promoting better care (Slade et al, 2006). In any case, computers are more logical than people, and clearly more suited to helping to treat schizophrenia (Owen et al, pp. 453–454).
Close and careful study of the exciting paper by Boisjoli et al (pp. 415–419) is also justified. Anything that brings disruptive boys back into a socially inclusive fold is worth promoting and the evidence that academic performance was promoted and criminal behaviour reduced over a 15-year period in their ‘preventive intervention’ is impressive. But what is the main component of this intervention’s three-pronged assault, or are all three needed? This brings us back to food again, or rather its avoidance, in anorexia nervosa. The papers by Gowers et al (pp. 427–435) and Byford et al (pp. 436–440) show that general child and adolescent psychiatric services can give themselves a pat on the back for their efforts in successfully treating this condition and that in-patient services should be avoided. Is there a message here? Well, everyone knows how unattractive hospital food is to the average customer, and when this knowledge is combined with the expansion of Danish cuisine across the Oresund to Sweden, is it so surprising that the outcome of Swedish adolescents with anorexia nervosa has improved dramatically (Hjern et al, 2006)? So, please, be like the Danes, don’t put a piece of another journal’s indigestible verbal bread over your British Journal of Psychiatry smørrebrød, let it caress your taste buds and allow you to stay at the slow food restaurant till closing time.
SERVING UP THE FAST-TRACK OPTION
We introduced a fast-track option in the British Journal of Psychiatry a year ago. This, like many innovations in medical journalism, was introduced by The Lancet, who claim that for the really important papers they ‘can publish a peer-reviewed manuscript in the print journal in as little as 4 weeks of receipt, after full clinical/scientific and statistical review’. Nice aspiration, but I wonder how often this really happens. We will be reporting on our own fast-track results shortly, but in the mean-time could I remind contributors that the following recent reasons given for the fast track route are not, shall we say, looked on with enthusiasm:
I am getting married in the autumn and would like to have it in print for my weddingIam looking for promotion but need to have a least one publication on my CV
Although this subject is not of international importance at present it will become so when my paper is published
The subject is of great local interest and will cause great excitement at the parish council meeting
Try again, please.
REFERENCES
- Garety, P. A., Craig, T. K. J., Dunn, G., et al
(2006) Specialised care for early psychosis: symptoms, social
functioning and patient satisfaction. Randomised controlled trial.
British Journal of Psychiatry,
188, 37
–45.
[Abstract/Free Full Text] - Hjern, A., Lindberg, L. & Lindblad, F.
(2006) Outcome and prognostic factors for adolescent female
in-patients with anorexia nervosa: 9- to 14-year follow-up. British
Journal of Psychiatry, 189, 428
–432.
[Abstract/Free Full Text] - Johnson, S., Nolan, F., Hoult, J., et al
(2005) Outcomes of crises before and after introduction of a
crisis resolution team. British Journal of Psychiatry,
187, 68
–75.
[Abstract/Free Full Text] - Kendrick, T., Simons, L., Mynors-Wallis, L., et al
(2006) Cost-effectiveness of referral for generic care or
problem-solving treatment from community mental health nurses, compared with
usual general practitioner care for common mental disorders: randomised
controlled trial. British Journal of Psychiatry,
189, 50
–59.
[Abstract/Free Full Text] - Shipley, K., Hilborn, B., Hansell, A., et al (2000) Patient satisfaction: a valid measure of quality of care in a psychiatric service. Acta Psychiatrica Scandinavica, 101, 330 –333.[CrossRef][Medline]
- Slade, M., McCrone, P., Kuipers, E., et al
(2006) Use of standardised outcome measures in adult mental
health services: randomised controlled trial. British Journal of
Psychiatry, 189, 330
–336.
[Abstract/Free Full Text]
Related articles in BJP:
- Prevalence of depressive symptoms and syndromes in later life in ten European countries: The SHARE study
- ERICO CASTRO-COSTA, MICHAEL DEWEY, ROBERT STEWART, SUBE BANERJEE, FELICIA HUPPERT, CARLOS MENDONCA-LIMA, CHRISTOPHE BULA, FRIEDEL REISCHES, JOHANNES WANCATA, KAREN RITCHIE, MAGDA TSOLAKI, RAIMUNDO MATEOS, and MARTIN PRINCE
BJP 2007 191: 393-401.[Abstract] [Full Text] - Genotype effects of CHRNA7, CNR1 and COMT in schizophrenia: interactions with tobacco and cannabis use
- STANLEY ZAMMIT, GILLIAN SPURLOCK, HYWEL WILLIAMS, NADINE NORTON, NIGEL WILLIAMS, MICHAEL C. O’DONOVAN, and MICHAEL J. OWEN
BJP 2007 191: 402-407.[Abstract] [Full Text] - Impact and clinical significance of a preventive intervention for disruptive boys: 15-year follow-up
- RACHEL BOISJOLI, FRANK VITARO, ÉRIC LACOURSE, EDWARD D. BARKER, and RICHARD E. TREMBLAY
BJP 2007 191: 415-419.[Abstract] [Full Text] - Structured patient–clinician communication and 1-year outcome in community mental healthcare: Cluster randomised controlled trial
- STEFAN PRIEBE, ROSEMARIE McCABE, JENS BULLENKAMP, LARS HANSSON, CHRISTOPH LAUBER, RAFAEL MARTINEZ-LEAL, WULF RÖSSLER, HANS SALIZE, BENGT SVENSSON, FRANCISCO TORRES-GONZALES, ROB VAN DEN BRINK, DURK WIERSMA, and DONNA J. WRIGHT
BJP 2007 191: 420-426.[Abstract] [Full Text] - Clinical effectiveness of treatments for anorexia nervosa in adolescents: Randomised controlled trial
- SIMON G. GOWERS, ANDREW CLARK, CHRIS ROBERTS, ALISON GRIFFITHS, VANESSA EDWARDS, CLAUDINE BRYAN, NICOLA SMETHURST, SARAH BYFORD, and BARBARA BARRETT
BJP 2007 191: 427-435.[Abstract] [Full Text] - Economic evaluation of a randomised controlled trial for anorexia nervosa in adolescents
- SARAH BYFORD, BARBARA BARRETT, CHRIS ROBERTS, ANDREW CLARK, VANESSA EDWARDS, NICOLA SMETHURST, and SIMON G. GOWERS
BJP 2007 191: 436-440.[Abstract] [Full Text] - Are people with schizophrenia more logical than healthy volunteers?
- GARETH S. OWEN, JOHN CUTTING, and ANTHONY S. DAVID
BJP 2007 191: 453-454.[Abstract] [Full Text]
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