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From the Editor's desk

Published online by Cambridge University Press:  02 January 2018

Peter Tyrer
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The British Journal of Psychiatry , Volume 185 , Issue 5 , November 2004 , pp. 446
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Copyright © 2004 The Royal College of Psychiatrists 

Red Queen: You must run as fast as you can to stay in the same place.

Alice: Isn't it strange, we are running as fast as we can and getting nowhere.

Psychiatry in Wonderland is not very different, as many of the articles in this issue testify. We would all like to think that we have made significant advances in our understanding and management of mental illness in the past few years. Doubtless we have, but we need to be aware when we are apparently running ahead of ourselves but really standing still. So Lars Kessing and his colleagues (pp. ) have found that ‘the progressive deteriorating course’ of recurrent affective disorders has been unaffected by the introduction of new antidepressants, and despite a great increase in psychotropic drug use and more focused treatments, the overall prevalence of neurotic and psychotic disorders has remained unchanged since 1993 (Brugha et al, pp. ). Schizophrenia also, considered to be a ‘neurodevelopmental disease’ since Kraepelin's prediction of a temporal lobe focus was apparently confirmed by Johnstone and her colleagues in 1976 (Lancet, ii, 924–926), now has a new theoretical model, an ‘anthropology of the self’, that explains how social and childhood factors can have such an influence on the manifestation of disorder (Harland et al, pp. ). So back to the old safe explanations of ‘complex disorders consisting of both genetic and social factors, with a developmental component’, which not only works for schizophrenia and eating disorders (Collier & Treasure, pp. ) but also for much of what we still need to be humble about in our discipline.

References

DECLARATIONS OF INTEREST

It is now necessary for authors, referees, reviewers and correspondents to. the Journal, and indeed to most other journals, to record any. declarations of interest. What constitutes a declaration of interest is open. to debate; most accept the need to declare commercial and professional links. but the BMJ nicely defines a more hidden layer of interest – which includes close relationships with, or antipathy towards, the authors, or. deep political, personal or religious convictions – as ‘something. that would embarrass you if it became generally known after. publication’.

The message has struck home with a vengeance, and the enthusiasm for. declaring all competing interests has now reached such a state of purgatorial. ecstasy that it is interfering with communication. Thus, I see colleagues at. scientific meetings spending as much time in their presentations declaring. their links to pharmaceutical companies as they do presenting their original. data, and damning disclosures such as ‘I own a mobile phone’ from. an author writing about potential hazards of this medium. Most of all, I fear. receiving a paper with a title such as ‘Post-traumatic stress in fox. cubs created by hunting’ as I think it highly unlikely that anyone can. avoid a ‘close relationship with’ or ‘antipathy. towards’ the authors now that opinions have become so polarised on this. subject in the country. As a consequence potential referees can all decline to. assess because of their pre-existing views and the paper becomes parked in no. man's land, rather like a trial that has to be abandoned as members of. the jury have been so influenced by extraneous evidence not delivered in. court.

There is no easy answer to this problem, but at times I become attracted to. the most succinct declaration of interest I have read, from an author whose. first language was definitely not English; his response was: ‘£ 54.50 (after conversion to English pounds)’. The nature of. the source was not disclosed.

And, by the way, the Journal is in need of more corresponding. editors from some of the countries where we are short of local knowledge, and. we have vacancies for trainee editors. Any declarations of interest?

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