Welcome to this issue of IJPCP, a journal in its tenth year. The international nature of the journal is illustrated by the country of origin of the review articles and original research reports: we trust the contents of these papers fulfil our goal of ensuring relevance to psychiatric practice.
Non-fatal self-harm and psychiatric illness
Around the world, people continue to harm themselves in substantial numbers. The retrospective study of almost 1000 presentations after non-fatal self-harm reported by Belgamwar and colleagues (Stoke, England) suggests that rates increased in men over an 8-year period, although the rate of completed suicide in the same geographical area decreased over the same time. The importance of establishing the presence of psychiatric illness in people presenting after self-harm is demonstrated by the consecutive case series (n=100) described by Rihmer and colleagues (Budapest, Hungary), in which at least one Axis I mental disorder was present in 92% of cases, 60% of patients having co-morbid conditions.
Problems in sleeping and eating
The common problem of insomnia is addressed in two articles. In the first, Mayers (Southampton, England) reviews relationships between sleep disturbance and depression, and argues that distortions of subjective perceptions of sleep are important in depressed patients. This contention is echoed by findings from the large (n=1332) community survey reported by Aslan and colleagues (Ankara, Turkey), in which two-thirds of those who reported problems on the Insomnia Severity Index had symptoms suggestive of only minor or sub-threshold sleep disturbance. The use of screening instruments to detect “caseness” is also examined by Noma and colleagues (Kyoto, Japan), who report that two commonly used measures correlated substantially in 80 patients with eating disorders, especially in well characterised conditions such as bulimia and anorexia.
Alcohol, mood and personality disorder
Luty and O'Gara (Southend and London, England) examine the concurrent validity of three depression rating scales in a secondary care sample (n=108) of alcohol-dependent patients, and argue that the self-administered Beck Depression Inventory represents a suitable alternative to observer-rated scales for assessing depression severity in this population. The comorbidity of mood disorders with personality disorders was investigated by Altindag and colleagues (Sanliurfa, Turkey): in 70 euthymic bipolar patients, 57% fulfilled criteria for at least one Axis II disorder, the most common being obsessive-compulsive personality disorder, reflecting the common association of OCD and bipolar disorder in larger epidemiological studies.
Hazards (and benefits) of treatment
In a review of hyponatraemia during antidepressant treatment, Egger and colleagues (Salzburg, Austria) remind us of demographic risk factors such as female gender, older age and lower body mass index, but conclude that the incidence of this condition, which can present with insidious neuropsychiatric symptoms such as lethargy, remains uncertain. A rather more florid presentation of iatrogenic illness is described by Selek and colleagues (Gaziantep, Turkey), namely massive uvulal oedema associated with lithium treatment. The inverse relationship between drug reactions and mental disorder is examined by Bavbek and colleagues (Ankara, Turkey), who could find no evidence that patients (n=61) with well-documented drug allergies were more likely to report depressive or anxiety symptoms than matched controls. The report from Motlova and colleagues (Prague, Czech Republic) provides some reassurance that treatment is not necessarily hazardous: in a naturalistic longitudinal study, relapse in patients with schizophrenia and related conditions was reduced through supplementation of antipsychotic drug treatment and rehabilitation with group family psychoeducation.
The demise of the case report
For a while IJPCP resisted the trend in continuing to publish case reports considered scientifically interesting or particularly pertinent to clinical practice. We now announce that the Journal will no longer accept submissions of reports: the constraints on space, the low “level” of evidence that reports provide, and difficulty in establishing unequivocal causality together limit their value, and it is time to move on. Reports already accepted for publication will appear in due course, the last members of a dying breed. David Baldwin Siegfried Kasper