Welcome to this issue of IJPCP, a journal now in its second decade of publication. As usual this issue contains a broad range of original research papers and scholarly reviews from around the world, all focused on how to improve clinical outcomes in psychiatric practice.
A cluster of papers address the benefits and risks of antipsychotic drug treatment. For example, Joseph Peuskens (Leuven, Belgium) and colleagues provide a comprehensive review of the efficacy and tolerability of the second generation antipsychotic drug quetiapine in the management of acute illness episodes in patients with schizophrenia or bipolar disorder, and argue that oral administration of atypical antipsychotics offers advantages over other forms of treatment in this situation. This suggestion is echoed in the paper from Pei-Xian Mao and colleagues (Beijing, China) which describes the findings of a cross-sectional evaluation of antipsychotic drug prescriptions in 503 inpatients with schizophrenia, in which indices of possible metabolic complications were more common in those patients exposed to clozapine or conventional neuroleptics, than in those who were receiving second generation antipsychotic drugs. The most intriguing paper in this group naturally comes from Jules Angst and colleagues (Zurich, Switzerland), which reports the findings of a naturalistic longitudinal study in over 400 patients with mood disorders followed-up for 20 years, which finds evidence that long-term treatment with lithium or clozapine may attenuate the severity of dementia. Could this be due to the neurotrophic effects of these compounds, seen in some animal models?
This issue also includes two papers assessing the psychometric properties of new interviews and scales for use in psychiatric practice. In the first, Isobel Cameron and colleagues (Aberdeen, UK) describe the properties of the revised version of the Behaviour and Symptom Identification Scale (BASIS-24), a self-rated measure of psychopathology and overall functioning, in primary care (n=630) and psychiatric inpatient and outpatient samples (n=588) and find it has adequate reliability, validity and sensitivity to change and could therefore be useful in assessing clinical outcomes. In the second, Michael Linden and colleagues (Berlin, Germany), delineate the properties of a modified version of the well-known Positive and Negative Syndrome Scale (that was employed by psychiatrists who were not exhaustively trained in its use) in 1895 outpatients with schizophrenia, and report that it is sufficiently robust for use in routine clinical practice.
Two reports from Turkey describe the burden of mental health problems in particular patient or socio-demographic groups. Cinar Yenilmez and colleagues (Meselik Eskitschir) compare measures of state and trait anxiety, hopelessness, and job and life satisfaction in Bulgarian-born individuals subject to forced migration to Turkey in 1989 with the local Turkish population, and find few differences in reported psychological symptoms or satisfaction, perhaps due to a shared cultural heritage or to adaptation over time. By contrast, Recep Dursun and colleagues (Konya) report a high prevalence (41%) of mental disorders in a large (n=73) outpatient sample of patients with operationally defined Behcet's disease subject to structured clinical interview, with no clear association between the presence of psychiatric disorder and the severity of physical symptoms.
Three clinical studies illustrate how the effectiveness of common treatment interventions might be refined. In a case–control study (n=82) of the effects of an educational and support programme for parents of adolescents with anorexia nervosa, Pamela Carlton and Renee Pyle (Stanford and Palo Alto, USA) found that parents of probands in the control group felt significantly more knowledgeable and involved, and more able to care for their child at home, suggesting that such an intervention might improve outcomes in teenagers with eating disorders. In the second, Christophe Lancon and colleagues (Marseilles, France) analyse five randomised controlled comparison of the active enantiomer escitalopram with the parent racemic compound citalopram, and find clinically relevant differences in efficacy with superiority for escitalopram and some evidence for greater cost-effectiveness, this being an increasingly important consideration for health service providers. Finally a short communication from Randy Sansone and colleagues (Dayton, USA) of a naturalistic study of the relationships between Axis I diagnoses and self-harming behaviour in 110 psychiatric inpatients describes no clear association between particular diagnoses and measures of self-harm, reinforcing the observation that detailed examination of psychopathological symptoms is needed in patients who harm themselves.
We are most grateful to all those who so graciously accept the invitation to review manuscripts submitted to this Journal, and want to acknowledge the colleagues who have undertaken this often arduous additional work over the course of the 2006. Thank you very much indeed.