Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-26T01:23:51.533Z Has data issue: false hasContentIssue false

Doing our best to ‘do no harm’

Published online by Cambridge University Press:  24 June 2014

Gin S. Malhi*
Affiliation:
Discipline of Psychological Medicine, University of Sydney, Sydney, NSW, Australia CADE Clinic, Department of Psychiatry, Royal North Shore Hospital, Sydney, NSW, Australia. E-mail: [email protected]
Rights & Permissions [Opens in a new window]

Abstract

Type
Editorial
Copyright
Copyright © 2009 Blackwell Munksgaard

As doctors caring for patients, and researchers attempting to understand the pathophysiology of neuropsychiatric disorders, we are united by a collective goal to improve the outcomes for those who suffer from mental illness. This aspiration is fundamental to all we do and, when considered in abstract terms, is an irrefutable principle that is both self-evident and seemingly easy to support and implement. However, in clinical practice, diagnostic and treatment decisions are often not clear-cut with respect to the benefits they provide to patients. Furthermore, determining the means by which advances in research are achieved and whether these impinge upon the rights of an individual, or a society as a whole, can often prove challenging.

In this issue of Acta Neuropsychiatrica, a number of articles address aspects of this matter. Lopez-Munoz and Alamo Reference Lopez-Munoz and Alamo(1) address psychotropic drug research in Nazi Germany in an editorial with a commentary provided by Robertson and Walter Reference Robertson and Walter(2). Almeida et al. Reference Almeida, Macedo-Soares and Issler(3) report upon the long-term side-effects of psychotropic medications and examine the metabolic syndrome in patients with bipolar disorder. However, the crux of the issue, namely our potential relationship with patients, is explored in one of our regular sections, Intervention Insights, and the overall salience of research is touched upon in Pictures and Prose.

In addition to this theme, three other articles report aspects of ‘multi-modal imaging and assessment’ using electrophysiological, neuropsychological and eye movement analysis tools (Reference Debagriele and Lagopoulos4Reference Cocchi, Bosisio and Berchtold6). Each of these investigational leads holds much promise and ultimately hopes to translate into earlier and more reliable diagnosis, the development of targeted treatments and the monitoring of progress and outcome . Until such halcyon times, however, clinicians remain precariously poised in their management of patients knowing fully well that there are actions they can institute but that their treatments and strategies are as yet imperfect and may in reality confer more harm than benefit .

Therefore, perhaps ‘do no harm’ is an unrealistic expectation and, instead, we should continually strive to simply do our best.

References

Lopez-Munoz, F, Alamo, C.Psychotropic drugs research in Nazi Germany: the triumph of the principle of maleficence. Acta Neuropsychiatr 21:5053. CrossRefGoogle Scholar
Robertson, M, Walter, G.Commentary on Lopez-Munoz and Alamo. Acta Neuropsychiatr 21:5457. CrossRefGoogle ScholarPubMed
Almeida, K, Macedo-Soares, M, Issler, CKet al. Obesity and metabolic syndrome in Brazilian patients with bipolar disorder. Acta Neuropsychiatr 21:8488. CrossRefGoogle ScholarPubMed
Debagriele, R, Lagopoulos, J.A review of EEG and ERP studies in bipolar disorder. Acta Neuropsychiatr 21:5866. Google Scholar
Begre, S, Kiefer, C, Von Kaenel, R, Frommer, A, Federspiel, A.Rey visual design learning test performance correlates with white matter structure. Acta Neuropsychiatr 21:6774. CrossRefGoogle ScholarPubMed
Cocchi, L, Bosisio, F, Berchtold, Aet al. Visuospatial encoding deficits and compensatory strategies in schizophrenia revealed by eye movement analysis during a working memory task. Acta Neuropsychiatr 21:7583. CrossRefGoogle ScholarPubMed