A SPREADING PSYCHIATRIC ISSUE

There is a special delicacy in Mallorca called sobrasada, a combination of selected minced pork carefully seasoned with paprika, salt and spices. It is an onomatopoeic word as sobrasada spreads easily and can cover a great deal. This is an example of one of our sobrasada issues, as here psychiatry is spread easily across the panoply of existence. Thus, we range from the rediscovery of the word ‘recovery’ for those with severe mental illness (a word that must not be allowed to become lost in the mists of spin) (Lester & Gask, ), a similar re-affirmation of the value of the polygraph as a test of deception in sex offenders (Grubin & Madsen, ), and two large epidemiological surveys in Nigeria (Gureje et al, ) and the UK (Coid et al, ) showing rather lower prevalences of generalised anxiety disorder and personality disorder respectively compared with previous surveys, accompanied by an urgent plea for international guidelines on euthanasia, particularly when mental suffering is present (Naudts et al, ). It was the News of the World that first boasted the slogan ‘all human life is there’, but I should like to think that we represent more accurately that position now. Come to think of it, we deal with the same type of material as the News of the World – where else can you read about sex offenders, sexual harassment and bullying (Reference Mezey, Hassell and BartlettMezey et al, 2005), stalkers, whose pathology has been shown in recent Journal issues to have widespread impact across society (McIvor & Petch, ; Reference Dressing, Kuehner and GassDressing et al, 2005; Reference Purcell, Pathe and MullenPurcell et al, 2005), professionals’ degree of physical contact with children (Blower et al, ), the awful handicaps of Tourette syndrome (Ludolph et al, ), predicting which criminals will reoffend (Buchanan & Leese, ), and the suffering of Gulf War veterans (Fiedler et al, ), and all in measured prose without a single prurient comment or photograph in sight.

We also deal with highly relevant and important issues for ordinary psychiatric practice. Quality of life in dementia (Hoe et al, ), which drug therapy is best for psychotic depression (Wijkstra et al, ) and its place and cost-effectiveness in conjunction with other treatments (Reference Chisholm, Sanderson and Ayuso-MateosChisholm et al, 2004; Reference Proudfoot, Ryden and EverittProudfoot et al, 2005; Reference Schneider, Härter and BrandSchneider et al, 2005), and how agoraphobia relates to panic longitudinally (Bienvenu et al, ) are all current subjects of clinical debate that are moved forward by this issue of the Journal. This brings us back to ‘recovery’. When everything is done well and properly in clinical practice we can indeed conclude with Lester & Gask () that ‘hope and restoration of a meaningful life are possible despite a diagnosis of serious mental illness’. I wish they would publish that in the News of the World.

ETHICS OF RESEARCH WORLDWIDE

Although we are trying to make a contribution to improving the publication of papers from low- and middle-income countries (Reference TyrerTyrer, 2005) the correspondence on shows another side of the coin. Global research requires common standards of methodology, procedure and ethics, but these are difficult to achieve in settings where there is much local variation that is dependent on culture, long-established practice and very large differences in attitudes towards our service users. We are pleased to be able to contribute to this debate, already stimulated by the BMJ (Reference MudurMudur, 2006; Reference PatelPatel, 2006), and hope that the responsible and constructive airing of the issues will move us towards a better balance. We thank our colleagues from the Indian Journal of Medical Ethics for stimulating us to action.