Psychiatric journals as the mirror of the dominant psychiatric model

Lifeworlds in pain: a principled method for investigation and intervention

The experience of pain spans biological, psychological and sociocultural realms, both basic and complex, it is by turns necessary and devastating. Despite an extensive knowledge of the constituents of pain, the ability to translate this into effective intervention remains limited. It is suggested that current, multiscale, medical approaches, largely informed by the biopsychosocial (BPS) model, attempt to integrate knowledge but are undermined by an epistemological obligation, one that necessitates a prior isolation of the constituent parts. To overcome this impasse, we propose that an anthropological stance needs to be taken, underpinned by a Bayesian apparatus situated in computational psychiatry. Here, pain is presented within the context of lifeworlds, where attention is shifted away from the constituents of experience (e.g. nociception, reward processing and fear-avoidance), towards the dynamic affiliation that occurs between these processes over time. We argue that one can derive a principled method of investigation and intervention for pain from modelling approaches in computational psychiatry. We suggest that these modelling methods provide the necessary apparatus to navigate multiscale ontology and epistemology of pain. Finally, a unified approach to the experience of pain is presented, where the relational, inter-subjective phenomenology of pain is brought into contact with a principled method of translation; in so doing, revealing the conditions and possibilities of lifeworlds in pain.

Female researchers in high-impact psychiatric journals: What do they focus on?

The regular analysis of publication trends, including gender aspects, is an important contribution to the identification of gender-specific differences in academic psychiatry. The present study aimed to characterise publication topics in three high-impact psychiatric journals across three time points within 15 years (2004, 2014 and 2019). Publication patterns of female authors compared to their male colleagues were examined. All articles published in 2019 in the three high-impact psychiatry journals JAMA Psychiatry, British Journal of Psychiatry and American Journal of Psychiatry were included and compared with data from the 2004 and 2014 assessments. Descriptive statistics were calculated and Chi-square tests were performed. In 2019, a total of 473 articles were published, 49.5% were original research articles, of which 50.4% were published by female first authors. The results of this study showed a stable trend in the publication of research on mood disorders as well as schizophrenia and psychotic disorders in high-ranking psychiatric journals. Although the percentage of female first authors in the three most common target populations under study (mood disorders, schizophrenia and general mental health) increased from 2004 to 2019, gender equality has not yet been achieved in these fields. However, in the two most frequent subject matters, basic biological research and psychosocial epidemiology, the percentage of female first authors was more than 50%. Consistent monitoring of publication trends and gender distribution by researchers and journals in psychiatric research should be continued to identify and counteract the possibility of the underrepresentation of women in certain fields.

The Overall Diagnosis: Psychodynamic Psychiatry, Six-Minute Psychotherapy, and Patient-Centered Care

Optimal patient care in psychiatry necessitates attention to the treatment relationship and to the patient's experience as an individual. The growth of patient-centered medicine has led to an increased appreciation of the importance of the biopsychosocial formulation, the personhood of both the patient and the physician, the autonomy and authority of the patient, and the therapeutic alliance. Patient-centered medicine, developed by the seminal psychoanalytic theorist Michael Balint, has its roots in psychodynamic concepts. A psychodynamic approach to psychopharmacology improves psychiatric prescribing, and guides the psychiatrist in providing brief, limited psychotherapy, similar to that which the Balints recommended in primary care practice.

Geographic trends of scientific output and citation practices in psychiatry

BACKGROUND

Measures of research productivity are increasingly used to determine how research should be evaluated and funding decisions made. In psychiatry, citation patterns within and between countries are not known, and whether these differ by choice of citation metric.

METHOD

In this study, we examined publication characteristics and citation practices in articles published in 50 Web of Science indexed psychiatric and relevant clinical neurosciences journals, between January 2004 and December 2009 comprising 51,072 records that produced 375,962 citations. We compared citation patterns, including self-citations, between countries using standard x(2) tests.

RESULTS

We found that most publications came from the USA, with Germany being second and UK third in productivity. USA articles received most citations and the highest citation rate with an average 11.5 citations per article. The UK received the second highest absolute number of citations, but came fourth by citation rate (9.7 citations/article), after the Netherlands (11.4 citations/article) and Canada (9.8 citations/article). Within the USA, Harvard University published most articles and these articles were the most cited, on average 20.0 citations per paper. In Europe, UK institutions published and were cited most often. The Institute of Psychiatry/Kings College London was the leading institution in terms of number of published records and overall citations, while Oxford University had the highest citation rate (18.5 citations/record). There were no differences between the self-citation practices of American and European researchers. Articles that examined some aspect of treatment in psychiatry were the most published. In terms of diagnosis, papers about schizophrenia-spectrum disorders were the most published and the most cited.

CONCLUSIONS

We found large differences between and within countries in terms of their research productivity in psychiatry and clinical neuroscience. In addition, the ranking of countries and institutions differed widely by whether productivity was assessed by total research records published, overall citations these received, or citations per paper. The choice of measures of scientific output could be important in determining how research output translates into decisions about resource allocation.

The bicentennial volume of the British Journal of Psychiatry: the winding pathway of mental science

The Asylum Journal, first published in 1853, is now, as the British Journal of Psychiatry, in its 200th volume. It has changed greatly in its breadth and scope, but its core values and concerns--professional respect, removal of stigma, delivery of care, understanding of pathology, and informed treatment--have remained at its heart throughout. We predict some changes for the future, but not dramatic ones, and conclude that the impinging advances of science will elucidate and refine, but not remove, the need for a journal that is proud to represent psychiatry or, in the words of John Bucknill, its first editor, 'to render prominent its characteristics and to stamp it as a specialty'.