The Editorial present the arguments that an alliance between academic psychiatry and the pharmaceutical industry is harmful through a critical review of the academic literature and media coverage of activities of the pharmaceutical industry. The industry and the psychiatric profession both gain advantages from promoting biomedical models of psychiatric disturbance and pharmacological treatment. This confluence of interests has lead to the exaggeration of the efficacy of psychiatric drugs and neglect of their adverse effects and has distorted psychiatric knowledge and practice. Academic psychiatry has helped the industry to colonise more and more areas of modern life in order to expand the market for psychotropic drugs. Persuading people to understand their problems as biological deficiencies obscures the social origin and context of distress and prevents people from seeking social or political solutions. Psychiatry has the power to challenge the dominance of the pharmaceutical industry and should put its efforts into developing alternatives to routine drug treatment. Psychiatry needs to disengage from the industry if it wants to make genuine advances in understanding psychiatric disorder and help reverse the harmful social consequences of the widening medicalisation of human experience.

The author offers a perspective on the perceived conflicts of interest that influence scientific collaborations between academic psychiatry and the pharmaceutical industry. The author holds the position that the merits of a particular study should be judged based on the quality of the scientific methodology rather than on the credentials of the investigators or the source of funding.

No treatment has caused a greater revolution in the treatment of people with schizophrenia than chlorpromazine. The new generation of drugs has been embraced by psychiatry with an enthusiasm fostered by the unmet needs of both patients and industry. Recent, independently funded trials have highlighted already existing data illustrating how the new antipsychotics drugs are an additional advance but not a revolution. In this story there are lessons for psychiatry to opt for science rather than seduction.

Aims – There has been recent concern about interactions between academia and the pharmaceutical industry. This article seeks to explore the basis for the current sense of crisis. Methods – The approach taken is a historical one, outlining the origins of the crisis. Results – The analysis outlines the roles that brands, patents, and the control of the scientific literature play in the current marketing of psychotropic drugs, and describes the processes of guideline capture and brand fascism. Conclusions – The analysis makes it difficult to see current interactions between industry and academia as anything but bad for academia. One option that might restore some balance would be to restrict scientific meetings and journals to communications that made all relevant scientific data available, excluding exercises that restrict access to data.

Declaration of Interest: In recent years I have had consultancies with, or been a chairman or speaker at symposia for, or received support to attend meetings from Astra-Zeneca, and Lundbeck. I have been expert witness for the plaintiff in the past decade in 15 legal actions involving antidepressants and on patent case, and have been consulted on a much greater number of attempted suicide, suicide, and suicide-homicide cases linked to treatment, in which I have offered the view that the treatment was not involved or have declined to give a view.

Aims – To explore the current state of Italian social psychiatry research as evidenced by original papers published in peer-reviewed journals 2004-2006. Methods – Electronic databases and hand searches of leading peer-reviewed journals were used to identify original research papers published in 2004-2006, addressing a social psychiatric issue, having at least one Italian author, and reporting data from Italian samples. Results – A total of 174 papers were identified. A substantial proportion reported findings of international collaborative research. Quantitative methods dominated, with 86 papers on cross-sectional surveys. Only 18 papers showed results of intervention trials with pre and post measures. Most common target group were psychiatric patients in community mental health services which featured in 93 papers. Conclusions – There is a critical mass of Italian social psychiatry research, dominated by a few research centres and with considerable amount of international collaboration. The findings of this survey might reflect the relative shortage of national funding for social psychiatry research.

Declaration of Interest: None.

Aims – Specialist interventions in community psychiatry for severe mental illness are expanding and their place needs to be re-examined. Methods – Recent literature is reviewed to evaluate the advantages and disadvantages of specialist teams. Results – Good community mental health services reduce drop out from care, prevent suicide and unnatural deaths, and reduce admission to hospital. Most of these features have been also demonstrated by assertive community outreach and crisis resolution teams when good community services are not available. In well established community services assertive community teams do not reduce admission but both practitioners and patients prefer this service to other approaches and it leads to better engagement. Crisis resolution teams appear to be more successful than assertive community teams in preventing admission to hospital, although head- to-head comparisons have not yet been made. All specialist teams have the potential of fragmenting services and thereby reducing continuity of care. Conclusions – The assets of improved engagement and greater satisfaction with assertive, crisis resolution and home treatment teams are clear from recent evidence, but to improve integration of services they are probably best incorporated into community mental health services rather than standing alone.

Declaration of Interest: The author has been the sole consultant in two assertive outreach teams since 1994 and might there- fore be expected to be in favour of this genre of service. He has received grants for evaluation of different services models from the Department of Health (UK) and the Medical Research Council (UK).

Aims – The term “presenteeism” is used to describe workers who are present in the workforce, but who are not functioning at full capacity. The objective of the study was to describe the impact of mood and anxiety disorders on presenteeism in a population sample. Methods – Random digit dialing was used to select a sample of n= 3345 subjects between the ages of 18 and 64. A computer assisted telephone interview that included the Mini Neuropsychiatric Diagnostic Interview (MINI), the Stanford Presenteeism Scale 6 (SPS-6) and a pharmacoepidemiology module was administered. Results – Among subjects with comorbid mood and anxiety disorders 75.0% reported interference with their work compared with only 13.3% of subjects without mood or anxiety disorders. Mood and anxiety disorders were associated with lower presenteeism ratings. Regression analysis uncovered a significant gender by anxiety disorder interaction, indicating that the effect of anxiety disorders was greater in men than women. Conclusions – This is the first study to report the impact of mental disorders on presenteeism in a general population sample. The results confirm that the problem of presenteeism is not restricted to specific occupational groups, but is instead a widespread problem in the general population.

Declaration of Interest: This study was funded by the Alberta Depression Initiative through the Institute of Health Economics (www.ihe.ab.ca). Dr. Esposito was supported by an International Resident Fellowship from the University of Calgary. Dr. Patten is a Health Scholar with the Alberta Heritage Foundation for Medical Research and a Fellow with the Institute of Health Economics. Dr. Wang is a New Investigator with the Canadian Institutes for Health Research.

Aims – The present paper is an overview of studies examining chronic, persistent offending and recidivism in adolescents and young offenders. Methods – The review focused on published papers dealing with chronic offending of adolescents and young offenders. Results – The paper provides the picture on definition on juvenile delinquency, definition of recidivism, measurement and operationalisation of recidivism, definition of chronic offenders, correlates and predictors of chronic offending, differences and similarities between chronic and non-chronic offenders, possible genetic influences in chronic offending, proportion of criminal activity attributed to chronic young offenders, factors differentially associated with initiation, escalation, persistence and desistance in juvenile offending. Conclusions – Overall the boundaries of the sociological approach to the study of chronic offending are stressed and the possible advantages of employing a social psychological approach to the study of chronic offending are noted.

Declaration of Interest: The research of this article was financially supported by the Greek State Scholarships Foundation. There is no potential conflict of interest related to the present paper.

Aims – Media reports related to people suffering from mental illness appear to deal prevalently with acts of violence and crimes. The present study focused on all newspaper reports relating to homicides, suicide, and other acts of violence, in an attempt to ascertain whether a different pattern emerged in some Italian newspapers in describing deeds committed by the mentally ill. Materials and methods – All articles published over a six–month period in the two main national and two main regional newspapers relating to homicides, suicides, and other acts of violence were selected. A comparison of reports regarding events attributed to mentally ill people was performed according to quantitative parameters. Results – 2279 articles were considered; 54% regarded homicides, 8.2% suicides and attempted suicides, 2.1% homicides/suicides; the remaining 35.8% regarded other acts of violence. A significantly higher number of words, accompanying photos and a more stigmatizing language were used in reporting deeds when attributed to mentally ill people. Conclusion – An excessive emphasis on deeds related to a psychopathological condition still emerged in media reports, almost as though acts of violence committed by the mentally insane should be viewed in a different light. These findings support the hypothesis that media portrayal mirrors the enduring stereotype of “diversity” of the mentally ill.

Declaration of Interest: no conflict of interest declared.

Aims – To present the psychometric properties of the “Consumer–constructed Scale to measure empowerment” (Rogers et al., 1997 ) Italian version. Methods – After briefly recollecting “history”, contents and psychometric features of the original scale, proceeding from Stratico & Degli Esposti's translation (2002), in this paper, the psychometric properties of the Italian version are described. The text of the instrument has been brought for discussion in a users' focus group and subsequently tested for reliability study; a second focus group followed to reach the definitive Italian version. Results – The Italian version of the Scale, consists of 28 items, showed an adequate internal consistency and reliability both for the whole scale and for most of the items, which have shown to have also good discriminative capacity. Conclusions – SESM can be an useful instrument to give empiric evidence supporting empowerment concept. Considering the results, it can be a qualifying and irreplaceable instrument for “empowered condition” evaluation.

Declaration of Interest: no grants and financial support received for the study.

Epidemiologia e psichiatria sociale, 16, 2, 2007, pag. 144