SEEING, BELIEVING AND DELVING
Most things are never quite what they seem and one of the tasks of every mental health professional is to look below the surface of a problem and make sense of what lies underneath. This issue is a good one for digging and delving. Maughan & Kim-Cohen () expose the advantages of the developmental perspective in understanding continuing child and adult psychopathology, and Green et al () reinforce the evidence highlighted by an earlier paper (Reference Arseneault, Cannon and WittonArseneault et al, 2004) that cannabis, whether taken currently or in the past, is associated with higher odds of developing schizophrenia and related disorders. Digging deeper below psychological layers, a well-recognised pathogen in medicine, the streptococcus, is suggested by Dale et al () as the potential cause of at least some cases of obsessive–compulsive disorder through autoimmune responses in the central nervous system. Adshead & Bluglass () identify a completely different pathology for another apparent compulsion, abnormal illness behaviour by proxy in mothers, in which insecure attachment behaviour is often a precursor; not an easy problem to treat (Reference Murray, Cooper and WilsonMurray et al, 2003), but clearly an early marker for later psychopathology.
There is, therefore, enough uncertainty in the honest presentation of illness to question what appears to be obvious, but this is added to by deliberate deceit, or lying. How gratifying to read from Yang et al () that we now may have the beginnings of a test for the ‘veracity of mendacity’ by examining the amount and proportion of prefrontal white matter with structural magnetic resonance imaging. There must be more subtle changes going on as well, but this is an excellent start. Perhaps it might be considered unfair to expose the novelist, Sebastian Faulks, to this test, but he has incurred the ire of one frequent contributor to the Journal, Tim Crow, by attributing Crow's theory of the origin of psychosis, linking language, genetic mutation and cerebral independence, first published with us 10 years ago and developed subsequently (Reference CrowCrow, 1995; Reference Ceccherini-Nelli and CrowCeccherini-Nelli & Crow, 2003), to his fictional psychiatrist, Thomas Midwinter, in his latest book, Human Traces (Reference FaulksFaulks, 2005). The midwinter of Crow's discontent is partly that in 1910, when the action in Human Traces takes place, there could be no possible way in which a psychiatrist, even of Crow's equivalent inventive stature, could have developed such a complex theory. However, Crow is also concerned about the primacy of his theory. People in future may come to believe that he plagiarised Midwinter's theory in 1995, or that it was around for years in one form or another, when it was, as I know from personal discussions, the outcome of genuinely original thought. The trouble is, as Goebbels once famously said, when a lie is repeated often enough it becomes the truth. Despite my attempts to widen the appeal of the Journal (Reference TyrerTyrer, 2003), it is likely that more people will read Human Traces than volume 167 of the British Journal of Psychiatry, and so the word that Crow is a plagiariser might get around. The importance that every journal now attaches to declarations of interest has not yet extended to fiction but it might well do so. However, even this declaration has its down side. It is a sad fact that almost every psychiatrist has received some degree of support, overt or covert, from the pharmaceutical industry, and this is rightly declared in our pages, but the assumption that this necessarily creates a conflict of interest is sometimes unwarranted, as, for example, in Calton's recent letter to the journal (Reference CaltonCalton, 2005), an apology for which appears in this issue (p. 390).
So please be assured that we at the Journal will continue to make every attempt to be fair and accurate in our reporting and to steer a successful path around the obstacles of fiction, fancy and fraud, and, on the few occasions when we stray and collide, that we will admit these errors openly.
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