Search

Investigators from minoritized backgrounds are underrepresented in psychiatric research. That underrepresentation contributes to disparities in outcomes of access to mental health care. Drawing on lived experience, scholarly qualitative reports, and empirical data, the authors review how the underrepresentation of minoritized researchers arises from interlocking, self-reinforcing effects of structural biases in our research training and funding institutions. Minoritized researchers experience diminished early access to advanced training and opportunities, stereotype threats and microaggressions, isolation due to lack of peers and senior mentors, decreased access to early funding, and unique community and personal financial pressures. These represent structural racism—a system of institutional assumptions and practices that perpetuates race-based disparities, in spite of those institutions' efforts to increase diversity and in contradiction to the values that academic leaders outwardly espouse. The authors further review potential approaches to reversing these structural biases, including undergraduate-focused research experiences, financial support for faculty who lead training/mentoring programs, targeted mentoring through scholarly societies, better use of federal diversity supplement funding, support for scientific reentry, cohort building, diversity efforts targeting senior leadership, and rigorous examination of hiring, compensation, and promotion practices. Several of these approaches have empirically proven best practices and models for dissemination. If implemented alongside outcome measurement, they have the potential to reverse decades of structural bias in psychiatry and psychiatric research. [ABSTRACT FROM AUTHOR]

Introduction: In terms of academic positions and activities, women seem to be disadvantaged in various aspects all over the world. Our study aims to investigate the representation of male and female genders in academic psychiatry journals in Turkey. Method: We included the publications in the academic psychiatry journals indexed in The Scientific and Technological Research Council of Turkey, Turkish Academic Network and Information Center, which were published between 2011 and 2020.12 journals were grouped as SCI-E/ SSCI (n=4), ESCI (n=4), and other international indexes (n=4). A total of 5179 articles were reviewed. Results: The ratios of female authors per article, female first author, female correspondence author, and female last author were found to be lower in the SCI-E/SSCI and ESCI groups compared to the other international index groups (p<0.05). In all article types, the rate of women as the last author was lower than the rate of women as the first author (p<0.05). Conclusion: The paucity of the female authors in the last authorship position and the editorial articles can be interpreted as the glass ceiling effect. To ensure gender equality in academic publications, universities and the editorial boards of journals should fight against gender-based bias and discrimination. [ABSTRACT FROM AUTHOR]

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.

Aims and Method: Higher specialist trainees (HSTs) in psychiatry in Ireland were recruited to complete a 21-item online questionnaire anonymously. Questions were designed to establish the research experience of HSTs in various years of training, identify perceived barriers to participation and generate potential strategies to overcome these barriers., Results: Of 165 HSTs surveyed, 50 (30%) responded. Most respondents (58%) were in the second or third year of HST. Most (72%) were training in general adult psychiatry. Themes that emerged from analysis of the qualitative data were 'collaborative research culture', 'guidance', 'choice' and 'access to resources'. Participants felt they needed more structured guidance and regular supervision, and expressed a desire for more networking and collaboration., Clinical Implications: The need for a supportive, collaborative research culture within psychiatry was predominant among responses. Structured research programmes and access to resources may facilitate a more positive research culture and should be considered as part of the training curriculum.

This editorial considers the value and nature of academic psychiatry by asking what defines the specialty and psychiatrists as academics. We frame academic psychiatry as a way of thinking that benefits clinical services and discuss how to inspire the next generation of academics.

Alison R Hwong,1 Stefana Morgan,1 Chelsea Anne Young,2 Aaron D Besterman,3 Michael Jacob,1 Jody Williams,1 Victor I Reus,1 Carol A Mathews,4 Erick Hung,1 Susan Voglmaier1 1Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA; 2Department of Psychiatry, Stanford University, Palo Alto, CA, USA; 3Department of Psychiatry, University of California, San Diego, CA, USA; 4Department of Psychiatry, College of Medicine at the University of Florida, Gainesville, FL, USACorrespondence: Alison R HwongUniversity of California, San Francisco, Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, 401 Parnassus Avenue, Box 0984, San Francisco, CA, 94143-0983, USATel +1 406 414 7185Email alison.hwong@ucsf.eduAbstract: Psychiatry residency programs with robust research training can prepare physician-scientists to make contributions that advance the mental health field. Our psychiatry residency developed a chief resident for research position to help provide mentorship, community building, and advising around scholarly activities for residents. We present the process of implementing this new position in our residency to offer a model for engaging psychiatry residents in research.Keywords: academic psychiatry, residency training, research career

Gender parity and authorship diversity are declared goals in the publishing world. This study assessed the progress of authorship gender distribution over a quarter of a century and geographic diversity over the last 15 years in high-impact psychiatric journals. All articles published in 2019 in the American Journal of Psychiatry, the British Journal of Psychiatry, and JAMA Psychiatry were included and compared with data from three points in time starting in 1994. Descriptive statistics were gathered, and chi-square tests were performed. All tests were conducted as two-tailed, and p-values < 0.05 were considered to be statistically significant. Inter-rater reliability was calculated via Cohen's kappa. In 2019 a total of 473 articles were published. Forty percent of all authors, 42.3% of first authors, and 29.4% of senior authors were female. Counting original research articles only, female first authorship reached 50.4%. In the 25-year period between 1994 and 2019, female first (p <.001), female senior (p <.001), and female overall (p <.001) authorship has increased. In the specific period between 2014 and 2019, overall female senior authorship in all articles (p =.940) as well as first (p =.101) and senior (p =.157) in original research plateaued. In non-original research articles, female first authorship was higher in 2019 compared to 2014 (p =.014), whilst female senior authorship plateaued (p =.154). Geographic diversity was low and did not change over time. Gender parity in the subcategory original research articles was reached for the first time in 2019. Senior female authorship and geographic diversity remain areas of concern that need further investigation and specific interventions. [ABSTRACT FROM AUTHOR]

An editorial is presented on Glucocorticoids such as cortisol being essential for guiding normal brain development. Topics include glucocorticoid release from the adrenal glands constituting a primary component of the physiological response to stress; and neurotypical controls from two brain regions strongly implicated in the pathophysiology of both disorders the prefrontal cortex and the amygdala.

Amoud University in Borama is located in the self‐declared state of Somaliland, in the Horn of Africa. Past conflicts and resulting economic hardship have led to a lack of local academic psychiatry faculty and resources. Amoud has been for some years partnering with voluntary faculty in the United Kingdom to teach psychiatry to its medical students through in‐person "teaching missions." This was recently led by a Borama‐native psychiatry resident in Ethiopia. COVID‐19 added further hardships due to restrictions to travel and in‐person gatherings. These challenges also created the opportunity for the development of an innovative, international, hybrid (online onsite), self‐sustaining partnership model which has been successful in improving psychiatry teaching for undergraduate students in 2020–2021 and will continue in 2021–2022. An international, 'online‐connected' department of psychiatry comprising a primary care physician in Somaliland, three postgraduate trainees in Ethiopia and the United States, and three senior psychiatrists in the United Kingdom developed a local faculty‐led, hybrid‐delivered, dynamic curriculum (bedside teaching, in person and online lecturing) that adapted to the needs, resources, faith and culture of Somaliland. While 2020–2021 has been the pilot year for the program, the overall experience has been enriching for students and faculty, leading to valuable cross‐cultural conversations with impact on teaching and research. While learning about Somalilanders' and trauma, the program leads, also the authors of this article, have identified ways to harness the resilience and faith of students to bring about improvements in global mental health. [ABSTRACT FROM AUTHOR]

The authors make the case for using a written instead of a spoken supervision agreement at supervision's outset in order to provide clarity and education about supervision, supply an accessible document that supervisees can readily reference, sidestep memory issues that negatively affect the supervision process, and enable dyadic collaboration that sets an immediate positive tone for supervision. The invitational, clarifying, educational, empowering, and transparent (ICEE-T) supervision agreement approach is described, with emphasis on the essential elements to put in place at the outset of supervision. A written agreement, which is valuable at any supervisee developmental stage, can be invaluable when working with novice supervisees (e.g., because of the anxieties and self-doubt of first-time supervisees) and is explored with that group foremost in mind., Competing Interests: The authors report no financial relationships with commercial interests.

"Mr. A," a 24-year-old man, presents for evaluation of worsening depression. He describes a history of depression since adolescence, although he notes that he suffered a troubled childhood, including emotional neglect. He believes a recent breakup and having been denied a promotion precipitated this episode. "I'm sleeping all the time, and my body feels heavy," he adds. He also reports increased appetite, weight gain, and "urges to cut, which I have not done in years." However, he remains social and actively involved in several hobbies. He discontinued bupropion and escitalopram in the past because of "terrible headaches and irritability." Initially, you consider starting lamotrigine. However, your office recently implemented a clinical decision support system that recommends a trial of phenelzine. The patient's symptoms remit entirely on the medication suggested by the system. Curious as to how the system decided on this treatment, you download several papers on its development. [ABSTRACT FROM AUTHOR]

The article focuses on Dr. A, a Black woman researcher and clinician-educator in the Department of Psychiatry at a prestigious academic institution, who was appointed chair of the Diversity, Equity, and Inclusion (DEI) committee in 2017, in the context of public complaints and media coverage concerning sexism and racism. It mentions that Dr. A receives negative e-mails in response to the statement, with minimal support from the department, and assembles a DEI committee.

BackgroundEarly identification of patients with mental health problems in need of highly specialised care could enhance the timely provision of appropriate care and improve the clinical and cost-effectiveness of treatment strategies. Recent research on the development and psychometric evaluation of diagnosis-specific decision-support algorithms suggested that the treatment allocation of patients to highly specialised mental healthcare settings may be guided by a core set of transdiagnostic patient factors.AimsTo develop and psychometrically evaluate a transdiagnostic decision tool to facilitate the uniform assessment of highly specialised mental healthcare need in heterogeneous patient groups.MethodThe Transdiagnostic Decision Tool was developed based on an analysis of transdiagnostic items of earlier developed diagnosis-specific decision tools. The Transdiagnostic Decision Tool was psychometrically evaluated in 505 patients with a somatic symptom disorder or post-traumatic stress disorder. Feasibility, interrater reliability, convergent validity and criterion validity were assessed. In order to evaluate convergent validity, the five-level EuroQol five-dimensional questionnaire (EQ-5D-5L) and the ICEpop CAPability measure for Adults (ICECAP-A) were administered.ResultsThe six-item clinician-administered Transdiagnostic Decision Tool demonstrated excellent feasibility and acceptable interrater reliability. Spearman's rank correlations between the Transdiagnostic Decision Tool and ICECAP-A (−0.335), EQ-5D-5L index (−0.386) and EQ-5D-visual analogue scale (−0.348) supported convergent validity. The area under the curve was 0.81 and a cut-off value of ≥3 was found to represent the optimal cut-off value.ConclusionsThe Transdiagnostic Decision Tool demonstrated solid psychometric properties and showed promise as a measure for the early detection of patients in need of highly specialised mental healthcare.

Psychotherapy supervision is an essential component of graduate medical education in psychiatry. However, most psychotherapy supervisors have never had training specific to supervision, and the requisite skills have received little attention in the literature. The authors of this article describe the first year of a pilot project that was aimed at fostering interest and skill in psychotherapy supervision among senior residents. In this model, a postgraduate year (PGY)-4 resident supervised a PGY-2 resident's psychodynamic psychotherapy while receiving supervisory support from a senior faculty member. Feedback from the two residents and the residency program director was positive. The PGY-2 resident reported benefiting from near-peer supervision. The PGY-4 resident continued to supervise residents after graduation and felt well prepared to assume that role. The residency program continued to use this model after the pilot period. Other training programs can replicate this model to nurture the next generation of psychotherapy supervisors., Competing Interests: The authors report no financial relationships with commercial interests.

Women are currently underrepresented in academic psychiatry. As publication activity reflects both leadership and participation in academia, we examined temporal trends in women's authorship by conducting a large-scale bibliometric study of psychiatry journals. We examined changes in proportions of women in the first, last, and overall authorship positions over time; relationship to journal impact factor and editorial board makeup; and rates of transition to senior author status using original research articles published in the 24 highest-impact psychiatry journals between January 2008 and May 2018. In 30,934 articles, women represented 40.0% of all authors in 2008 and 44.8% in 2018, with a significant increase in the percentage of women as first authors (2008: 43.5%, 2018: 49.5%; B = 0.64, p =.002) and last authors over time (2008: 30.0%, 2018: 35.7%; B = 0.64, p = 1 × 10−5). Articles with women as last authors were significantly more likely than those with men as last authors to have a woman as first author (χ2 1 = 126.1, p < 2.2 × 10−16). Women exhibited slower rates of transition to the last author position (log rank p = 2 × 10−16); time to 10% transition was 5 years for men and 9 years for women. These results indicate continued improvement in the representation of women authors in psychiatry journals, resulting in near parity in first authors. However, slower rates of transition to the senior author position and continued underrepresentation of women as senior authors suggest ongoing challenges in achieving gender parity in academic leadership. At the present rate of change for last authors (0.64% increase per year), women would achieve parity in senior authorship in ∼20 to 25 years. [ABSTRACT FROM AUTHOR]

Objectives: To compare explicit and implicit stigmatizing attitudes towards mental illness among undergraduate students, medical school students, and psychiatrists, and to assess whether attitudes are associated with education level, exposure to, and personal experience with mental illness.Methods: Participants from McMaster University were recruited through email. Participants completed a web-based survey consisting of demographics; the Opening Minds Scale for Healthcare Providers (OMS-HC) 12-item survey, which measures explicit stigma; and an Implicit Association Test (IAT), measuring implicit bias toward physical illness (diabetes mellitus) or mental illness (schizophrenia).Results: A total of 538 people participated: undergraduate students ( n = 382), medical school students ( n = 118), and psychiatrists ( n = 38). Psychiatrists had significantly lower explicit and implicit stigma than undergraduate students and medical school students. Having been diagnosed with mental illness or having had a relationship with someone experiencing one was significantly associated with lower explicit stigma. Mean scores on the OMS-HC "disclosure/help-seeking" subscale were higher compared with the "attitudes towards people with mental illness" subscale. There was no correlation between the OMS-HC and IAT.Conclusions: These findings support the theory that increased education and experience with mental illness are associated with reduced stigma. Attitudes regarding disclosure/help-seeking were more stigmatizing than attitudes towards people with mental illness. The groups identified in this study can potentially benefit from anti-stigma campaigns that focus on reducing specific components of explicit, implicit, public and self-stigma. [ABSTRACT FROM AUTHOR]

An editorial is presented on the Dismantling Structural Racism in Academic Psychiatry to Achieve Workforce Diversity. The article discusses that the recruitment and retention of Black, Indigenous, and people of color (BIPOC) faculty in academic medicine remains a challenge. Significant changes in the demographic landscape of the United States over the past decade highlight the need for medicine and health care systems to align better with the social and cultural needs of those seeking care.

Objective: This paper gives guidance for developing collaborative clinical research within an academic psychiatry department.Methods: We describe the experience at the Australian National University Medical School, and present three case studies.Results: The results reveal that general principles include, but are not limited to, intellectual curiosity, mentorship, collaboration and protected time.Conclusions: We conclude that a particular strength of a new research department at a medical school may be close collaborative research within clinical settings. [ABSTRACT FROM AUTHOR]

Background Within academic psychiatry, women are underrepresented in the higher academic ranks. However, basic determinants of women's lack of academic advancement such as publication activity are poorly understood. The present study examines women's publication activity in high-impact psychiatry journals over two decades and reports developments in the numbers of male and female authorship over time and across cultural areas. Methods We conducted a retrospective bibliometric review of all articles published in 2004 and 2014 in three high-ranking general psychiatry journals. Statistical comparisons were made between the two years and with results from a baseline assessment in 1994. Results The overall percentage of female authors increased from 24.6% in 1994 to 33.2% in 2004 to 38.9% in 2014. Though increases in female authorship were statistically significant for both decades, there was less difference between 2004 and 2014, indicating a possible ceiling effect. Rates of female first authors increased between 1994 and 2014, though to a lesser degree between 2004 and 2014. Numbers of female corresponding authors plateaued between 2004 and 2014. Within Europe, Scandinavia displayed the most balanced gender-wise first author ratios. Western European and Central European countries increased their rates of female first authors substantially between 2004 and 2014. Conclusions Despite gains in some areas, our study reveals considerable deficits in the diversity of the current academic psychiatric landscape. Ongoing efforts and interventions to enhance the participation of underrepresented groups on institutional, political and editorial levels are necessary to diversify psychiatric research. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Research methodologies in psychiatry have followed both the changes in mental health care and the need of updating programs of medical residency. To identify empirical articles in the indexed literature from 1997 to 2002, with the aim of analyzing and discussing methodological aspects of research dealing with the description and assessment of residency programs in psychiatry. METHOD: The bibliographic survey was performed using MedLine, PsycLit, Web of Science, and Lilacs. Twenty-one articles were identified. RESULTS: Nineteen studies were characterized as exploratory-descriptive and two as experimental. Data collection used questionnaires in 12 of them, and combined techniques in the other seven and the two experimental studies had data collected by tests applied before and after the teaching intervention. Most of the subjects were residents and program directors. Fifteen studies used statistical analysis. CONCLUSIONS: All the articles outlined the problems based on literature reviews. Most of the studies made use of standard techniques of social research and only two used experimental procedures. Only three studies employed external measures in order to establish correlations with the collected data. Procedures to validate and assess the reliability of the instrument by means of pilot-studies were absent in 11 studies, what may indicate methodological biases.OBJETIVOS: As metodologias de pesquisa na psiquiatria têm acompanhado tanto as transformações nos sistemas de atendimento à saúde mental como a necessidade de atualização dos programas de residência médica. Identificar, analisar e avaliar na literatura indexada entre 1997 e 2002 artigos empíricos relativos à avaliação de programas de residência em psiquiatria. MÉTODO: O levantamento bibliográfico foi realizado através dos indexadores MedLine, PsycLit, Web of Science e Lilacs. Foram identificados 21 artigos. RESULTADOS: 19 estudos caracterizam-se como descritivos exploratórios e dois, experimentais. Em 12, a coleta de dados utilizou questionários, em sete, técnicas combinadas e, nos dois estudos experimentais, os dados foram coletados por meio de testes aplicados antes e depois da intervenção. Residentes e diretores de programas constituíram a maioria dos sujeitos. Em 15 trabalhos, a análise de variáveis utilizou procedimentos estatísticos. CONCLUSÕES: Todos os artigos delinearam os problemas com base em revisão da literatura. A maioria dos trabalhos utilizou técnicas comuns na pesquisa social e apenas dois empregaram recursos experimentais. Somente três estudos utilizaram medidas externas para estabelecer correlações com os dados coletados. Procedimentos de validação e aferição de confiabilidade do instrumento, por meio de estudos-piloto, não foram realizados em 11 estudos, o que pode indicar vieses metodológicos.

• This is the first study to explore gender disparities in Psychiatry endowed chairs. • Overall models found that women were more likely to hold endowed chairs than men. • For faculty with an MD, gender was not associated with holding an endowed chair. • For faculty with a PhD, women were more likely to hold endowed chairs than men. The current study examined gender differences in endowed chairs within Departments of Psychiatry and Behavioral Sciences across the top 10 NIH-funded Schools of Medicine. The names of full professors with and without endowed chairs were collected and a multivariable logistic regression model was constructed to predict having an endowed chair considering gender, primary degree, NIH funding, and citation number. Secondary analyses repeated the models separately for individuals holding an MD or MD/PhD versus those with a non-MD doctoral degree (i.e., PhD). There were 715 full professors (36% women) and 115 endowed chairs (35% women). When adjusting for primary degree type, funding, and citations, women were significantly more likely to hold an endowed chair than men. Secondary models indicated that findings differed based on primary degree type. Among those with an MD or MD/PhD, gender was not associated with holding an endowed chair while among faculty with a PhD, women full professors were significantly more likely to hold an endowed chair than men. These results diverge from a prior study of Departments of Medicine in which endowed chairs were found to favor men. [ABSTRACT FROM AUTHOR]

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., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Trimmel, Amering, Suessenbacher-Kessler, Schrank and Gmeiner.)

How do psychotherapy supervisors most effectively integrate issues and concerns about multiculturalism and social justice (MSJ) into the supervisory experience? Concrete examples of how to best address this integration are needed, and this article provides one such example. The authors propose multicultural streaming as one approach to orient supervisees about, and prepare them for, incorporation of MSJ matters into group supervision and to foster their evolving sense of culturally humble practice. This article defines multicultural streaming, presents a plan for its implementation at the group's outset, and identifies implementation guideposts for consideration. A set of cultural humility guidelines adapted for group supervision is also proposed for group facilitation. This perspective is presented with the hope of generating further discussion about integrating MSJ issues into the group supervisory experience.

The biopsychosocial model, the current method in psychiatric assessments, is reviewed and critiqued. The history and original intents leading to the conception of the biopsychosocial model are briefly discussed. Five inherent problems with the use of the biopsychosocial model in psychiatric assessments and training programs are presented. Two alternative approaches are discussed and promoted for clinical, educational, and research practices in medicine. [ABSTRACT FROM AUTHOR]

The article informs about successful and rapid implementation of telehealth to conduct hospital psychiatry services at a large academic hospital. Topics discussed include terms of minimizing the use of personal protective equipment and of maximizing social distancing; deployed a comprehensive telehealth solution that allowed to deliver outstanding patient care and maintain our educational mission; and clinical workflows, both inpatient psychiatry and consultation-liaison psychiatric services.

Abstract: In the second half of the 19th century new drugs introduced by the pharmaceutical industry helped lead to the establishment of academic departments in psychiatry. Causal treatment of cerebral pellagra by nicotinic acid and cerebral syphilis by penicillin in the first half of the 20th century led to major changes in the diagnostic distribution of psychiatric patients. In the second half of the 20th century with the introduction of a rapidly growing number of psychotropic drugs, pharmacotherapy became the primary form of treatment in mental illness. Psychiatrists today perceive neuropharmacology as one of the basic sciences of psychiatry and psychopharmacology as the bridge between the mode of action and the clinical indications of psychotropic drugs. Pharmacotherapy with psychotropic drugs focused attention on the differential responsiveness to the same drug within the same diagnostic category. Yet, instead of re-evaluating psychiatric nosology and conducting research in psychopathology, a statistical methodology was adopted for the demonstration of therapeutic effectiveness in pharmacologically heterogeneous populations. Employment of consensus-based classifications and psychiatric rating scales in the clinical development of psychotropic drugs led to semi-finished products, which are prescribed indiscriminately. Replacement of single-center clinical trials by multi-center centrally coordinated clinical investigations led to the control of education in pharmacotherapy by the pharmaceutical industry. To separate education from marketing, the identification of the treatment-responsive forms of illness and the delineation of the therapeutic profile of psychotropic drugs are proposed with the employment of a new methodology, the “Composite Diagnostic Evaluation System.” It is postulated that development of a pharmacologically valid psychiatric nosology with the employment of a “nosologic matrix” would provide the pharmaceutical industry with the necessary feedback to develop clinically selective drugs in mental illness and to break the impasse of progress in “translational research” in psychiatry. [Copyright &y& Elsevier]

Objective: To examine the relationship between academic psychiatry and the pharmaceutical industry, focusing on a partnership between academics in Melbourne and Eli Lilly and Company (Lilly Melbourne Academic Psychiatry).Conclusions: Relationships between the pharmaceutical industry and the medical profession (including psychiatry) are under scrutiny as never before. Despite the complex nature of the relationship, the present paper argues that partnerships with external corporations such as pharmaceutical companies are of increasing importance for academic departments of psychiatry and research institutes, in environments in which core funding for tertiary institutes is being reduced. The partnership between Melbourne psychiatric academics and Eli Lilly and Company shows that benefits accrue to both parties, and suggests that there is a worthwhile place for other industry- academic collaborations of a similar nature in Australia. [ABSTRACT FROM AUTHOR]

Objective: To give an overview of academic departments of psychiatry in Australia, emphasising the contribution they have made to the development of psychiatry in this country and the current pressures on them. Method: Review of the literature, historical perspective and personal observation. Results: University departments of psychiatry are under considerable stress in Australia because of pressure on both the health and education budgets. Conclusion: In the current climate, university departments need to reconsider their core goals and review their sources of funding if they are to survive and prosper. [ABSTRACT FROM AUTHOR]