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Povl Munk-Jørgensen edits left

2015; Wiley; Volume: 132; Issue: 6 Linguagem: Inglês

10.1111/acps.12482

1600-0447

Gordon Parker,

European and International Law Studies

It is this editor's attitude that lack of knowledge is not the major problem in clinical psychiatry. A major problem is the use of existing new knowledge and its implementation without too long a latent period. We welcome you to a special issue of Acta Psychiatrica Scandinavica. In addition to several general contributions, it analyses and honours the editorship of Povl Munk-Jørgensen, who steps down this month from an 18-year tenure as Acta Psychiatrica Scandinavica's editor. Reflecting his priorities and legacies, this issue has a key primary topic – editing and disseminating clinical psychiatric research; and two related topics – mentoring young authors, and the provision of training in research and scientific writing for medical students. As readers consider these contributions, they will effectively observe the Acta Psychiatrica Scandinavica back story of the last eighteen years. Not simply Povl's rich set of skills, but his mentoring of a next generation of academic leaders and editors. Vitae lampada tradunt. His professional legacy has been substantive but, in addition to being a man of substance, Povl is a man of style. He has been gimlet-eyed in tackling the convergent tasks that face an editor but also shown an impish divergence, marked by whimsy and wit, and indicating a lightness of being and mental youthfulness. Proof that he has actually enjoyed being an editor, and support for Stephen King's observation ‘ … to write is human, to edit is divine’. The reader can appreciate those endearing and enduring personality characteristics that shape his editorial signature by reading his response to some of the questions in the published Interview and, more palpably, in the appended Povlisms abstracted from cyberspace. In the individual commentaries addressing the meaning and undertaking of clinical psychiatric research, we can observe quite disparate themes. Increasingly, Psychiatry has favoured a strong weighting to evidence-based research and efficacy studies. Reasons are identified in one commentary. In essence, if Psychiatry was to move from a cult-based discipline with idiosyncratic and ideological theories so as to regain and retain credibility, a weighting to scientific method was not only wise but fitted with the medical zeitgeist. But it may be that Psychiatry embraced the science too closely in a reductionistic rush, so leading to concerns about a swing from ‘brainless Psychiatry’ to ‘mindless Psychiatry’ – with the latter comprising extreme biologism and marginalizing of Psychiatry's other domains. A point made in another commentary is that we should recognize the strengths as well as the limitations of both evidence-based efficacy studies and real-world effectiveness studies, and then, rather than polarizing to one extreme, seek to determine how each domain can complement the other to create a ‘balanced evidence base’ and contribute to translational research (the latter a concept variably valued by our commentators). Another contributor rightly states that clinical research has always had a problem in measuring up to pure science but, rather than this leading to nihilism, it could be embraced as a challenge. Some research models attract heavy criticism in terms of how they may constrain or mislead clinical research. Recent DSM paradigms are a predictable target but the extent to which journals reify any DSM model limitations by favouring or even effectively mandating ‘DSM diagnoses’ receives little mention. One projected research model (RDoc) attracts trenchant criticism of its logic and its risk of generating ‘metaphysical schematics’. An editor has the capacity but not always the fortitude to effectively challenge any dominant model that is worthy of critical analysis – but also needs to ensure that such criticism is constructive and not simply polemical. Povl has shown great acuity and subtlety in addressing this issue, one that is generally relegated to the too hard basket of editorial tasks. The argument is put by one writer that clinical research is better viewed as an investment than as an expense. It is likely that even the bean counters see some value in investing in psychiatric research. Perhaps the issue is, more, whether psychiatry obtains a fair share of the investment in clinical research. There are many examples that can be nominated but a good one is the discovery of lithium as a mood stabilizer. After its approval by the US FDA, an article in Science 1 quantified that lithium's benefits had conferred savings to the US economy of $145 billion by the mid-nineties. In our interview, Povl rightly argues that psychiatrists need to ‘straighten up’ and be prouder of our profession, rather than enervated by lingering stigma. As an extension, psychiatrists need to be more assertive in their arguments for an equitable share of medical funding. There is a tendency for psychiatry's scientific community to view publication of clinical research for its own evaluation and use, but several of our authors make the point that such research is also for consumers, and there can be little doubt that consumers’ representation and equity in perusing research findings has expanded considerably and led to a more informed discourse with managing clinicians, a change that should not only be welcomed but advanced. It may also assist in addressing a concern put by several past, present and future editors – the future existence of psychiatry journals. Many of the contributors summarize the tasks of an editor and, while there is strong agreement about the fundamental set of job descriptors, the extent to which the commentaries articulate nuances is illuminating. In particular, how a successful editor needs to lead both from in front and from behind – but without leaving obvious tracks. The first requires clear strategy and vision, the latter involves elbow grease in attending to tasks that define the journal's quality. Both require a very broad skill set to enable an editor to act, in the description of one commentator – as ‘a handmaiden to science’. In addition to the substantive editorial ‘tasks’, an editor can chose the manner in which he or she relates to their key constituents – those who submit their papers – and, in particular, where the editor positions themselves along an interpersonal dimension: people management as one commentator observed. The editors of old would offer brief or extensive notes to their contributors, whether apologizing for their inability to accept a submission, or in suggesting revision or – the ultimate – on accepting a paper. Increasingly now, however, we observe multilevel editorship (where deputy and assistant editors may share the burden but which may result in The Editor never actually sighting the submission), while communication from the journals runs to a formulaic model with The Editor seemingly a ghost in the machine. When the commentaries are read as a whole, it is notable to observe the impact that a direct personal editorial communication can make. As once observed by Leo Busaglia, ‘Too often we underestimate the power of…a kind word, a listening ear, an honest compliment, or the smallest act of caring’. No contributor is sanguine about having a submission rejected. But the editor who can offer a simple brief note (e.g. ‘Sorry X, it doesn't quite fit for us’. ‘Apologies, but not quite up to your usual standard’) has a loyal fan for life. Thus, manners also market the editor. To show sensitivity and consideration does not disallow a firm decision. As Leslie Stephen (father of Virginia Woolf) observed: ‘The editor … . must, by necessity…be autocratic. He will do his best to be a considerate autocratic’. Both Povl and his ever obliging Editorial Secretary, Birgitte Christiansen, have demonstrated alone and in tandem great sensitivity, skill and thoughtfulness in communicating with the constituents. In essence, Povl has served as an exemplary personal editor. He has nurtured contributors, aspirant contributors, assessors and students in a manner that reflects his civility. It reflects well on him and has given a value-added stamp to the journal. As one contributor notes, Povl has achieved this by sincerity, charm and dignity. In addition, his whimsical self-deprecatory style has endeared him to his constituents. To capture that dimension, his unique voice, we include a structured interview and the appended Povlisms. We members of the editorial board hope that this special issue captures his extraordinary contributions as an editor and, of equal importance, his special presence. Gordon Parker is supported by an NHMRC Program Grant (103796)