A15 15..15

Several papers in the BJPsych this month present findings that challenge accepted notions in psychiatry, and one paper focuses specifically on the extent to which the findings of highly cited papers are subsequently replicated. Tajika et al (pp. 357–362) identified highly cited studies claiming evidence of effective treatments reported in a range of high-impact general medical and psychiatric journals. Following the progress of attempts at replication in the literature over 10 years, the authors found almost half had not been subject to any attempt at replication (40 of 83), 16 were contradicted and 11 were found to have substantially smaller effects. The authors advise readers to exercise caution when interpreting the significance of studies reporting large treatment effects on the basis of small study samples, even if the studies are published in high-impact journals and are highly cited. Challenging the notion that stigma is the explanation for the reluctance of military personnel to seek treatment for mental ill health, Adler et al (pp. 346–350) found evidence to support a broadening of the conceptualisation of barriers to and facilitators of mental healthcare and, in particular, found an important preference for self-management among surveyed US soldiers. In the field of interventions for mental health vocational rehabilitation, the effectiveness of individual placement and support (IPS) is well accepted. However, its implementation has been limited by the requirements for time-unlimited support and fixed case-loads. Burns et al (pp. 351–356) challenge the essential nature of these requirements and find that IPS-LITE (time-limited) is equally effective to IPS and, the authors argue, may be more cost-effective. Also challenging current notions are arguments made in favour of applying a developmental perspective to psychiatric classification in an editorial by Hall & Owen (pp. 281–282), while Castle and Singh (pp. 288–292) debate the current notion that separate early intervention in psychosis is still the best option.