South African Psychiatry - February 2019

FROM THE EDITOR
Dear Reader,
Welcome to our first issue for 2019. The year is well underway. Since the
last issue I had a response from the Department of Higher Education and
Training (DoHET) regarding accreditation. The outcome did not surprise –
not recommended. At one level I can understand the DoHET’s requirement
for a certain conformity of content - and process - that is recognized as
scientific, and thus worthy of accreditation. However, the outcome got me
wondering how much bad science is published in peer reviewed journals,
accredited by the DoHET, that is subsequently rewarded with subsidy? I
suppose that depends on one’s definition of bad science. Another way
of looking at it is how much good science does not see the light of day?
I suppose the distinction between good and bad rests at the foot of peer review – and editorial
discretion. Certainly the merits of peer review are not infrequently discussed in the scientific literature.
Clearly for good reason. The process is an area of contention albeit an accepted requirement for
acceptance for publication and ultimately deemed an absolute requirement for a publication’s
scientific credentials. The ability of a peer reviewer to reject or accept publication can have
significant consequences for researchers. Bias is hard to control for, but I am not sure that we are
ready for the move to non-peer reviewed content that is subject to the scrutiny of the consumer
who decides whether an article has utility or not – subject to any such data having been the
outcome of a valid review of both methodological and ethical components of the study protocol.
And who controls for that I wonder? Then there is the thorny issue of the relationship with industry.
Industry adverts are an absolute no-no in scientific publications deemed suitable for inclusion by
the DoHET, but industry sponsored drug trials are seemingly ok…albeit that inherent bias in reporting
has been consistently shown in terms of favouring the product of the sponsoring company. Most
importantly such content must be peer reviewed, and should not be accompanied by an actual
advert. Maybe so called drug trials should simply appear in a repository and not be published
in journals? Maybe we should do away with journals altogether, and have repositories of studies
conducted at universities or institutions freely available in the interests of science to all who would
seek them out – but contained in a directory of such work that would direct clinicians or researchers
accordingly. Can you imagine, a world without data driven journals who own the copyright of the
work of others? No scientific publishing industry – noting that in a 2017 article the industry was worth
19 billion USD annually https://www.theguardian.com/science/2017/jun/27/profitable-businessscientific-publishing-bad-for-science?
The article in question went on to highlight the business
model contributing to such turnover…it is worth a read. The democratization of science. No impact
factors, no publish or perish and promotion by number of publications in ranked journals? Are these
such dangerous ideas? To return data ownership to the owners, to make data freely available?
What would replace these publications? Maybe those that publish articles that require thoughtful
reflection by experienced clinicians (or researchers) to provide meaningful information and
sharing of knowledge that truly enhances patient care – interpreting available data and fusing that
with their lived experience of patient care, in the real world. When was the last time a data driven
piece actually fundamentally changed the way you practiced? Of course I am being provocative,
but when I consider the meaningful contributions to South African Psychiatry over the years of its
existence I find so much of real value – that is both scientifically and, as importantly, experientially
based. And yet, not scientific enough. Frankly, DoHET accreditation was never a have to have…but
it would have been nice – for the authors of valuable content...and the subsidy their effort would
have yielded them…at least a portion of whatever was awarded to their university. Another thorny
issue…another time. I have been invited to speak at the forthcoming World Psychiatric Association
Congress in Lisbon (August, 2019) on the topic of… The Future of Publications…I think I have some
talking points already. Audience response will be interesting. I might start out by simply using the
word… imagine…and a recurring backing track…cue John Lennon.
As always, the current issue has a range of content ranging from the psychodynamics of the Life
Esidimeni Tragedy to pharmacogenomics and psychiatry… with quite a bit in between. Please feel
free to submit…science is everywhere. Enjoy!
Louw Roos - Department of Psychiatry, University of Pretoria
Zuki Zingela - Head, Department of Psychiatry, Walter Sisulu University
Bonga Chiliza - Head Department of Psychiatry UKZN; President South African Society of Psychiatrists
Headline Editor: Bernard Janse van Rensburg
Acknowledgement: Thanks to Lisa Selwood for assistance with proof reading
SOUTH AFRICAN PSYCHIATRY ISSUE 18 2019 * 5