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Modelling the Functional Psychoses

Professor Parker’s contribution ‘Blood brothers or just neighbours: modelling the functional psychoses’ warrants comment [1]. He provided a catchy title; dumbed down the issue with a polarized ‘proposition that schizophrenia and bipolar disorder are a single condition’; exaggerated and quoted creatively; and, not unexpectedly, he also referred to the need for subtyping of depression as well. His technique of attributing his proposition to unnamed ‘many journalists’, along with his engaging style (‘Blood brothers or just neighbours’; ‘parachutes them into the no man’s land’; ‘a no brainer’) and use of metaphors (the sharing of genes by humans and sea urchins) is typical of the linguistic techniques of those who wish to promote contentious ideas [2]. Oddly enough, bearing in mind the content of Parker’s piece, in neither the article by Lichtenstein et al., nor the Lancet editorial by Owen and Craddock, was the word ‘unitary’ utilized [3,4], although it has been in subsequent correspondence [5]. Parker introduced a dichotomy by using the words ‘as against’ when he contrasted two components of a sentence in the editorial when he asserted that ‘The editorial went on to contemplate whether ‘‘the functional psychoses are better conceptualized as a continuum’’ as against a ‘‘set of overlapping processes’’.’ This, however, conveniently omitted a third proposition in the complete sentence, which actually read: ‘How many distinct disorders it might be useful to recognize, or whether the functional psychoses are better conceptualized as a continuum or as a set of overlapping processes, is not yet known.’ This statement is hardly proposing a ‘unitary model’, which Parker arrived at by selectively quoting. In contrast to Parker’s style, which implied that dissent from his views would defy common sense (‘logic would dictate’), the editorial of Owen and Craddock provided reasoned commentary about data that match clinical experience, with a variety of options to further clarify our understanding of the association between what we refer to as schizophrenia and bipolar disorder. Clearly Parker’s ‘Reflections’ did not fit as a regular article, and they were not included as part of the Correspondence columns. Do they belong in a scientific journal? References