From the Editor's desk

Red Queen: You must run as fast as you can to stay in the same place.

Alice: Isn't it strange, we are running as fast as we can and getting nowhere.

Psychiatry in Wonderland is not very different, as many of the articles in this issue testify. We would all like to think that we have made significant advances in our understanding and management of mental illness in the past few years. Doubtless we have, but we need to be aware when we are apparently running ahead of ourselves but really standing still. So Lars Kessing and his colleagues (pp. ) have found that ‘the progressive deteriorating course’ of recurrent affective disorders has been unaffected by the introduction of new antidepressants, and despite a great increase in psychotropic drug use and more focused treatments, the overall prevalence of neurotic and psychotic disorders has remained unchanged since 1993 (Brugha et al, pp. ). Schizophrenia also, considered to be a ‘neurodevelopmental disease’ since Kraepelin's prediction of a temporal lobe focus was apparently confirmed by Johnstone and her colleagues in 1976 (Lancet, ii, 924–926), now has a new theoretical model, an ‘anthropology of the self’, that explains how social and childhood factors can have such an influence on the manifestation of disorder (Harland et al, pp. ). So back to the old safe explanations of ‘complex disorders consisting of both genetic and social factors, with a developmental component’, which not only works for schizophrenia and eating disorders (Collier & Treasure, pp. ) but also for much of what we still need to be humble about in our discipline.