From the Editor-in-Chief's Desk

This issue of the journal is noteworthy for its geographic diversity and wide variety of clinical foci. For instance, Xia et al. present a welcome meta-analysis of the comparative efficacy and safety of both olanzapine and risperidone in children and adolescents with psychosis, utilizing both the English and the Chinese literature. The letter from Moore, practicing in Australia, presents an instructive snapshot of alternative medicine approaches to pediatric acute-onset neuropsychiatric syndrome, illustrating a widespread phenomenon: when science argues about cause, clinical orthodoxy has no currency.

I encourage you to pay attention to two compelling papers. The letter from Naguy et al. describes an interesting scenario: symptoms of compulsive buying (“oniomania”) that emerge as side effects of psychotropic treatment with methylphenidate and aripiprazole (Abilify). The authors' interest in this non-DSM diagnosis may not appeal to many readers, but their diligence in documenting connections between symptoms and adverse drug reactions (ADRs) is laudable. I also draw your attention to a welcome reference to the Naranjo scale, which provides a simple and understandable method for classifying possible ADRs as definite, probable, possible, or doubtful.

Elsewhere, Tahkapaa et al. present a truly fascinating analysis of benzodiazepine use in Finnish young adults based on Finland's national Prescription Register, an indispensable tool for epidemiological research on trends in psychopharmacology. I strongly encourage readers to examine this paper, which provides insight in at least three critical areas: first, the age of onset of steady use of benzodiazepine anxiolytics; second, the decrease in the prevalence of long-term use over the past decade; and third, the gender disparities in problematic long-term use. “To our knowledge, the present study is the first nationwide register-based study focusing on use and long-term use of benzodiazepines among young adults,” the authors write. “The overall prevalence of use decreased by one fifth and long-term use decreased by over one third between 2006 and 2014. Overall benzodiazepine use was more common among females, whereas long-term use was more common among males.”

The authors counsel that even though use is decreasing, demographic trends mean doctors should “pay more attention to benzodiazepine prescribing and monitoring for young men who are especially prone to long-term use.” They hypothesize this follows from reports that “abuse or misuse of anxiolytics and hypnotics in adolescence to be significantly more common in males than females in Finland compared with many other European countries.”

This is truly a fascinating and optimistic time to be in the field—for even as research priorities shift or dollars dry up in one country, the whole world is using newly available data and leveraging clinical experience and conjecture in novel and remarkable ways.