Critical psychiatry has often been confused with what is widely known as ‘anti-psychiatry’. In this article the distinction is clarified and the particular contribution critical psychiatry makes is outlined. That contribution is constructive criticism: of the relationship between medicine and mental health practice, of the way drug and psychotherapeutic treatments for mental health difficulties might be better understood. These have implications for everyday clinical practice and there is much to be gained by openly embracing the controversies critical psychiatry highlights.

A series of editorials in this Journal have argued that psychiatry is in the midst of a crisis. The various solutions proposed would all involve a strengthening of psychiatry's identity as essentially ‘applied neuroscience’. Although not discounting the importance of the brain sciences and psychopharmacology, we argue that psychiatry needs to move beyond the dominance of the current, technological paradigm. This would be more in keeping with the evidence about how positive outcomes are achieved and could also serve to foster more meaningful collaboration with the growing service user movement.

Luiz Dratcu makes a case for a new specialty of acute inpatient psychiatry; Frank Holloway argues otherwise. In neither instance are the arguments at all surprising, and in both they are eloquently expressed. The case for a new specialty is based upon recognition of a continuing need for acute psychiatric in-patient services, and recognition that these services require particular skills and facilities which are likely to be most efficiently and effectively provided when interests and activities are focused upon them. The case against does not deny the need for attention to widely acknowledged shortcomings of many acute psychiatric in-patient services, but it does ask the questions ‘what should constitute a specialty?’ and ‘what benefit would flow from having a specialty and for whom?’

Recent studies have shown that cognitive therapy is an effective treatment for panic disorder. However, little is known about how cognitive therapy compares with other psychological and pharmacological treatments. To investigate this question 64 panic disorder patients were initially assigned to cognitive therapy, applied relaxation, imipramine (mean 233 mg/day), or a 3-month wait followed by allocation to treatment. During treatment patients had up to 12 sessions in the first 3 months and up to three booster sessions in the next 3 months. Imipramine was gradually withdrawn after 6 months. Each treatment included self-exposure homework assignments. Cognitive therapy and applied relaxation sessions lasted one hour. Imipramine sessions lasted 25 minutes. Assessments were before treatment/wait and at 3, 6, and 15 months. Comparisons with waiting-list showed all three treatments were effective. Comparisons between treatments showed that at 3 months cognitive therapy was superior to both applied relaxation and imipramine on most measures. At 6 months cognitive therapy did not differ from imipramine and both were superior to applied relaxation on several measures. Between 6 and 15 months a number of imipramine patients relapsed. At 15 months cognitive therapy was again superior to both applied relaxation and imipramine but on fewer measures than at 3 months. Cognitive measures taken at the end of treatment were significant predictors of outcome at follow-up.

This paper presents the results of a project designed to investigate the techniques used to make late bronze age Aegean stirrup-jars and to determine whether the identified techniques were influenced by regional-cultural factors. The project was initiated by the need to address the question of whether 12th-cent. BC stirrup-jars from Tell es-Sa'idiyeh in the Jordan valley, apparently of local clay, were made by local potters or by immigrant Mycenaeans. The stirrup-jars studied comprised examples from Tell es-Sa'idiyeh, Gezer, the Greek mainland, Aegina, Rhodes, Cyprus, Caria, and Egypt. Xeroradiography was used to elucidate variations in construction techniques, and the findings were tested by practical experimentation. The observations indicate that there is a degree of linkage between the techniques of manufacture and cultural background. In order to make the discussion of production techniques more secure, neutron activation analyses were also carried out; these provided information on the place of manufacture as opposed to the find-spot, and have also thrown some interesting light on patterns of trade in the Mediterranean area towards the end of the Late Bronze Age.