December 18, 1998

While journals that you can hold in your hand, leaf through, and whose page corners you can fold down are by no means an endangered species, APA members will soon be able to read journals published by APA and American Psychiatric Press Inc. (APPI) by turning on their computers.

Beginning next month, APA members will be able to take advantage of a new venture with Stanford University Libraries' HighWire Press in which that organization will develop and maintain a system through which psychiatrists can access electronic editions of nine psychiatry-related journals.

APA members would have free online access to the online journals published by American Psychiatric Publishing Group (APPG) to which they now subscribe. APPG now publishes the journals formerly published by both APA and APPI. Both members and nonmembers will have the option of paying an annual fee to subscribe to the system, which will allow them to read all APPG journals that HighWire Press offers online. APA members will be able to subscribe at a lower fee than nonmembers and may have the option of subscribing just to all the journals published by APPG. These fees are still being worked out.

For the first six to eight weeks of the project, APA members will have free online access to all APPG journals, noted Ronald McMillen, director of publishing operations for APA.

This project will allow APPG to increase the dissemination of the information in its journals and offers the possibility that APA can increase its publications-related revenue, according to APPI President and CEO Carol Nadelson, M.D.

This expansion of the APPG publication effort comes at a time when the two organizations have assumed a closer relationship than ever. Earlier this year, the publishing business functions of APA and APPI were consolidated and named the American Psychiatric Publishing Group.

This will end the duplication of computer systems and other business operations and lead to considerable cost savings through economies of scale, Nadelson explained.

Ken Hausman of Psychiatric News talked with Nadelson last month about an array of issues concerning APPI and its publication processes.

Psychiatric News: In addition to the HighWire Press project, are there any other innovations on the way?

Nadelson: Yes, there is one in particular that we are excited about. We are starting a project in which some of our books will be available on the World Wide Web and will be updated online as new information appears and new developments become part of psychiatric practice. Purchasers will be able to get all of the updates to a particular book via their computer until the next print version of that book is published. It's like having a living text. The books' authors will do the updating.

We are beginning, probably early next year, with two of our most popular books, the upcoming edition of the Textbook of Psychiatry and the second edition of the Textbook of Psychopharmacology, which came out in June.

PN: APPI quickly became a profitable venture. What formula does it use to determine how much of that profit is turned over to APA?

Nadelson: There is no formula for determining APPI's contribution to APA. We return all of our net profits to APA.

PN: What in general has been the size of this contribution?

Nadelson: It has varied tremendously. Since 1985 the smallest contribution has been $50,000, which was in 1986. In 1994, when DSM-IV was published, we were able to contribute just over $6 million to APA. Last year's contribution was $250,000.

PN: How does APPI compare in terms of size and market share with other companies that publish books on psychiatry and mental health?

Nadelson: We're proud to say that APPI now publishes more psychiatric books than any of its competitors. From 1988 to 1995, about 100 psychiatry-oriented books were published each year throughout the world, and APPI's share grew from about 20 percent of that total in 1988 to about 50 percent by 1995. This year it looks like we will be publishing about 75 percent of the psychiatric titles.

PN: Can you comment on how APPI prices its books and whether that pricing system elicits many complaints from purchasers?

Nadelson: Our goal has always been to price our books at a point that is both competitive and affordable to our customers. We get few complaints about our prices, and ironically the ones we do get tend to be about our least expensive books, such as the Concise Guides and our paperback monograph series. People sometimes compare the size of one of our books with that of popular books, which are often called trade books, and wonder why they only have to pay $5 or $6 for one of those and $19 for one of our briefer books.

We explain that the answer lies in three factors-development and editorial costs; the cost of manufacturing each book, that is, its unit cost; and the price at which similar books are marketed. In addition, the quality of the production requires durability. Unlike a paperback novel that can fall apart after the first or second reading, our books have to last through a great deal of use.

There are greater costs in developing scientific and medical publications because of the editing expertise needed, for example. Also, the costs of printing, binding, and the paper itself are much less with mass-market publications than with the considerably fewer units that will be sold to a limited professional audience. The per-unit manufacturing cost of one of our Concise Guides for example, is about $4, while for a mass-market paperback, similar expenses are about 35 cents.

Here are some interesting statistics about our pricing. In 1995, the average APPI book was priced at about $43. In comparison, the average psychology book cost about $61, the average psychiatric textbook about $57, and the average medical textbook about $81.

I also want to remind APA members that they are entitled to a 10 percent discount on any APPI publication and anything they purchase from our HealthSource Bookstore catalogue. These discounts come with membership in the HealthSource Bookbuyers Club, and APA members automatically belong to the club.

PN: Speaking of HealthSource, has APPI been satisfied with its venture into the retail bookstore business?

Nadelson: HealthSource Bookstore has been a very exciting undertaking that is turning out to be quite profitable as well. The store stocks books on a wide range of health-related topics of interest to both professionals and the general public.

PN: Has the bookstore added or deleted books on specific topics over the years in response to customer interest or lack thereof?

Nadelson: Terri Thomas, who manages the bookstore, indicates that there has been a surge in interest in books on alternative therapies lately so we have boosted the roster of titles available on that topic. Interest has also grown considerably in books on massage therapy and physical therapy. Also, physicians and a wide variety of health professionals are very interested in books that help them practice more successfully in the managed care environment, and books on billing procedures have also become popular. On the other hand, we have dropped books on chemistry and dentistry, for example, because of scant interest.

PN: To what extent do the latest trends in psychiatry affect the books APPI decides to publish?

Nadelson: We always carefully review all book proposals, and we certainly solicit considerable expert input on a topic that is "hot." This is because from the time we get a proposal from a potential author, it takes a minimum of two years until there is a book coming off the presses. It takes about a year just to write most psychiatric books, perhaps longer if there are multiple authors, so we try to avoid accepting a proposal on a topic that shows signs of being a passing fad or of brief interest.

We have expert peer reviewers, and members of the APPI Editorial Advisory Board assess book proposals to ensure that they cover areas that are important. They evaluate whether a topic is current and salient and whether the author is viewed as an expert in this area. We sometimes suggest that someone proposing a book on such a topic write a journal article instead.

Among topics that have recently gained considerable attention, we have books in the pipeline on psychiatry and religion, the efficacy and cost-effectiveness of psychotherapy, and sexual misconduct by physicians, for example.

I want to emphasize that our goal is always to publish titles that are really important to the field and cutting edge, even if we don't expect them to earn money. For example, we publish books on the history of psychiatry, which are important for APA but have a limited readership. We are always conscious of the needs of our diverse constituency.

APPI's Web address is . HighWire Press's Web address is .

The APPI Board of Directors

With the recent consolidation of APPI's business functions with those of APA, Jerry M. Wiener, M.D., chair of the APPI Board of Directors, explained how that board is selected and how it relates to the APA Board of Trustees.

Despite the consolidation, APPI remains a wholly owned subsidiary of APA, Wiener pointed out, and the APA Board of Trustees will continue to elect members of the APPI board, based on nominations from APPI directors, as it has done since APPI's founding in 1981. The APA trustees can add names to the candidate list submitted by APPI.

When deciding on potential APPI board members, the current board considers three criterion areas, Wiener noted. These are experience with publications and editing, experience with APA's governance and component structure, and the variety of areas in psychiatry-administrative, clinical, public sector, private practice, for example-in which the nominee is knowledgeable.

The board's twofold mission, he pointed out, is to make sure that APPI generates income for APA so that the Association can reduce its reliance on dues income and to serve as an educational arm of APA. The latter goal means that its publications must speak to the interests and concerns of psychiatrists, others in the mental health profession, and the general public. "APPI works hard to keep these two missions in balance," he said.