BACKGROUND: In the last years many people have questioned the reliability of research results and the societal relevance of much of today's clinical research; they are critical too about the current publication culture in which scientists are judged according to the number of articles they have published, impact factors and citations. AIM: To make a close study of the publication culture that now prevails in the Dutch biomedical sciences. METHOD: Discussion of results described in the thesis entitled 'Publish and Perish; research on research and researchers'. RESULTS: To investigate what 'pressure to publish' is, we designed the Publication Pressure Questionnaire. In addition, in a group of 437 professors, we found a relationship between 'pressure to publish' and burnout; about 25% of the professors reported having suffered from severe burnout. We used focus groups to discover the factors that scientists consider are harmful in today's publication culture. They mentioned aspects such as impact factors, problems with research funding, authorship of articles, publication bias, emphasis on quantity rather than quality and 'domineering egos'. Next, we sought the views of 400 Dutch psychiatrists on the influence of pharmaceutical sponsorship on clinical trials. The psychiatrists seem to overlook the effects that pharmaceutical sponsoring might have on research results, but were more critical of results that appeared to be 'too good to be true'. A character study of more than 500 biomedical professionals revealed a link between scientific misconduct and pressure to publish; Machiavellian characteristics seemed to be associated with this misconduct. Finally, the author of the thesis (with 'tongue in cheek') describes a new psychiatric disorder which he calls 'publiphilia impactfactorius', defined as a disorder affecting biomedical professionals characterised by narcissistic, psychopathic, manipulative and emotionally unstable traits, whose egos are focused primarily on publication and high citation scores. CONCLUSION: ...