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• Friday, February 22nd, 2013

It will come as no surprise to anyone following issues in the treatment of mental illness

and central nervous system disorders that the medical psychiatric community and the

pharmaceutical industry seem to be rift with charges of conflicts of interest.

As an example, over the last year, numerous reliable North American news sources have

questioned why nearly 7 out of 10 of the committee members responsible for creating the

DSM-5, (the Fifth Edition of the Diagnostic and Statistical Manual of Mental Illness),

have acknowledged  financial ties to the powerful international pharmaceutical  community.

The DSM is essentially the Bible for researchers, clinicians, psychiatric drug regulation

agencies. health insurance companies, as well as policy makers and pharmaceutical


Obviously these facts seem to confirm, what has been long suspected by many, which is–

the medical psychiatric and the pharmaceutical industry are riddled with conflicts of interest

and financial relationships —at the expense of the patients themselves. As example, in the

new DSM-5, for which these people are responsible, the definition of depression has been

expanded to include bereavement-a change which, The Washington Post suggests, could

give drug companies a potential $10 billion dollar increase in antidepressant sales,

 Peter Whoriskey, Washington Post , December 26. 2012.

While no evidence has come to light showing that committee members broadened the diagnosis to aid the drug companies, the process of developing the handbook was fraught with financial links to the industry:

■ Eight of 11 members of the APA committee that spearheaded the change reported financial connections to pharmaceutical companies — either receiving speaking fees, consultant pay, research grants or holding stock, according to the disclosures filed with the association. Six of the 11 panelists reported financial ties during the time that the committee met, and two more reported financial ties in the five years leading up to the committee assignment, according to APA records.

■ A key adviser to the committee — he wrote the scientific justification for the change — was the lead author of the 2001 study on Wellbutrin, sponsored by GlaxoWellcome, showing that its antidepressant Wellbutrin could be used to treat bereavement.

■ In 2010, another APA panel developed guidelines on how to treat patients once they have been diagnosed with major depression, including advice on medication. Six of the seven panelists had received consultant pay, lecture fees or research support from pharmaceutical companies, according to their disclosures. The association also appointed an oversight panel that declared that the recommendations had been free of bias, but most of the members of the “independent review panel” had previous financial ties to the industry.

In an interview, APA chief executive James H. Scully Jr. noted that in preparing the new handbook the organization had taken steps to reduce conflicts of interest. Two years before the Institute of Medicine published its restrictions, the APA required that panel members regularly file disclosures and placed limits on their financial connections to drug companies.

Each work group member was allowed to receive as much as $10,000 a year in income from pharmaceutical companies and hold as much as $50,000 in stock. Members could also receive unlimited amounts of money from pharmaceutical companies to conduct research.                                                                       (Whoriskey, 2012) .

The DSM-5 has been developed by an American Psychological Association appointed task force and various panels consisting of experts in diverse fields of psychiatry. But many of these experts serve, or have served, as paid spokespeople or scientific advisors for drug companies, or conduct pharmaceutical industry-funded research. Some of the most conflicted panels are those for which drugs represent the first line of treatment, with two-thirds of the mood disorders panel, 83 percent of the psychotic disorders panel and 100 percent of the sleep disorders panel disclosing “ties to the pharmaceutical companies that manufacture the medications used to treat these disorders or to companies that service the pharmaceutical industry,” according to the study.

“We’re not trying to say there’s some Machiavellian plot to bias the psychiatric taxonomy,” said Lisa Cosgrove, professor of psychology at the University of Massachusetts, and who is also a research fellow at Harvard’s Edmond J. Safra Center for Ethics. “But transparency alone cannot mitigate unintentional bias and the appearance of bias, which impact scientific integrity and public trust.”

“We’re not opposed to the proper use of psychiatric drugs when there’s a real diagnosis and when a child or an adult needs pharmacological intervention,” said David Elkins, president of the American Psychological Association’s society for humanistic psychology and chairman of the committee behind the petition. “But we are concerned about the normal kids and elderly people who are going to be diagnosed with these disorders and treated with psychiatric drugs. We think that’s very, very dangerous.”

“Controversy continues to swell around the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, better known as DSM-5. A new study suggests the 900-page bible of mental health, scheduled for publication in May 2013, is ripe with financial conflicts of interest.” Katie  Moisse, ABC World News with Dianne Sawyer, March 2012.

QuietMinds makes no allegations.  We simply compiled information regarding the controversy and report it to you.  Like everything with QuietMinds we urge you to research the information and decide for yourself the facts.

Category: Mental Disorder
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