Psychiatry’s Bible And Ties To Pharma
10 CommentsBy Ed Silverman // January 2nd, 2008 // 10:46 am
Most of the 27 members of an American Psychiatric Association task force that is updating the psychiatrist’s bible - the Diagnostic and Statistical Manual of Mental Disorders, or DSM, have financial ties to pharma, and several failed to disclose significant aspects of their relationships when the panel was announced last July, according to a recent story in US News and World Report.
The APA sought to pursue the “most transparent” policy possible, after the last edition of the DSM contained newly named disorders that were seized on by drugmakers and a 2006 study showed that more than half of the researchers who worked on that manual had at least one financial tie to pharma, the mag writes.
But the summaries of the disclosure statements that were recently released to the public are sparse - they show only the existence of corporate connections, not dollar amounts or their duration, US News reports. Even an APA board member suggested the disclosure is less than revealing. In a 2006 memo to the board obtained by the mag, William Carpenter wrote: “Simple listing of all relationships is not very informative and does not identify potential conflicts that may need to be resolved.”
One example - Dilip Jeste, a professor of psychiatry at the University of California-San Diego, had consulting ties that didn’t appear on his disclosure form, but during 2003, he was a consultant to Pfizer and AstraZeneca, and received honoraria from Pfizer, according to documents cited by the mag. Another instance cited - task force chair David Kupfer of the University of Pittsburgh School of Medicine reported payments from two CME firms, but didn’t note their funding comes from Forest Labs and Pfizer, although the APA maintains reporting this type of relationship wasn’t required.
[UPDATE: It should be noted that such ties don't automatically confer bias and the participants agreed to limit industry income to $10,000 annually]. Nonetheless, APA President Carolyn Robinowitz says that task force nominees “were on the honor system” and acknowledged the association had made no effort to check their accuracy, the mag writes.
APA medical director James Scully pledged full disclosure for the 150-plus psychiatrists who will be named later this year to the panels that will construct the next DSM, which is due in 2012, according to Integrity in Science Watch, which adds that Scully rejected a call by some members of the group to exclude anyone with ties to drugmakers.
Hat tip to Integrity in Science Watch
Ken Thomas, RN
And thus we find out how a fraud is perpetrated on humankind.
sid
gaylord? gaylord focker?
Lisa Van S
Sid,
Lost me on that one.
Atlex
There are a couple of things to note that weren’t spelled out in ths summary. First, all participants agreed to limit industry-related fees to $10K for the length of this commitment. Second, based on the Dilip Jeste example, it is disengenuous to suggest that participants are hiding their arrangements. The participants were asked to provide a listing of their industry relationships over the past 3 years. Since the document was released in July 2007, I assume that Dr. Jeste’s 2003 arrangements have no bearing. Thus, there is not a relevant example of inaccurate disclosures.
Ed Silverman
Hi Atlex,
You raised a couple of good points. First, the limit has now been noted in an update. Second, the names of the nominees were announced in July 2007, as the APA press release indicates, although these were the people who made the final cut. The actual nominations may have occurred in 2006, so the reach back to 2003 data would then be relevant. We’ll ask the APA for clarification.
Regards,
ed at Pharmalot
Lisa Van S
Does anyone know how much funding the APA receives from Industry? Rabinowitz,”were on the honor system” I would label this as being delusional. A Conflict is a Conflict..
Ed Silverman
Here’s the promised update to the point raised by Atlex: The APA tells us that Jeste was nominated in 2006 and, therefore, the info from 2003 was relevant.
Dan
Just the simple fact that the DSM is revised questions the diagnosis and disorders of mental illnesses as well as the validity of them. Psychiatry is a rather soft science, comparatively speaking. Neurology, however, is a different matter.
Truthman
Ahh, The DSM…
The DSM is possibly the most facist book published in the world today. It’s purpose is to help psychiatrists disect and box human emotions and feelings, categorise quirks and neuroses and of course to prescribe meds for the pharmas. It has as much genuine medical and scientific value as toilet paper. And as a matter of fact, that could be a much better use for it, if you ask me…
Psychiatry is an outdated and ultimately failed belief system which has become nothing but a profitable pimp and whore for the pharmaceutical industry, it must be abolished…
One day It will be , I am sure of that..
Brian
Ah mental illness
The last great frontier of science and source of entertainment for the rest of us..