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Sorry if this is a dupe....
Psychiatric experts found to have financial links to drugmakers
All who worked with mood and psychotic disorders had such ties
Shankar Vedantam, Washington Post
Thursday, April 20, 2006
Every psychiatric expert involved in writing the standard diagnostic criteria for disorders such as depression and schizophrenia has had financial ties to drug companies that sell medications for those illnesses, a new analysis has found.
Of the 170 experts who contributed to the manual that defines disorders ranging from personality problems to drug addiction, more than half had such ties, including 100 percent of the experts who served on work groups on mood disorders such as depression and psychotic disorders such as schizophrenia. The analysis did not reveal the extent of their relationships with industry ties or whether they preceded or followed their work on the manual.
"I don't think the public is aware of how egregious the financial ties are in the field of psychiatry," said Lisa Cosgrove, a clinical psychologist at the University of Massachusetts in Boston, who is publishing her analysis today in the peer-reviewed journal Psychotherapy and Psychosomatics.
The new analysis comes as debate grows over the rising use of medication as the primary or sole treatment for many psychiatric disorders, a trend driven in part by definitions of mental disorders in the psychiatric manual.
Cosgrove said she began her research after discovering that five of six panel members studying whether certain premenstrual problems were a psychiatric disorder had ties to Eli Lilly & Co., which was seeking to market Prozac to treat that very problem. The process of defining such disorders is far from scientific, Cosgrove added: "You would be dismayed at how political the process can be."
The American Psychiatric Association, which publishes the guidelines in its bible of disorders known as the Diagnostic and Statistical Manual, said it was planning to require disclosure of the financial ties of experts who write the next edition of the manual, due around 2011. The manual carries vast influence over the practice of psychiatry in the United States and worldwide.
Darrel Regier, director of the association's division of research, argued that concerns over disclosure were a relatively recent phenomenon, which may be why the last edition, published in 1994, did not note them.
Both Regier and John Kane, an expert on schizophrenia who worked on the last edition, agreed with the need for transparency, but said financial ties with industry should not undermine public confidence in the conclusions of its experts. Kane has been a consultant to drug companies including Abbott Laboratories, Eli Lilly & Co., Janssen and Pfizer.
"It shouldn't be assumed there is a true conflict of interest," said Kane, who said his panel's conclusions were driven only by science. "To me, a conflict of interest implies that someone's judgment is going to be influenced by this relationship, and that is not necessarily the case."
Steven Sharfstein, president of the American Psychiatric Association, said Wednesday that the presence of experts with ties to companies on the manual's expert panels was understandable, given that many of the top experts in the field are involved in drug research.
"I am not surprised that the key people who participate have these kinds of relationships," he said. "They are the major researchers in the field and are very much on the cutting edge and will have some kind of relationship -- but there should be full disclosure."
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