All of the panel members that produced the American Psychiatric Association (APA)’s Practice Guideline for the Treatment of Patients with Major Depressive Disorder had numerous financial ties to drug companies that manufacture antidepressants, raising questions about the trustworthiness of the guideline, a UMass Boston researcher says.
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.
The manual, published by the American Psychiatric Association, details the diagnostic criteria and recommended treatments — many of which are pharmacological — for each and every psychiatric disorder. After the 1994 release of DSM-4, the APA instituted a policy requiring expert advisors to disclose drug industry ties. But the move toward transparency did little to cut down on conflicts, with nearly 70 percent of DSM-5 task force members reporting financial relationships with pharmaceutical companies — up from 57 percent for DSM-4.
Despite promises to cut back on Pharma funds, 56% of DSM V panel members have reported industry ties— Zero improvement over the percent of DSM-IV members.
First the good news: The Physician Payment Sunshine Act is now law, signed by President Obama as part of the health care bill overhaul. Starting in 2012, drug and medical device companies must report all consulting, speaking and other payments to doctors and teaching hospitals in excess of $100 annually to the federal Department of Health and Human Services, which will post the payments on a public website. This is an important first step toward making transparent the pervasive financial ties between doctors who are studying or promoting specific drugs and medical devices and the companies that manufacture these products.
Two essays published in separate periodicals this week raise troubling questions about the extent to which psychiatrists may be unduly influenced by the pharmaceutical industry, and how this relationship may effect public trust in psychiatry. The upshot? The concern about corruption, or at least the appearance of corruption is palpable. Sigmund Freud (see photo) would not be pleased. Interestingly, one of the authors is Tom Insel, the director of the National Institute of Mental Health.