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.
Is the new Journal of the American Medical Association a special issue on reform? It doesn’t stop with its demands for new publication standards. It’s also showcasing a rallying cry from National Institute of Mental Health Director Dr. Thomas Insel, who calls on his fellow psychiatrists to “clean up our act.”
Dr. Thomas Insel stops short of calling researchers corrupt or asking them to stop taking money from drug companies. But he highlights a “bias in prescribing practices” that favors brand names drugs over cheaper generics and non-drug treatments. And he says the situation must change with new standards for transparency and full disclosure of psychiatry’s collaborations with industry.
The irresistible, plus-size piñata for on-the-case journalists is the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, now undergoing revision. The DSM famously includes snoring and jet lag as mental disorders. I took a whack last year, calling the 880-page doorstop “a naked land grab by a profession threatened with marginalization by biomedical research.”
MEDICAL advances can take your breath away. Over the past decade, medical experts have started decoding the human genome to provide genetically-personalised medicine. The experts behind these advances are geniuses. Perhaps in the same vein, the psychiatric profession imagines that their new bible of mental disorders — more than 10 years in the making — will be hailed as milestone of medical achievement. If so, they’d be wrong.