The secret behind mental illness manuals
By Lisa Richwineindia Updated: Apr 22, 2006 20:35 IST
Most of the experts who wrote the manual widely used to diagnose mental illness have had financial ties to drug makers such as research funding or stock holdings, US researchers said on Thursday.
Writing in a new study, they called for full disclosure of the relationships between companies and the medical experts on panels that craft future editions of the Diagnostic and Statistical Manual of Mental Disorders, known as the DSM.
"Transparency is especially important when there are multiple and continuous financial relationships between panel members and the pharmaceutical industry, because of the greater likelihood that the drug industry may be exerting an undue influence," the researchers wrote in a study to be published in the journal Psychotherapy and Psychosomatics.
The American Psychiatric Association, which publishes the DSM, said it would require financial disclosures for the next version, due out in 2011.
The study found 56 per cent of 170 psychiatric experts who worked on the most recent edition, published in 1994, had at least one financial link to a drug maker at some point from 1989 through 2004.
The relationships included speaking or consulting fees, ownership of company stock, payment for gifts and travel and funding for research.
All of the experts who developed sections defining mood disorders, schizophrenia and other psychotic disorders had such links, the study said.
"The connections are especially strong in those diagnostic areas where drugs are the first line of treatment for mental disorders," the study said.
Critics say psychiatric drugs are overprescribed.
Dr Darrel Regier, director of the American Psychiatric Association's research division, said the study was "an attempt to develop probably some guilt by association with the pharmaceutical industry."
He said he did not believe financial connections to companies influenced development of the manual.
If none of the experts were involved with the industry, "that would mean they were really out of step with the major advances in the treatment of mental illness," he said.
The authors of the new study, researchers from the University of Massachusetts and Tufts University, said they based their findings on searches of various databases, financial disclosures in medical journals and other records.
They said they could not determine if the experts had ties to the companies while they were working on the manual.
But Lisa Cosgrove, one of the study's authors, said the associations could raise questions even if they occurred after the experts updated the DSM.
"They can certainly leverage their participation on the DSM, which is very prestigious, into lucrative consulting contracts," said Cosgrove, a clinical psychologist at the University of Massachusetts in Boston.
Ken Johnson, a spokesman for the Pharmaceutical Research and Manufacturers of America, said the industry group had not yet reviewed the study. "But it is important to note that the physicians and other health care professionals who sit on expert medical advisory panels have impeccable integrity and base their decisions on independent judgments and research," he said.