Study: Medical Manual's Authors Often Tied to Drugmakers
USA Today, Apr 19 , 2006
majority of the medical experts who created the "bible" for
diagnosing mental illness have undisclosed financial links to
drugmakers, says a study out Thursday.
And some panels overseeing disorders that
require treatment with prescription drugs, such as schizophrenia and
"mood disorders," were 100% filled with experts financially tied to
the pharmaceutical industry, says the study published in the journal
Psychotherapy and Psychosomatics.
The Diagnostic and Statistical Manual for
Mental Disorders, or DSM, is the American Psychiatric Association's
diagnosis manual. It is also used as the basis for insurance
payments for psychiatric treatments, including drugs.
"No blood tests exist for the disorders in
the DSM, it relies on judgments from practitioners who rely on the
manual," says lead study author Lisa Cosgrove of University of
The researchers looked for research funds,
consultancies, patents and other gifts or grants received by members
of the 18 separate DSM preparation panels from 1989 to 2004, both
before and after their terms.
They found that among the 170 medical experts
who created the two most recent editions of the manual, 56% had one
or more financial ties to the pharmaceutical industry. In addition
to the schizophrenia and mood disorder panel's links, more than 80%
of panel members for "anxiety disorders," "eating disorders,"
"medication-induced movement disorders" and "premenstrual dysphonic
disorder" had financial ties.
rely on the APA (American Psychiatric Association) to police its
activities, and we take that responsibility very seriously," says
association psychiatrist Darrel Regier. The next edition, scheduled
for release in 2011, will disclose all industry financial ties to
panel members, he says, either in the manual or on a website.
"I don't think that's good enough. People
don't poke around in the latest issue looking for
conflict-of-interest statements," says physician Peter Lurie of
Public Citizen, a consumer advocacy group based in Washington, D.C.
Ideally, the DSM would be created by experts without any financial
links to drugmakers, he says.
The Pharmaceutical Manufacturers Association
responded, in a statement by spokesman Ken Johnson, that the health
care professionals on these panels "have impeccable integrity and
base their decisions on independent judgments and research."
But the journal, PLOS Medicine, in
April accused the drug industry of "disease-mongering," inventing
diseases from everyday aggravations, such "restless legs syndrome,"
and widening definitions to sweep up more patients.
Psychologist David Healy of the United
Kingdom's Cardiff University notes that recent revisions to the DSM
eliminated a subtype of schizophrenia that responded poorly to
drugs. And "melancholia" was eliminated in favor of major depressive
disorder, Healy says. "The upshot is that some patients are going to
lose out," he says.
Regier disputes the claims.
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