Financial Ties between DSM-IV Panel Members and the Pharmaceutical Industry

Abstract

Background: Increasing attention has been given to the transparency of potential conflicts of interest in clinical medicine and biomedical sciences, particularly in journal publishing and science advisory panels. The authors examined the degree and type of financial ties to the pharmaceutical industry of panel members responsible for revisions of the Diagnostic and Statistical Manual of Mental Disorders(DSM). Methods: By using multimodal screening techniques the authors investigated the financial ties to the pharmaceutical industry of 170 panel members who contributed to the diagnostic criteria produced for the DSM-IV and the DSM-IV-TR. Results: Of the 170 DSM panel members 95 (56%) had one or more financial associations with companies in the pharmaceutical industry. One hundred percent of the members of the panels on ‘Mood Disorders’ and ‘Schizophrenia and Other Psychotic Disorders’ had financial ties to drug companies. The leading categories of financial interest held by panel members were research funding (42%), consultancies (22%) and speakers bureau (16%). Conclusions: Our inquiry into the relationships between DSM panel members and the pharmaceutical industry demonstrates that there are strong financial ties between the industry and those who are responsible for developing and modifying the diagnostic criteria for mental illness. The connections are especially strong in those diagnostic areas where drugs are the first line of treatment for mental disorders. Full disclosure by DSM panel members of their financial relationships with for-profit entities that manufacture drugs used in the treatment of mental illness is recommended.

Guidelines: l'évidence comme pierre angulaire

“…Toutefois, il est difficile de déterminer si leurs évalua- [19]. Il convient en outre de relever que les conflits qui influencent notre façon de penser ne sont pas seulement d'ordre financier, mais aussi d'ordre intellectuel [20].…”

Reducing the stigma of public health messages. Invited commentary on … Everybody gets stressed

“…Recent revelations about the links between leading psychiatrists and pharmaceutical companies are not reassuring for the profession or the public. 3,4 The most common field where psychiatric diagnostic categories run into difficulty is general practice. Family doctors rarely make a specific diagnosis of major depression before prescribing antidepressants.…”

Diagnóstico Psiquiátrico e Clínica Psicanalítica

“…O próprio contexto político onde houve o desenvolvimento do DSM-IV é um assunto polêmi-co. O uso do manual em pesquisas por parte da indús-tria farmacêutica e das seguradoras de saúde sugere uma alta probabilidade de, em algumas situações, haver um conflito de interesses. Essas suspeitas tem como origem o fato de que cerca de 50% dos autores e pesquisadores que previamente selecionaram e definiram as desordens psiquiátricas que seriam incluídas no DSM-IV tiveram ou ainda têm algum nível de relacionamento com a indústria farmacêutica (Cosgrove, Krimsky, Vijayaraghavan & Schneider, 2006). Isso possibilitou a discussão de que a "criação" de muitas categorias diagnósticas compiladas no DSM-IV pode ter sido influenciada por motivos de lucro financeiro, e que isso seria, em parte, um dos grandes responsá-veis pelo exponencial aumento da medicalização dos pacientes, mesmo em situações onde não parece haver uma razão clara para tal (Kirk, 2005).…”