DR LISA COSGROVE - CONFLICTS OF INTEREST - ABSTRACT OF ORIGINAL ARTICLE - FINANCIAL TIES BETWEEN DSM4 AND DSM5 PANEL MEMBERS AND THE PHARMACEUTICAL INDUSTRY. "We should stick to labelling envelopes not children's unverifiable mental health issues."

Financial Ties between DSM-IV Panel Members and the Pharmaceutical Industry
Lisa Cosgrove(a), Sheldon Krimsky(b), Manisha Vijayaraghavana, Lisa Schneidera
aUniversity of Massachusetts, Boston, Mass., and
bTufts University, Medford, Mass., USA

2006 : 75 : p 150 - 164.


    Conflicts of interest
    Ethics
    Financial interests
    Psychopharmacologics


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. 

Are the recommendations valid and acceptable?

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 with generous fees (22%) and speakers bureau, high levels of expense claims(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,including for children. 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.



ISSUES ARISING:

1) Can this process of selecting new diagnostic conditions be either ethically sound or morally acceptable to society when such financial benefits are made readily available for the academics involved in the panel meetings?
2) What is the intent of the pharmaceutical industry in applying such financial leverage?
3) Are the companies share holders aware of such linkages and how they may be interpretted by the wider public and ethics committees?
4) What are the total financial inducements including sponsorship of journals, costs of free disemination conferences in exotic locations, gifts of a variety of types and direct payments?

Common high end locations are Hawaii,The Seychelles,The Carribean and Egypt.

5) Do these academics report these financial links and inducements appropriately to their university authorities as 'declared earnings,' or benefits. Clearly  Dr Cosgrove has shown many do not and are being investigated currently by the Senate Hearings. Several professors and senior lecturers have had to step down from their positions in recent months.
6) Can this questionable process be allowed to reach fruition by the U.S. and U.K. governments and DSM5  be published in 2013 when the implications are so profound for the population as a whole but for young people in particular?

"We should stick to labelling boxes and leave children to discover their own unique place in life without the use of psychiatry as ameans of social control."