Allen Frances ‘Replies’

BACKGROUND

On June 19, 2015, I published a post titled Allen Frances’ Ties to Johnson & Johnson.  In that post, I set out some very serious allegations against Dr. Frances.  I drew these allegations from a document titled Special Witness Report dated October 15, 2010.  The report was written by David Rothman, PhD, Professor of Social Medicine at Columbia College of Physicians and Surgeons.

Dr. Rothman’s report was produced in the context of a lawsuit filed by the State of Texas against Janssen Pharmaceutica, a subsidiary of Johnson & Johnson.

The allegations against Dr. Frances and two other psychiatrists, John Docherty, MD, and David Kahn, MD, arise from their production of an expert consensus schizophrenia treatment guidelines document.  The essential allegation is that Dr. Frances and his two partners violated, to a marked extent, the ordinary standards regarding conflicts of interest in the preparation and publicizing of the guidelines.

I quoted some passages from Dr. Rothman’s article, perhaps the most telling of which is the following:

“EKS [i.e., Drs. Frances, Docherty, and Kahn] wrote to Janssen on July 3, 1996 that it was pleased to respond to its request to ‘develop an information solution that will facilitate the implementation of expert guidelines.’…It assured the company:  ‘We are also committed to helping Janssen succeed in its effort to increase its market share and visibility in the payor, provider, and consumer communities.’”  [Emphasis added]

Paula Caplan, PhD, a clinical and research psychologist, and an Associate at Harvard’s DuBois Institute, had written an earlier article on this topic in Aporia.  Dr. Caplan had titled her article Diagnosisgate: Conflict of Interest at the Top of the Psychiatric Apparatus, and on March 6, 2015, Dr. Frances had published a very weak and ineffective rebuttal titled ‘Diagnosisgate’ Deconstructed and Debunked

. . . . . . . . . . . . . . . . 

Last Sunday, June 21, 2015, Dr. Frances tweeted to  me:  “Setting the record straight on careless claims” with a link to his earlier rebuttal.

So, to set the record straight:

Dr. Frances’s rebuttal did not address a single issue from the David Rothman report, and his tweeted claim that the rebuttal set the record straight is nothing short of fanciful. 

In my article, I challenged Dr. Frances to respond to two questions:

  1. Are the allegations against him and his EKS partners that are set out in detail in the David Rothman report accurate?
  1. Are the quotations in that report that are attributed to Dr. Frances accurate?

This challenge still stands.

The allegations against Dr. Frances are extremely serious, and in my view, comparable misconduct in reputable professions would result in censure, or even expulsion.  But with very few exceptions, the silence from psychiatry on this issue has been deafening, even though the David Rothman report has been in the public arena for almost five years.

At the present time Dr. Frances is presenting himself as the champion of moderation, and he routinely lays the blame for the overuse of psychiatric drugs on pharma marketing and on general practitioners.  But he has never, to the best of my knowledge, acknowledged that in the preparation and dissemination of the Tri-University Guidelines, he and his partners formed what they described as a “strategic partnership” with Janssen, and expressed a firm commitment to “helping Janssen succeed in its effort to increase its market share…”  And to guard against any misunderstandings, the issue here is not that Dr. Frances helped Janssen increase its market share.  The issue is that he did this in the guise of producing an objective treatment guidelines document.

Why aren’t psychiatrists screaming in protest?  Where is the outrage and censure?  Is psychiatry truly so intellectually and morally bankrupt that they will turn a blind eye to virtually anything, provided it expands psychiatric turf?

  • all too easy

    Who Distorts the Facts?
    “The guideline project occurred several years after DSM IV was already in print. The term ‘Diagnosisgate’ is no more than Dr Caplan’s misleading attempt to attract an audience and has no connection to reality.”

    “It is nonsense for Dr. Caplan to claim there was “data distortion” in either DSM IV or in the guidelines. Both efforts were the result of completely transparent and forthright processes. Both efforts had very clear and published methodological rules of the road that were conscientiously followed every step of the way.”

    “…the raw data were presented in full and that a pre-established statistical algorhythm translated survey results into guideline recommendations. There was no “misrepresentation” of results on any scale because the data were presented and spoke for themselves.”
    Allen Frances

  • Jim Keiser

    How is your statement an answer to the 2 questions above?-
    “1- Are the allegations against him and his EKS partners that are set out in detail in the David Rothman report accurate?
    2-Are the quotations in that report that are attributed to Dr. Frances accurate?”
    -curious

  • Jim Keiser

    ‘…ALL SO-CALLED MENTAL DISORDERS ARE ARBITRARILY INVENTED, NAMED, LABELED, DESCRIBED, AND CATEGORIZED by a committee of psychiatrists, from menus of human behaviors.

    Their findings are published in periodically updated editions of The Diagnostic and Statistical Manual of Mental Disorders (DSM), printed by the American Psychiatric Association.

    For years, even psychiatrists have been blowing the whistle on this hazy crazy process of “research.”

    Of course, pharmaceutical companies, who manufacture highly toxic drugs to treat every one of these fictional disorders, are leading the charge to invent more and more mental-health categories, so they can sell more drugs and make more money.

    But we have a mind-boggling twist. One of the great psychiatric honchos, who has been out in front inventing mental disorders, has gone public. He’s blown the whistle on himself and his colleagues.

    His name is Dr. Allen Frances…’-Jon Rappoport

  • all too easy

    When did big pharma invent the symptoms of ADHD?

  • Jeanne Smith

    They don’t invent symptoms, they invent disease labels so they can sell speed to children. Speed drugs kill neurons and disrupt endocrines. Change the schools, don’t maim the foot to fit a broken shoe. You are not really very smart, for all your book-learning, you don’t argue logically. Nobody is suggesting that the drug corporations create sickness. Well, maybe they do.

  • all too easy

    Children buy speed from pharmaceuticals?

    How many children have dead neurons from taking speed for a fictitious disease? How many of their neurons died, 1, 27, 303, 9,000,000,005?

    I am not very smart? Good point.

  • Jeanne Smith

    ADHD drugs are chemically almost identical to amphetamines and they destroy the basal ganglia of the brain in addition to disrupting normal endocrine function, including the production of Human Gonadotropic Hormone, which regulates growth. I assumed that the above quotes by Allen Frances were posted by him, if you are not him, you need to identify yourself. I don’t want to yell at the wrong person.

  • Zoe

    I really do take my hat off to Phil, for raising awareness for issues that are otherwise swept under the carpet. Thanks Phil!

  • all too easy

    “Speed drugs kill neurons and disrupt endocrines.” How many children have dead neurons from taking speed for a fictitious disease? How many of their neurons died, 1, 27, 303, 9,000,000,005?

    “ADHD drugs are chemically almost identical to amphetamines and they destroy the basal ganglia of the brain in addition to disrupting normal endocrine function, including the production of Human Gonadotropic Hormone, which regulates growth. I assumed that the above quotes by Allen Frances were posted by him, if you are not him, you need to identify yourself. I don’t want to yell at the wrong person.

    Asked for proof, Ms. Smith presents more allegations.

  • Rebecca Smith

    http://learn.genetics.utah.edu/content/addiction/ritalin/.

    I want to put this on here and say that it is not for or against it shows one side and the other generally. It takes the debate we have and gives you the opportunity to check the facts too. This was a fast look at something.

    Now to the point of this guy who Phil has decided to write about . In the minimal that i have seen it seems that he probably will take the road to the whoever is more powerful and has more points. If I am wrong okay.

    Back to the ADHD. I am saying this one more time. My son was abused and they decided he had ADHD. Looking at it now, if the school had just thought to check what both were they are much alike in behaviors. I am hate when people try to say that they think they know ADHD. No we don’t know enough because it still gets misdiagnosed a lot. I for a fact wish I never tried my son on the medications because when the meds fell out of his system by dinner he was more a mess from that than just being depressed because he was feeling horrible. He may have looked to have ADHD, but come to find out that is was the abuse that was truly hurting his behaviors. I put him through hell for what so we can say AHDHD is or isn’t real. I dont care too much if it is…I care that kids can get hurt by these drugs.

  • Rebecca Smith

    I can look even further to get both sides, but they are uppers and that is a fact so don’t come in and say you know these drugs too. I know what they I have seen it first hand.

  • Phil_Hickey

    Rebecca,

    Thanks for coming in. It’s always nice to hear from you. And yes, kids can definitely get hurt by these drugs. We need to keep saying that.

    Best wishes.

  • all too essy

    Document that statement, Phil. If you don’t mind, post all the evidence upon which you relied to justify it.

  • all too easy

    “NEURON”
    The psychiatric disorders autism and schizophrenia have a strong genetic component, and copy number variants (CNVs) are firmly implicated. Recurrent deletions and duplications of chromosome 16p11.2 confer a high risk for both diseases, but the pathways disrupted by this CNV are poorly defined. Here we investigate the dynamics of the 16p11.2 network by integrating physical interactions of 16p11.2 proteins with spatiotemporal gene expression from the developing human brain. We observe profound changes in protein interaction networks throughout different stages of brain development and/or in different brain regions. We identify the late mid-fetal period of cortical development as most critical for establishing the connectivity of 16p11.2 proteins with their co-expressed partners. Furthermore, our results suggest that the regulation of the KCTD13-Cul3-RhoA pathway in layer 4 of the inner cortical plate is crucial for controlling brain size and connectivity and that its dysregulation by de novo mutations may be a potential determinant of 16p11.2 CNV deletion and duplication phenotypes.

    Spatiotemporal 16p11.2 Protein Network Implicates Cortical Late Mid-Fetal Brain Development and KCTD13-Cul3-RhoA Pathway in Psychiatric Diseases

    Guan Ning Lin

    x

    Guan Ning Lin

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    Affiliations

    Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA5,

    Roser Corominas

    x

    Roser Corominas

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    Affiliations

    Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA5,

    Irma Lemmens

    x

    Irma Lemmens

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    Affiliations

    Department of Medical Protein Research, VIB, and Department of Biochemistry, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium,

    Xinping Yang

    x

    Xinping Yang

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    Affiliations

    Center for Cancer Systems Biology (CCSB) and Department of Cancer Biology, Dana-Farber Cancer Institute, and Department of Genetics, Harvard Medical School, Boston, MA 02215, USA,

    Jan Tavernier

    x

    Jan Tavernier

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    Affiliations

    Department of Medical Protein Research, VIB, and Department of Biochemistry, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium,

    David E. Hill

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    David E. Hill

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    Affiliations

    Center for Cancer Systems Biology (CCSB) and Department of Cancer Biology, Dana-Farber Cancer Institute, and Department of Genetics, Harvard Medical School, Boston, MA 02215, USA,

    Marc Vidal

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    Marc Vidal

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    Affiliations

    Center for Cancer Systems Biology (CCSB) and Department of Cancer Biology, Dana-Farber Cancer Institute, and Department of Genetics, Harvard Medical School, Boston, MA 02215, USA,

    Jonathan Sebat

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    Jonathan Sebat

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    Affiliations

    Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA

    Beyster Center for Genomics of Psychiatric Diseases, University of California San Diego, La Jolla, CA 92093, USA,

    Lilia M. Iakoucheva

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    Lilia M. Iakoucheva

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    Affiliations

    Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA

    Correspondence

    Corresponding author
    Spatiotemporal 16p11.2 Protein Network Implicates Cortical Late Mid-Fetal Brain Development and KCTD13-Cul3-RhoA Pathway in Psychiatric Diseases

  • All too moron

    Please, paste some more crap nobody here is taking any notice of, we want you to stay another 5 months at this site, you moron.

  • all too easy

    Protein interaction network of alternatively spliced isoforms from brain links genetic risk factors for autism

    Roser Corominas

    Roser Corominas
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    Xinping Yang

    Xinping Yang
    Dana-Farber Cancer Institute
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    Guan Ning Lin

    Guan Ning Lin
    University of California, San Diego
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    Shuli Kang

    Yun Shen

    Yun Shen
    Harvard University
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    Lila Ghamsari Nature Communications (Impact Factor: 10.74). 04/2014; 5:3650. DOI: 10.1038/ncomms4650
    Source: PubMed

    Lila Ghamsari
    Columbia University
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    Accumulating evidence suggests that many genetic risk factors are shared between different neurodevelopmental disorders 36–39. We examined whether newly identified ASIN preys are involved in other neurodevelopmental syndromes characterized by psychiatric phenotypes, such as intellectual disability, mental retardation and developmental delay. We observed that ASIN is significantly enriched in preys involved in these disorders compared with HI-II-11 (5.2% versus 2.6%, Fisher’s exact P ¼ 0.02, Supplementary Table 1, Supplementary Data 7), and the enrichment is maintained when analysis is restricted to only brain-expressed genes (6.1% versus 2.9%, Fisher’s exact P ¼ 0.012, Supplementary Table 1, Supplementary Methods). Among 31 highly ranked ASIN preys, nine are relevant to other psychiatric abnormalities (annotated as ‘psychiatric phenotype’ in Online Mendelian Inheritance in Man in Fig. 5a). The transcription factor TCF4 is involved in Pitt-Hopkins syndrome, which is characterized by mental retardation and distinctive facial features 40. Recently, de novo point mutations of TCF4 have been implicated in developmental delay 41–43 and autism 35, and common variants of TCF4 were recurrently implicated in schizophrenia 44,45 Similarly, mutations in the transcriptional inhibitor ZEB2 are the cause of Mowat–Wilson syndrome, a complex developmental disorder characterized by mental
    retardation, delayed motor development, epilepsy, microcephaly and a wide spectrum of clinically heterogeneous features 46. Other psychiatric abnormalities with mutations in ASIN preys include Prader–Willi (the 15q11.2 region, which includes MKRN3),
    speech-language disorder (FOXP2), and lissencephaly (NDE1). In addition, some CNV regions harbouring highly ranked preys are associated with multiple phenotypes. For example, NDE1 is located in 16p13.11, a genomic region that is impacted by CNVs in autism 7,14, schizophrenia 47, mental retardation 48,49 attention-deficit hyperactivity disorder 50 and epilepsy 51 Considering the above observations it is tempting to speculate that the convergence of the risk factors for genetically- and phenotypically-heterogeneous neurodevelopmental disorders may occur at the level of protein interaction networks. In summary, our study emphasizes the importance of isoform-
    resolved PPI networks for improving understanding of autism along with other neuropsychiatric diseases. .
    The genius of these scientists

  • all too easy

    Documented proof in peer reviewed literature is the standard. You don’t have any, do you? Neither do the trolls trying to dismiss a scientifically viable disorder. Don’t say you know these drugs.

    So far, you who hate modern medicine, only offer bologna, the kind which fills the brains of Baughman, Breggin, Berezin, and their meathead crowd.

  • Rebecca Smith

    Simply put you are a troll. I answered the question and you keep bashing me and others for what we know about meds. we take. I can’t take them without having horrible side effects. Plus I did not say no one should take them, but. I do say be aware of the side effects and that is that. You keep on bullying people to no end and I am not into bullies period. Try being nicer and then we can talk from here on out. I will not tque your word as truth as long as you bully. Sorry it is not what I do. This will be my last response to you until you treat people with respect. I advise others to do the same now. Oh and for other peoples info my son went on rwmpages after coming down from the meds daily. Just the facts from my personal experience. He decided he did not like it not me. I tried to do the “right” thing and it WAS wrong for him.

  • all too easy

    Too bad you can’t see. The ones you should ignore, those nasty bullies you call them, they ain’t me and you know this. You represent a quality of poster who despises what she doesn’t understand and cling to pseudoscience and its proponents.

    You all try everything you can imagine to try to get me to shut-up. However, as you know, I am smarter and better educated and much more articulate than the jealous posters who can’t live without my recognizing them.

  • johnnybe

    mental health–psychiatry–its almost like its shhhh dont tell em ok—tell em their &^%$$&d – get the bag—shhhhh.