Conflict of Interest

As my regular readers know, I am a big fan of Jeffrey Lieberman, MD, eminent President of the American Psychiatric Association. I study his bulletins on Psychiatric News avidly, not only for the insights they provide in the areas of human frailty and self-deception, but also for their literary qualities of obfuscation and semantic distortion. It is, therefore, with some alarm that I confess that I missed the good doctor’s epistle of December 13. This was pointed out to me by a reader, who was also kind enough to say that without my clarificatory commentary, he is simply unable to fathom Dr. Lieberman’s insights and erudition. ...

BACKGROUND On November 20, JAMA Psychiatry (formerly Archives of General Psychiatry) published an interesting letter. It was headed: Failure to Report Financial Disclosure Information, and was signed by Robert D. Gibbons PhD, David J Weiss PhD, Paul A. Pilkonis PhD, Ellen Frank, PhD , and David J. Kupfer MD. The letter is an apology for failing to disclose a financial interest in an article, Development of a Computerized Adaptive Test for Depression, that had appeared in Archives of General Psychiatry a year earlier (November 2012). The article described a computerized questionnaire for depression (the CAT-DI) and was generally positive with regards to the potential usefulness of the test in clinical settings. In the article, the authors had clearly stated that they had no conflicts of interest, but that: ...

BACKGROUND On December 8, I received the following question from a reader: (The subject matter is the controversial CAFÉ – Comparisons of Atypicals in First Episode of Psychosis - study. This was the study in which Dan Markingson committed suicide.) "It appears that there was no head-to-head with a control group taking a placebo pill. Nor was there a control group featuring 'old' types of 'antipsychotic'. If that was the case then it is very poor study. If you are just looking at 3 'new' subtypes of a 'new' class - then what on earth can you hope to show from the data." ...

In December 2012, Mark Olfson, MD, et al, published an article in the Archives of General Psychiatry. The title is National Trends in the Office-Based Treatment of Children, Adolescents, and Adults with Antipsychotics. The authors collected data from the National Ambulatory Medical Care Surveys for the period 1993-2009, and looked for trends in antipsychotic prescribing for children, adolescents, and adults in outpatient visits. Here are the results: Age Increase in no. of antipsychotic prescriptions per 100 population (1993-2009) 0-13 0.24-1.83 (almost 8-fold) 14-20 0.78-3.76 (almost 5-fold) 21+ 3.25-6.18 (almost 2-fold)   The authors provide a breakdown of the diagnoses assigned to the children and adolescents during the antipsychotic visits. ...

ANOTHER VIDEO FROM DR. LIEBERMAN On October 28, Jeffrey Lieberman, MD, President of the APA, made another video. This one is titled An Important Look at Mortality in Mental Illness: A Decade of Data on Psychotropic Drugs, and was made for Medscape. You can see the transcript at the same site. Medscape is a web resource for medical practitioners. The video is Dr. Lieberman’s commentary on an article that appeared in JAMA Psychiatry online on August 28: Comparative Mortality Risk in Adult Patients With Schizophrenia, Depression, Bipolar Disorder, Anxiety Disorders, and Attention-Deficit/Hyperactivity Disorder Participating in Psychopharmacology Clinical Trials, by Arif Khan, MD, et al. ...

SSRI’S AND SUICIDE Bob Fiddaman has a post up today called MHRA Consultant Calls for Antidepressant Use in Young. The article highlights some of the dangers associated with SSRI’s, and also describes some of the attempts to suppress or discount the significance of this information. Apparently in 2010, Swedish psychiatrist Göran Isacsson, MD, PhD, published a paper in Acta Psychiatrica Scandinavica. The piece was titled Antidepressant medication prevents suicide in depression, and reported that of a group of 1,077 depressed people who had committed suicide, only 15.2% had measurable amounts of antidepressants in the blood stream at the time of the suicide. ...

There’s a new article on Psychiatric News titled Change, Challenge, and Opportunity: Psychiatry Through the Looking Glass of Research. It’s dated October 17, and was authored by Steven Hyman, MD, and Jeffrey Lieberman, MD. Thanks to Mental Health Law on Twitter for the link. Dr. Lieberman is President of the APA. Dr. Hyman was Director of NIMH from 1996 to 2001, and is now the Director of the Stanley Center for Psychiatric Research at the Broad Institute. The Broad Institute is affiliated with Harvard University, and Dr. Hyman is a Harvard Distinguished Service Professor. ...

Those of us on this side of the psychiatric debate have long maintained that there is a link between the so-called antidepressant drugs and the mass murders that have become an increasingly common feature of American society in recent decades. The call for a formal investigation of this link, however, has been consistently resisted, and instead there has been a well-orchestrated medical campaign clamoring for more mental health services and more active outreach and prevention services. As an example, see Jeffrey Lieberman’s guest post on Everyday Health, In the Wake of the Navy Yard Shooting: A Way Forward. ...

Recently, Carl Elliott posted a link to a statement written by Jonathan Moreno, PhD, a renowned bioethicist at the University of Pennsylvania. Dr. Moreno’s statement was in reference to an Oregon court case. The Oregon Department of Justice had accused two cardiologists of concealing information from patients. Apparently the cardiologists had put heart implants into patients without informing the patients that they (the cardiologists) had financial ties to the manufacturer of the implants. ...

There’s an interesting article, recently published in Journal of Contemporary Psychotherapy, on Springer Link. It’s titled Shooting the Messenger: The Case of ADHD, and it was written by Gretchen LeFever Watson, PhD, et al. Apparently some of the authors had noted in 1995 a marked increase in the “diagnosis” and “treatment” of the condition known as ADHD in southeastern Virginia. This is a large urban conglomeration of six different cities, including Norfolk, Portsmouth, and Virginia Beach. ...