Conflict of Interest

I’ve come across an article by Lisa Cosgrove et al entitled Conflicts of interest and the quality of recommendations in clinical guidelines. It was published in the Journal of Evaluation in Clinical Practice in December of last year. As everyone knows, the APA publishes the DSM, but they also publish “Clinical Practice Guidelines” for various “diagnoses,” including the condition known as major depression. Dr. Cosgrove and her colleagues examined the guidelines for major depression to see if the authors had financial or intellectual conflicts of interest. An example of a financial conflict of interest would be recommending drug treatment when one is on the payroll of a drug company. An example of an intellectual conflict of interest would be relying on and citing a poor quality study in support of a position in which one had a stake. ...

BACKGROUND I recently wrote a post called DSM-5: Another Step in the Wrong Direction. In that article I argued that DSM-5 was simply another step in the APA’s ongoing agenda to medicalize all human problems and to legitimize the administration of drugs as the front line “solution” to these problems. I also expressed concern that the widely publicized movement to develop an alternative diagnostic system might not look all that different from what we have today. ...

Alice Keys, MD, has recently written a short article for Mad in America. You can see it here. Dr. Keys points out that to maintain a medical license, one must accumulate continuing education credits, and that these credits have to be approved by state licensing boards. It’s widely known that pharmaceutical companies have largely hijacked this process in recent decades, and that their “educational” presentations might be better described as infomercials. ...

Recently, courtesy of Hersteltalent on Twitter, I came across this newspaper article: Doctors Urge Mental Health Screenings with Physicals. It appeared in USA Today, and was written by Jessica Contrera of the Lafayette, Indiana Journal and Courier. Dateline March 12. The gist of the article, which is written for the general public, is that when you go in to your doctor for a check-up, you should ask for a mental evaluation as well. The article reminds us that “25% of American adults suffer from some form of mental illness each year.” ...

I’ve recently come across (courtesy of Tallaght Trialogue) an article in Current Psychiatry (Feb 2013) on this topic. The author is Henry A. Nasrallah, M.D., and you can see it here. Dr. Nasrallah, who is Editor-in-Chief of Current Psychiatry, states that there are 273 bio-markers for schizophrenia. But wait. Dr. Nasrallah goes on to say: "None of the individual 273 biomarkers alone can serve as a diagnostic tool for the schizophrenias because there will be high rates of false positives and false negatives." ...

On March 5, 2013, a bipartisan panel of leading mental health experts and parents of children with “mental disorders” held a conversation (that’s newspeak for meeting) in Washington D.C. on the topic: Violence and Severe Mental Illness. The invited panelists were: Thomas Insel, MD, Director of NIMH Harold Koplewicz, MD, President of Child Mind Institute E. Fuller Torrey, MD, Founder of Treatment Advocacy Center Michael Welner, MD, Founder and Chairman of The Forensic Panel Michael Fitzpatrick, MSW, Director of NAMI And three parents of "diagnosed" children ...

In recent times a good deal of criticism has been directed towards the practice of involuntarily committing individuals to state and private mental hospitals. Most of this criticism focuses on the lack of effective due process; conflicts of interest in the case of private facilities; and failure to adequately explore alternatives. In my view, all of these criticisms are valid, and warrant attention. But there is another side to the story that is seldom aired outside the mental health centers. A great many clients like going to the mental hospital; they plan their trips in advance and “freak out” at the appointed time, knowing that the knee-jerk response of the mental health center will be a court-ordered admission. ...

I came across an interesting article Psychiatric Medication or Play Therapy? by Bob Fiddaman, a New Zealand writer. The article compares the efficacy and dangers of play therapy vs. pharmaceutical products for children with various problems. Here are some quotes: "…play therapy outcome studies support the efficacy of this intervention with children suffering from various emotional and behavioral difficulties." "Pharmaceutical companies spend billions on marketing psychiatric medication." "Front groups that purport to fly the mental health flag are, in fact, nothing more than agents, pimps for the pharmaceutical industry." ...

Another interesting article: Academic Integrity in Ireland and the UK: Is there any such thing? at Leonie fennells’ Blog. It’s about financial ties between pharmaceutical companies and psychiatrists. Same old story; different location. It’s worth a look. Thanks to Becky @yobluemama2 on Twitter for drawing my attention to this.

I have written frequently on this website about the hand-in-glove relationship between psychiatrists and the pharmaceutical companies. It is my general position that the business-first orientation of the pharmaceutical companies, coupled with their willingness to pay large sums of money to co-operative psychiatrists, has been, and continues to be, a corrupting influence. I have recently come across two articles by Carl Elliot, MD, PhD. “How to Get Away with Academic Misconduct at the University of Minnesota,” and “And That’s the News from the Department of Psychiatry." ...