Conflict of Interest

A regular commenter to this website has drawn my attention to a bill that has been proposed in the Connecticut state legislature. The bill would require public school and homeschooled children to be assessed by mental health practitioners at grades 6, 8, 10, and 12. The bill, sponsored by Senator Toni Harp and Representative Toni Walker, is in response to the recent Sandy Hook murders. And so it starts. Given the built-in vagueness of the DSM, and the inclusiveness bias of the mental health business, the outcome of these screenings (should the bill become law) is predictable: more and more parents disempowered with regards to their parenting responsibilities; more drugged children, and, tragically, more mass murders. ...

Last Saturday our local newspaper ran an article called “Mental Health Needs Reform.” It was written by a psychologist, and the main thrust of the piece was that if “serious mental health care reform” is not implemented, we will see more mass murders similar to those at Aurora and Newtown. The article contained several unwarranted assumptions, and recommended that mental hospitals “rebuild facilities for treating those patients.” My position, of course, is that there are no mental illnesses, and that cold-blooded killers are not sick in any meaningful sense of the term, but are, rather, individuals who have not internalized an age-appropriate respect for the lives and welfare of other human beings. ...

Prior to about 1994, childhood bipolar disorder was virtually unheard of. DSM-III-R (1987), in the section on manic episode, states, “…studies indicate that the mean age at onset is in the early 20s. However…a sizable number of new cases appear after age 50.”(p 216) Of course a mean age of onset in the early 20’s could include young children. The section on major depressive episode, however, contains the following: “The average age of onset is in the late 20s, but a major depressive episode may begin at any age, including infancy.” (p 220) ...

There is an interesting article in last month’s issue of the British Journal of Psychiatry. The article, titled Psychiatry beyond the current paradigm, was authored by Pat Bracken, an Irish psychiatrist, and 28 other British and Irish psychiatrists. The gist of the piece is that the current psychiatric paradigm, which the authors describe as “applied neuroscience,” is not supported by the evidence and needs to be abandoned. Here are some quotes: ...

A recent commenter, Dan, suggested I check out some of Jeffrey Lacasse’s articles on ghostwriting. I’ve read two of Jeffrey’s articles: Ghostwriting and Academic Medicine and Knowledge of ghostwriting and financial conflicts-of-interest reduces the perceived credibility of biomedical research (both co-authored with Jonathan Leo), and found them excellent. Ghostwriting in this context, for readers not familiar with the term, works like this. A pharmaceutical company does a piece of research which establishes that their product is effective and safe. (There are various ways to ensure this result, and the pharmaceutical companies know them all.) Then they get one of their own technical writers to write the research up, but this writer’s name does not go on the report. Instead, the pharmaceutical company gets an eminent medical academic who has a financial link to the company to put his name on the piece, as if he were indeed the researcher and the author. ...

There was an interesting article recently in the International Journal of Law and Psychiatry, “Exposing conflict in psychiatry: Does transparency matter?” by Chimonas, et al. The gist of the article is as follows. Senator Chuck Grassley of Iowa has devoted a great deal of time and effort to exposing conflicts of interest in psychiatry. He has focused particularly on undisclosed financial relationships between psychiatric researchers and pharmaceutical companies. His efforts resulted in the passage of the Physician Payments Sunshine Act, which requires manufacturers to disclose payments over $100 annually to physicians and teaching hospitals. The act requiring this will become active in 2014. The hope is that exposure will reduce the incidence of problems. It was this particular hypothesis that the researchers wanted to test. ...