Pharmaceutical Industry

BACKGROUND As I suppose everyone knows by now, psychiatry has been on the receiving end of some very serious criticism in recent years. The criticism has come from many sources, including: survivors of psychiatric “treatment,” non-psychiatric mental health practitioners, journalists, the general public, and even from some psychiatrists themselves. The content of the criticisms has been equally varied, and includes: that the concept of mental illness is fundamentally spurious and devoid of explanatory significance; that psychiatric “treatment” (i.e. drugging people) is ineffective, physically damaging and disempowering; that psychiatry has forged and continues to maintain corrupt and corrupting relationships with the pharmaceutical industry with regards to the peddling of drugs and the hijacking of research for commercial ends; etc… ...

Earlier this year, The American Society of Consultant Pharmacists published a report on the use of neuroleptic drugs in nursing homes. According to this report, 25% of nursing home residents receive neuroleptic drugs. In general, the Centers for Medicare and Medicaid Services (CMS) consider these prescriptions appropriate only if the recipient is psychotic. (Obviously we could discuss this at length, but let’s set that issue aside for now.) What CMS considers entirely inappropriate, however, is prescribing these products to residents with dementia as a way of controlling “difficult” behaviors such as wandering, being abusive, or resisting care. ...

PRESIDENT’S SPEECH On June 3, President Obama delivered a speech on the expansion of mental health services. The occasion was the National Conference on Mental Health, which was held at the White House. "The truth is," the President told us, "in any given year, one in five adults experience a mental illness — one in five." In most human endeavors something is true only if it can be shown to be so. In psychiatry and politics, however, a statement becomes true if it's repeated often enough. For the past 60 years, the APA has been systematically expanding their diagnostic net until – surprise, surprise – it now envelops 20% of the population. With the lowering of thresholds in DSM-5, we can be sure that this number will continue to rise, and whoever is President then will be able to tell us that one in four of the population has a mental illness. Gosh! Note also that the President uses the term “mental illness” as opposed to “mental disorder.” The APA use the latter term in their manual to make the concept somehow more acceptable. But these “disorders” always morph into illnesses in application. ...

The late George Albee, psychologist, never accepted the medical model of behavioral/emotional problems. He fought tirelessly for years to insulate psychology from the encroaching medicalization of its subject matter, and he died in 2006 believing that his efforts had failed. He authored more than 200 articles. As early as the 50’s and 60’s, he argued that social factors such as racism, poverty, and child abuse were largely responsible for the conditions known as mental illness. ...

On March 12 of this year, the Los Angeles Daily News ran an article by Susan Abram titled: Doctors report big pharma payouts for drug endorsements. It discusses the financial ties between physicians and drug companies in California. Here are some quotes: "In fact, hundreds of physicians, psychiatrists, and medical school faculty members across California are on the payroll of major drug companies, earning tens of thousands of dollars for speaking to other medical professionals at events held by industry leaders that make drugs such as Advair, Cymbalta, Viagra and Zoloft." ...

There’s an interesting article on MINNPOST, Many mental-illness websites show drug-company bias, study finds, dated May 16. The article is by Susan Perry, and presents the results of a Web survey of mental health websites conducted by John Read and A. Cain from the University of Auckland, New Zealand. The original study was published in Acta Psychiatrica Scandinavica. You can see the abstract here. The full article is behind a paywall. (Thanks to Leonie Fennell for the link.) ...

Jeffrey Lieberman, MD, is president-elect of the APA, and is scheduled to take over the reins from Dr. Dilip Jeste this month. Never in its history has the APA been subject to such scrutiny or criticism from such diverse sources, and one might reasonably have expected Dr. Lieberman to open on a conciliatory note, promising investigations, reforms, etc…. But no! He’s in the ring slugging furiously from the opening bell. Two days ago (May 20) he published an article in Scientific American titled DSM-5: Caught between Mental Illness Stigma and Anti-Psychiatry Prejudice. ...

There’s an interesting article in the May 2013 issue of the British Journal of Psychiatry. It’s called “The future of academic psychiatry may be social” by Stefan Priebe, Tom Burns, and Tom K. J. Craig. You can see it here. The abstract states: "The past 30 years have produced no discoveries leading to major changes in psychiatric practice. The rules regulating research and a dominant neurobiological paradigm may both have stifled creativity. Embracing a social paradigm could generate real progress and, simultaneously, make the profession more attractive." ...

I keep two dictionaries on my desk. The first is a 1964 Webster’s; the second is a 2009 Webster’s. This morning I looked up the word “depression” in both books. 1964: n. 1. a depressing or being depressed. 2. a depressed part or place; hollow or low place. 3. low spirits; dejection. 4. a decrease in force, activity, amount, etc. 5. a period marked by slackening of business activity, much unemployment, falling prices and wages, etc. ...

There’s a new post on Mick Bramham’s website called “A time to grieve, a time to console, and a time to profit?” You can see it here. You might have thought that, given the adverse publicity that pharma has been receiving in recent years, they would be easing up on their expansionist agenda. But you would be wrong. The APA has declared open season on bereavement, and although DSM-5 won’t be released for a few more weeks, Eli Lilly is already grooming their SNRI Cymbalta as a “treatment” for this pseudo illness. ...