Conflicts of Interest

Readers of Psychiatric News can observe in our own journal—as well as in other arenas such as our annual convention—that APA receives considerable support from industry. We have heard much discussion about the appearance of too-close ties between physicians and the pharmaceutical industry; indeed, Dr. Steven Sharfstein addressed the issue pointedly in his presidential address in may 2006.

Our colleagues in APA might be interested to know that we and other APA members have asked APA to address an issue of potential conflict of interest in the development of practice guidelines and of the DSM—namely, the predominance on deliberative committees of APA members who have financial ties to industry.

In a letter that we sent to APA last September, we noted the increasing public scrutiny about financial relationships between industry and influential physicians. We noted too that judgments about diagnosis and treatment draw upon many areas of expertise including sociology, economics, medical decision making, psychology, bioethics, forensics, statistics, and epidemiology, all in addition to psychopharmacology.

Accordingly, we requested that physicians who have financial relationships with industry be excluded as voting members of the committees on practice guidelines or diagnoses. There are other ways by which these physicians could provide the committees with data and expert opinion about psychiatric taxonomy and commercially produced treatments.

In making this request, we have asked APA to go beyond simply requiring that members of practice guidelines and DSM-V committees disclose their financial relationships with industry. Such disclosure has not been shown to decrease conflicts of interest. Adoption of our proposal would be a definitive way to address such concerns in the development of standards for psychiatric diagnosis and treatment.