In a recent cross-sectional analysis conducted by a team of doctors, including Dr. Lauren C. Davis and Dr. Brian J. Piper, the extent of financial ties between the panel and task force members of the American Psychiatric Association’s DSM-5-TR manual was critically examined. Their study revealed troubling patterns of financial conflicts, highlighting the need for stricter regulations on who should contribute to such influential medical guidelines.
Dr. Lisa Cosgrove emphasized, “We found that 60% of the 92 physicians who participated in the DSM-5-TR development had received payments from industry during 2016-19, with a total sum of $14.2 million. The influence these payments may have on psychiatric diagnoses cannot be overstated.”
Financial Ties Exposed
The research team, which also included Dr. Alexa T. Diianni, Dr. Sydney R. Drumheller, and Dr. Noha N. Elansary, utilized data from the Open Payments database to track financial ties from 2016 to 2019. The results were alarming, with more than half of the panel members receiving compensation from pharmaceutical companies. Dr. Cosgrove remarked, “Such payments can lead to implicit bias and compromise the integrity of medical research.”
“Even a third of the DSM-5-TR task force members, who should play an unbiased role in determining psychiatric classifications, had payments reported in the Open Payments system,” added Dr. Farahdeba Herrawi, another key researcher in the study.
The Impact on Psychiatric Diagnoses
The DSM-5-TR, published in 2022, plays a significant role in the field of psychiatry, influencing not only psychiatric diagnoses but also the approval of new drugs. According to Dr. Gianna N. D’Ambrozio, “Given the manual’s powerful role, the prevalence of financial ties among its creators raises serious ethical concerns.” The researchers found that panel members’ decisions could be swayed by industry interests, particularly in the approval of new psychiatric medications and the extension of patents, which can affect millions of patients globally.
Recommendations for Change
The research team urges the psychiatric community to consider stricter standards to avoid conflicts of interest. Dr. Brian J. Piper emphasized, “We recommend a rebuttable presumption that conflicts of interest should be prohibited in DSM panels.” He added, “If independent experts are unavailable, individuals with industry ties can consult but should not have decision-making authority.”
In conclusion, the research underscores the need for reform in the way panels like those of DSM-5-TR are constructed and calls for increased transparency to restore trust in psychiatric practices.
Citation
Davis LC, Diianni AT, Drumheller SR, et al. Undisclosed financial conflicts of interest in DSM-5-TR: cross sectional analysis. BMJ. 2023;384. doi:10.1136/bmj-2023-076902
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