Psychiatrists, the D.S.M., and Drug Makers : A Bad Diagnosis?
A recent study by public health researchers from Tufts University and from the University of Massachusetts found that more than half of the psychiatrists who played a part in developing the Diagnostic and Statistical Manual of Mental Disorders (D.S.M.-IV) had financial ties to drug companies both before and after the D.S.M. was published. According to today’s New York Times,
The researchers found that 95 — or 56 percent — of 170 experts who worked on the 1994 edition of the manual, called the Diagnostic and Statistical Manual, or D.S.M, had at least one monetary relationship with a drug maker in the years from 1989 to 2004. The most frequent tie involved money for research, according to the study, an analysis of financial records and conflict-of-interest statements.
The D.S.M.-IV (the fourth edition of the manual) contains the criteria for diagnosing an individual with autism. While these criteria hardly provide the “last word” in defining autism, it is more than a little troubling to think that less-than-professional and scientific interests might have had anything to do in developing the D.S.M..
If so, the D.S.M. could just as well be an acronym for Drug Sales Matter.
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POSTED IN: Psychology, Science
6 opinions for Psychiatrists, the D.S.M., and Drug Makers : A Bad Diagnosis?
Wade Rankin
Apr 20, 2006 at 5:40 pm
The unhealthy tripartite relationship among the pharmaceutical industry, academic scientists responsible for research and setting standards like the DSM, and government regulators reminds me of the “military-industrial complex” Ike warned us of over 40 years ago. I wonder what Ike would think of the conflicts in this business.
Kristina Chew, PhD
Apr 21, 2006 at 5:26 am
The article sent off an alarm in me. It also makes me wonder how doctors go about prescribing medications like SSRIs and neuroleptics (both of which Charlie takes). And I suspect it’s only the beginning of a bigger story.
Joseph
Apr 21, 2006 at 7:07 am
That’s not very surprising. The DSM-IV was first published in 1994 and diagnoses of autism and ADHD started to skyrocket. ADHD is particularly controversial. It came into existence by a show of hands. I understand Ritalin is prescribed to about 6 million children a year, despite concerns of cardiovascular adverse effects and being a potential carcinogenic. I’m not saying there’s a conspiracy, but the conflict of interest is relevant here.
The definition of ‘Autistic Disorder’ is also quite broad now. Before the 1990s the prevalence of autism in Europe and the U.S. stood, pretty much unchanged according to epidemiological studies, at 4 to 5 in 10,000. (This was about 10 in 10,000 in Japan). At around this time, Asperger’s syndrome became well known, along with the notion of a broad autism spectrum.
Kristina Chew, PhD
Apr 21, 2006 at 12:31 pm
Joseph, your comment brings to mind a phrase I hear a lot in regard to whether or not there is an increase in autism diagnoses: Is it from better and increased awareness of what autism is and a “broaded” definition of autism, or are there simply more autistic children out there?
Joseph
Apr 21, 2006 at 5:04 pm
Is it from better and increased awareness of what autism is and a “broaded” definition of autism, or are there simply more autistic children out there?
I’ve looked into this a lot, as you can tell from my blog. The numbers are, in my opinion, quite consistent with increased awareness, more willingness to seek and accept a diagnosis, broadening definition, and increasing recognition of autism in the population with intellectual disabilities.
Kristina Chew, PhD
Apr 21, 2006 at 6:21 pm
Yes; I have been thinking about this ever since we saw signs in Charlie over seven years ago. There are many autistic students in all spectra of education.
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