Group cites industry ties among psychiatric-manual reviewers

By Elizabeth Cooney
Globe Correspondent

Many of the people who literally write the book on mental illness collect pay checks from companies whose products treat some of those illnesses.

Sixteen of the 28 members of a task force overseeing revision of the psychiatry profession's diagnostic bible have disclosed financial ties to drug or medical device companies, according to the Center for Science in the Public Interest, raising concern about possible conflicts of interest.

"To me, this doesn't pass the smell test for conflict of interest,” said Merrill Goozner, a director at the watchdog center. “What they should have done is find psychiatrists without conflicts of interest."

The American Psychiatric Association, which will oversee publication of the fifth Diagnostic and Statistical Manual of Mental Disorders, defended its choice of panel members, who include Harvard Provost Dr. Steven E. Hyman. The association also noted that all panel members have pledged not to receive more than $10,000 per year from industry sources, aside from unrestricted research grants, until the manual is published in 2012.

"We have made every effort to ensure that [the manual] will be based on the best and latest scientific research, and to eliminate conflicts of interest in its development," Carolyn B. Robinowitz, president of the psychiatric association, said in a statement.

Hyman, who was head of the National Institute of Mental Health before returning to Harvard to become the provost and a neurobiology professor at Harvard Medical School, reported having consulted for five drug companies (Neurion, Seaside Therapeutics, Merck, Novartis, and Glaxo Smith Kline) and one biotech venture-capital partnership unrelated to psychiatry (Fidelity Biosciences) since 2005.

Hyman said he believes in disclosure, but acknowledges that "in some situations, disclosure, by itself, may not be adequate to reassure the public that the efforts are objective. That is why the American Psychiatric Association has also limited the amount of compensation that can be received from companies that produce drugs for mental disorders."

But Hyman defended the practice of researchers’ interacting with drug companies.

"It is critical for academics to connect to industry. Without the biotechnology and pharmaceutical industry there would be no new medications, and new medications are critically needed for people with mental disorders."

Lisa Cosgrove, a clinical psychologist at University of Massachusetts-Boston, who helped write a 2006 paper exposing conflicts of interest in the last edition of the manual, said the new task force has 14 percent more members with industry ties than the one working on the 1994 version.

"When I did that study, it was not an attempt to ban people with financial ties," she said in an interview. "I think a more balanced and realistic approach would be to actively recruit critics of industry-funded research as opposed to an outright ban."

Dr. Jerome P. Kassirer, a professor at Tufts University School of Medicine and a former editor of the New England Journal of Medicine, called disclosure “the easy way out.”

“Disclosure is a necessary part of dealing with financial conflicts of interest, but it’s not sufficient,” he said. “Disclosure is supposed to be the disinfectant but it’s not that at all.”

Instead, the solution is to populate such high-profile committees with people without financial conflicts, which would also make conflict-free status more attractive, he said.

In addition to Hyman, six other experts from Massachusetts are among 120 people picked for groups working on specific disorders. Three disclosed financial ties to drug or medical-device companies.

-Dr. Arthur J. Barsky III, Brigham and Women’s Hospital and Harvard Medical School, consulting fee from Glaxo Smith Kline, honorarium from Pfizer
-Dr. Deborah Blacker, Massachusetts General Hospital, Harvard Medical School, and Harvard School of Public Health, consulting fee and research grant from Glaxo Smith Kline
-Dr. Scott L. Rauch, McLean Hospital, honoraria and consulting fee from Novartis, grants and honoraria from Cyberonics, grant from Medtronic, honoraria from Neurogen and Sepracor, and post-doctoral fellow funding from Pfizer

The three others, without disclosures:
-Dr. Anne E. Becker, Massachusetts General Hospital
-Dr. Guilherme Borges, visiting scientist at the Harvard School of Public Health
-Barbara E. Wolfe, Boston College