Panel members for new psychiatric ‘bible’ received more than $14 million from industry, analysis finds

Sixty percent of U.S. doctors on the panel and task force for the American Psychiatric Association’s official manual of psychiatric disorders received industry payments totaling $14.24 million, according to a study published by The BMJ.

Because of the enormous influence of diagnostic and treatment guidelines, the researchers say their findings “raise questions about the editorial independence of this diagnostic manual.”

Often called the “bible” of psychiatric disorders, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) is the latest edition of the guide that doctors use to diagnose and treat patients. It is therefore essential that the authors of this psychiatric taxonomy are free from any links with the industry.

However, until the development of Open Payments (a database of financial relationships between companies and doctors), it was not possible to determine the amount of money received by the authors of diagnostic guides and clinical practice.

To address this issue, researchers used Open Payments data to assess the extent and types of financial industry ties of DSM-5-TR panel and working group members.

Their analysis included 92 U.S.-based physicians who served on a DSM-5-TR panel (86) or working group (6) from 2016 to 2019, during which time the work were launched and completed for the year 2022. text revision.

Of these 92 individuals, 55 (60%) received payments from industry. These panel members received a total of $14.24 million (£11.21 million; €12.96 million). Only two of the six task force members reported payments in open payments, totaling $196.02 and $792.67 for 2016-19.

The most common payment types were for food and drink (91%), followed by travel (69%) and advice (69%).

The largest proportion of compensation by payment category was for research funding (70%), which the authors noted was excluded from the American Psychiatric Association’s disclosure policy for the previous edition (DSM-5 ).

They point out some study limitations, such as excluding payments to doctors based outside the United States or non-physician prescribers, and acknowledge that the amounts listed in the database may be imprecise.

Nonetheless, they say this study “provides valuable new data on conflicts of interest in the DSM-5-TR and extends previous research on this topic.”

To ensure unbiased, evidence-based mental health practice, there should be a rebuttable presumption to prohibit financial conflicts of interest among Diagnostic and Statistical Manual of Mental Disorders panel and working group members, write -they.

Where no independent person with the required expertise is available, they suggest that people associated with industry could consult the panels, but would not have decision-making authority over revisions or the inclusion of new ones. troubles.

“As researchers, clinicians, policymakers, and leaders in evidence-based medicine have argued, guideline writers should be free from any financial relationships with industry, particularly authors responsible for a textbook as influence on psychiatric taxonomy”, they conclude.