Does pharma dominate psych manual?

If you're acquainted with the psychiatric world, you know that it's ruled by the mental-illness code, the Diagnostic and Statistical Manual of Mental Disorders. It determines what's mental illness and what isn't. Drug companies can get approval to market products only for DSM-sanctioned disorders.

So when the DSM is updated, as it is every decade or so, drug makers hope for newly defined illnesses. The current manual, the DSM-IV, delivered. It gave us social anxiety disorder, among others. And the American Psychiatric Association came under fire because more than half those who worked on that manual had financial ties to pharma.

Now, it's DSM-updating time again. The APA says it's screening its task force for info about stock ownership, speaking fees, consulting fees and the like. But the association isn't sharing much. Disclosures show only which panel members have ties to which companies. No dollar amounts, no time spans.

The organization required panel members to have no more than $10,000 in annual income from pharma sources -- but only at the time of their appointment. Once on the task force, they could sign up for more. And the limit doesn't apply to a panelist's employer, such as university labs that get huge grants from drug makers for research.

Critics are asking the APA to allow members with conflicts to offer their opinions, but restrict voting only to panelists that aren't beholden to pharma. That's not likely to happen. And the APA says several of its subgroups have to approve the manual, so there are "several layers of protection." And several layers full of potential conflicts.

- see the disclosure statements from the APA
- read the article from U.S. News and World Report
- check out the Pharmalot item