Undisclosed financial conflicts of interest in DSM-5-TR: cross sectional analysis
Study (92 physicians) found conflicts of interest among panel and task force members of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, fifth edition, text revision (DSM-5-TR) were prevalent (60% received payments from industry).
Source:
British Medical Journal
SPS commentary:
These panel members received a total of £11.2m of whom 33.3% had payments reported in Open Payments. The DSM published by the American Psychiatric Association, which standardises symptom criteria and codifies psychiatric disorders, plays a central role in the approval of new psychiatric drugs and the extension of patent exclusivity, and has been referred to as the ‘bible’ of psychiatric disorders. The researchers suggest that as industry influence over the development of this diagnostic guideline can have a profound effect, the standards for participation on a guideline development panel should be high.
In a linked opinion, the author points out an important caveat should be made to these findings in that financial conflicts of interest do not point to wrongdoing, but to a generic risk that researchers’ corporate ties may compromise the research process or undermine public trust. She suggests that a key step to creating trustworthy clinical guidelines is ensuring that they are developed by experts who are free of industry ties, and in the case of the DSM, this recommendation is also important because panel members are able to eliminate disorders—not just add new ones—and thus could play a vital role in tackling over-diagnosis and overtreatment.