Regular Article

Conflicts of Interest and Disclosure in the American Psychiatric Association's Clinical Practice Guidelines
Lisa Cosgrove^a, Harold J. Bursztajn^b, Sheldon Krimsky^c, Maria Anaya^a, Justin Walker<sup>a

a</sup>Department of Counseling and School Psychology, University of Massachusetts, Boston, Mass.,
^bDepartment of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass., and
^cDepartment of Urban and Environmental Policy and Planning, Tufts University, Medford, Mass., USA

Address of Corresponding Author

Psychother Psychosom 2009;78:228-232 (DOI: 10.1159/000214444)

  Key Words

• Clinical practice guidelines
• Conflict of interest
• Financial associations

  Abstract

Background: Clinical practice guidelines (CPG) are developed, endorsed, and disseminated through professional medical organizations such as the American Psychiatric Association (APA) as the standard of care for health care providers. Because of their influence, it is critical that CPG are based on objective data, unprejudiced by stakeholder groups, and that any financial associations between authors of CPG and the pharmaceutical industry are made transparent. The present study examined the degree and type of financial ties to the pharmaceutical industry held by authors of 3 major CPG. Methods: By using multimodal screening techniques, we investigated the financial relationships to the pharmaceutical companies of 20 work group members who authored the guidelines for the treatment of schizophrenia, bipolar disorder, and major depressive disorder. Results: Eighteen CPG authors (90%) had at least 1 financial tie to the pharmaceutical industry. All of the CPG authors who had industry relationships had financial relationships with companies whose products were specifically considered or included in the guideline they authored. The leading categories of financial interest held by CPG authors were research funding (77.7%), consultancies (72.2%), members of corporate boards (44.4%), and collaborators in industry-funded studies (44.4%). Conclusions: Ninety percent of the authors of 3 major CPG in psychiatry had financial ties to companies that manufacture drugs which were explicitly or implicitly identified in the guidelines as recommended therapies for the respective mental illnesses. None of the financial associations of the authors were disclosed in the CPG.

Copyright © 2009 S. Karger AG, Basel

  Author Contacts

Lisa Cosgrove, PhD
Department of Counseling and School Psychology
University of Massachusetts, 100, Morrissey Blvd.
Boston, MA 02125-3393 (USA)
Tel. +1 617 287 7748, E-Mail lisa.cosgrove@umb.edu

  Article Information

H.J.B. has served as a consultant to physicians and institutions seeking to craft COI policies and as a plaintiff- or defendant-retained expert in competency to consent to neuropsychoharmaceutical treatment as well as product liability cases. All of the authors had full access to the data in the study; L.C. takes responsibility for the integrity of the data and the accuracy of the data analysis.

Received: December 22, 2008
Accepted after revision: January 27, 2009
Published online: April 28, 2009
Number of Print Pages : 5
Number of Figures : 0, Number of Tables : 0, Number of References : 31