How much advice on mental illness treatment is influenced by drug companies?

According to new research in the U.S. most of the experts giving advice on the diagnosis and management of mental illness have had financial links to drug makers such as research funding or stock holdings.

The researchers are calling for the relationships between companies and the medical experts on advisory panels to be disclosed.

The researchers from Tufts University and the University of Massachusetts studied financial records and conflict-of-interest statements in medical journals from 1989 to 2004.

They say future editions of the Diagnostic and Statistical Manual of Mental Disorders, known as the DSM, widely regarded as an industry handbook, to demonstrate transparency especially when there are multiple and continuous financial relationships between panel members and the pharmaceutical industry.

The researchers say this would eliminate the possibility that the drug industry may be exerting undue influence.

The American Psychiatric Association, which publishes the DSM, has already said it will require financial disclosures for the next version, due out in 2011.

The study found 56 percent of 170 psychiatric experts who worked on the most recent edition, published in 1994, had at least one financial link to a drug maker at some point from 1989 through 2004. The relationships included speaking or consulting fees, ownership of company stock, payment for gifts and travel and funding for research.

The most frequent financial tie involved money for research.

All of the experts who developed sections defining mood disorders, schizophrenia and other psychotic disorders had such links, the study said.

Lisa Cosgrove, lead author of the study and a clinical psychologist at UM, says the public is unaware of how egregious the financial ties are in the field of psychiatry.

Many critics have said psychiatric drugs are over prescribed and Cosgrove believes that drug makers have a "vested interest" in which disorders are included in DSM, citing the inclusion of newly classified disorders, such as social anxiety, as areas of potential industry influence.

Experts in the field have given a mixed reaction to the study and some say it is an attempt to develop guilt by association with the pharmaceutical industry, while others say it is flawed.

The study is published in the current edition of Psychotherapy and Psychosomatics.

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