Diagnostic and Statistical Manual of Mental Disorders, Duping Doctors©

A recently released study reports that the famous and often used, Diagnostic and Statistical Manual for Mental Disorders is not the reliable source it was once thought to be. The DSM offers definitions and analysis of mental, or personality disorders.  Treatments are also prescribed.  More often than not, these require drug therapy.  For decades, psychiatrists, psychologists, pharmacists, and other medical specialist have turned to this guidebook for counsel; it was considered the Holy Grail. This large book was looked upon as an objective reference; it is not.

Apparently, according to a recent study published in the Journal Psychotherapy and Psychosomatics, most of the expert authors have financial ties to the very drug makers whose medications they promote.  56 percent of 170 psychiatric experts who worked on the most recent 1994 edition of the Diagnostic Manual, had at least one financial encounter with a drug maker between 1989 and 2004.

The relationships ranged from speaking engagements to consulting fees.  Some specialist owned considerable shares of company stock.  Gifts were given.  Travel was also a frequently token.  Many “experts” were awarded funds for their research.  It is likely, all were the recipients of perks from the very drug-makers they promoted in the DSM.

In the group of specialists working on mood disorders, schizophrenia and other psychotic disorders, all had significant ties to pharmaceutical companies.  According to the assessment, “The connections are especially strong in those diagnostic areas where drugs are the first line of treatment for mental disorders.”

After ample research, lead author of the study, Dr. Paula Cosgrove reported that this guidebook differs little from any other paid advertisements.  The integrity of the information is in question.  Now that we know how much influence these companies had on the writing of the DSM IV, this source can no longer be considered trustworthy.

Benefits befell all tied to this Diagnostic Manual.  The doctors and researchers did well and the pharmaceutical companies prospered.  Speaking of the physicians, Lisa Cosgrove, a clinical psychologist at the University of Massachusetts in Boston said “They can certainly leverage their participation on the DSM, which is very prestigious, into lucrative consulting contracts.”

Drug manufacturers brought in a whooping $35 Billion dollars this year from the sales of psychotropic drugs and if history is a telling sign, the number is going to grow.

According to the Mental Health Policy and Psychotropic Drugs . . .

The amount of money spent on psychotropic drugs grew from an estimated $2.8 billion in 1987 to nearly $18 billion in 2001 (Coffey et al. 2000, Mark et al.  2005), and the amount spent on psychotropic drugs has been growing more rapidly than that spent on drugs overall (IMS Health 2005).

For example, spending on antidepressant and antipsychotic medications  grew 11.9 percent and 22.1 percent, respectively, in 2003, whereas  spending on drugs overall grew at 11.5 percent in 2003 (IMS Health  2005). “

A Washington Post article, Experts Defining Mental Disorders Are Linked to Drug Firms . . .

There is disagreement as to  the validity of this study.  One of the psychiatrists who worked on the current DSM was disparaging of the investigation. Nancy Andreasen, of the University of Iowa, headed the schizophrenia team.  She stated, this latest review is “very flawed.” She declared that there needed to be a distinction between those that had connections to the drug industry while working on the panel and those that established an association after.

Ms. Andreasen offered, “Two out of five researchers on her team had had substantial ties to industry.” In speaking of herself, she noted ??she would have to check her tax statements to know whether she received money from companies at the time she worked on the panel.’ She did add declaratively “What I do know is that I do almost nothing with drug companies. . . . My area of research is neuroimaging, not psychopharmacology.”

I find this interesting.  I am the granddaughter of a pharmacist, a scientist, and a curious soul.  I learned much from him.  My grandfather worked when chemicals were hand mixed.  He ground the concoctions people purchased in his own mortars and pestles.  Drugs were delivered to his store in glass bottles; some stood three-feet high.  I thought of these as toys.  Once again, I digress; my apologies; nevertheless.

My grandfather told me long ago as did a friend, a medical doctor, a man practicing in the field of psychiatry, if you want to learn of medicines, ask a chemist, a scientist, or a pharmacist.  These persons study chemical reaction on human cells.  They know what might be beneficial or harmful; what interacts well with other medications, and what might lessen the potency of a drug.

According to my friend, the doctor, physicians know only what the salesperson tells them.  Drug company representatives give gifts, small trinkets, and expensive dinners.  They cocktail and court a doctor while discussing the quality of their wares.  Ultimately, a physician is convinced this pill, caplet, or concoction is the best.  The doctor may know of no other.  A doctors knows what drugs representatives tells him/her.  He who enters or telephones the office is most influential.

Considering the validity of these opinions, the reality of drug interactions and side affects is not unexpected  Drug side affects were not documented in 1994, the year the most recent DSM IV was published.  Since then questionable practices are being investigated. Conflicts of interest have become an overriding issue; actually, it is these that may have promoted this just released survey.

While many question the reliability of the report, all seem to agree, transparency is necessary.  The researchers discovered the DSM, published by the American Psychiatric Foundation was fundamentally flawed, what was not known was its downfall.  On this, Dr. Cosgrove said, “Transparency is especially important when there are multiple and continuous financial relationships between panel members and the pharmaceutical industry, because of the greater likelihood that the drug industry may be exerting an undue influence.”

Undue pharmaceutical influence; now there is a study that even a novice researcher can do.  Clearly, there is a recent trend in medicine, push the pills on patients, and they, in turn, will tell their doctors what they need [or want.]  We see evidence of this everywhere.  On television and radio broadcasters tell us, take the purple pill and your stomach will be settled.  The blue pill will help you perform.  The yellow pill provides power, and the green capsule will make you mellow.  Looking for love, try potion number 9.

Commercials call us to action; they instruct.  Infomercials dominate the airwaves.  They teach the public to self-prescribe.  Of course, people are advised to consult their physicians before taking any medication.  However, it is well known in today’s world of medical malpractice suits, physicians fear denying patients their desires.  Thus, people are able to self-medicate legally.

There was a time when individuals believed that doctors knew best; they were as father figures. It was thought that a physician would not prescribe what is not necessary.  Those days, if they ever existed are long gone.  Some within the general public assume that a person willing to devote years of his or her life to study is dedicated and altruistic.  Doctors are thought to be knowledgeable.  They truly care for people.  Some do; however, many if not most are just human.

Rarely do health care workers engage in studies that correlate chemical and cellular interactions.  Yet, these are the persons, through the auspice of the Diagnostic and Statistical Manual for Mental Disorders prescribing drugs to treat psychological and personality maladies.

Are they qualified?  Might they be influenced by the almighty dollars that the drug companies throw their way?  Was there any doubt?  Not for me.

Now, there is solid proof for what my Grandfather and my friend the psychiatrist have always said.  Physicians and pharmaceutical companies are pushing pills aggressively on every front.  The public must be cautious.  Do not trust the diagnosis, the doctor, or the documentation.  Consumers and “crazies,” Be aware.  You may not be as sick as you think.

References for Review . . .
Who’s behind that diagnosis? Marketplace, American Public Media. Thursday, April 20, 2006
DSM-IV-TR Library, American Psychiatric Association
Online Psychological Services
Bias in Psychiatric Diagnosis By Paula J. Caplan (Editor), Lisa Cosgrove (Editor)
Diagnostic and Statistical Manual of Mental Disorders From Wikipedia
Excerpted from  the Introduction of Bias in Psychiatric Diagnosis, Edited by Paula J. Caplan, Ph.D  & Lisa Cosgrove, Ph.D
Mental illness writers had industry ties: study By Lisa Richwine. Reuters. Thursday, April 20, 2006 11:01 PM BST
The drug industry’s chokehold on America’s health care By Joanne Laurier, WSWS: Book Review, January 2005
Mental Health Policy and Psychotropic Drugs
Mental Health Policy and Psychotropic Drugs Richard G. Frank , Renam Conti, and Howard H. Goldman
Study: Medical manual’s authors often tied to drugmakers By Dan Vergano, USA TODAY
Experts Defining Mental Disorders Are Linked to Drug Firms By Shankar Vedantam. Washington Post Thursday, April 20, 2006
Mental illness writers had industry ties: study By Lisa Richwine. Yahoo News Thursday, April 20, 2006
Psychiatry manual linked to drug money, By Lisa Richwine. Reuters
Drugs.com
Preparers of key guide linked to drug firms By Judith Graham. Chicago Tribune

Buyers Bless You; Sellers Beware ©

It began innocently; an acquaintance suggested that I run an advertisement in the Recycler©.  I was selling my washer and dryer.  I already asked friends and family if they wanted to purchase the pair.  The machines were also offered to the buyers of my home.  Realtors were contacted; surely, they would know of someone that needed a like-new washer and dryer.  The duo is the top-of-the-line, in mint condition, and is barely three years old; they are Whirlpool Calypso’s.  They will sell easily says the companion.  “Place an ad in this periodical and they will be gone,” he reassures me.  The chum tells me that I can submit the classified online; I do.

The public notice is free and that works well for me.  I received an email almost instantly.  A man named Luis Spencer wants more information.  He requests photographs.  He inquires of the condition, and what is my bottom-line price? We mail back and forth.  I share all the details and Luis declares his interest.  He will pay my price. He states that an associate of his will arrange for the shipping, he is writing from England.

Luis Spencer assures me he will pay with a certified check.

Later, he reveals that his associate owes him $4500 dollars.  The business partner will send the full sum to me and Luis would like me to take my share and wire the remainder to him.  I immediately respond that this does not feel good to me.  I write, merely have the colleague send the money he owes to Mr. Spencer and then Spencer can pay me.

Dear Luis replies, it is too late; the check is in the mail.  He asks me to be trustworthy and he offers God’s blessings to me.  Mr. Spencer suggests that I get in touch with him once I receive the monies.  He will tell me where to wire the funds.  I assure him that the moment the note arrives; I will drive straight to the bank and then to Western Union.  I have no desire to delay.

Therefore, I ask that he send me the information now, for I do not feel good about any of this.  I want to get his money to him immediately, if not sooner.  I really want nothing to do with this “extra” money.

I promise him I will photocopy the check and all papers received, inclusive of the envelope.  I will disburse the currency as soon as I receive it.

Luis does not submit a response in his usual timely manner.  I write . . .

“I do not understand the delay in sharing information.  I requested the name and telephone number of your associate so that I might know whom I am working with. I also need your contact information.  I need to know where to send the money and who will pick up the machines.  Without this, I feel great concern. The sending of such a large sum to me, the lack of specific information . . . it all makes me very nervous.  I am troubled, very, very troubled.  I am not a person that hesitates.  If the check arrives, I will want to take care of it and all issues involved with it immediately. I will travel from the mailbox to the bank and then Western Union.

I am very concerned. Why no information?  Please help me to understand!”

Finally, I do understand.  It is as I supposed, a scam, or at least the attempt to.

A day later, I received another mail, this one from Williams Thomson.  He is in Texas.  There were differences and similarities.  I responded to the first of Williams’ mails, just in case.  By the second mail, he too offers God’s blessings. I felt vindicated.  This man too was willing to spend more to buy and ship used machines than he would have if he purchased the same new.  Sellers beware!  Others cannot genuinely give God’s blessing.  Remember, it is said; God helps people who help themselves.