The diagnostic manual in psychiatry is currently being rewritten.
Given the conflicts of interest among past authors of the psychiatric diagnostic manual, the psychiatrists who are currently in the process of creating a new diagnostic manual have pledged to limit their income from the pharmaceutical industry to $10,000 or less per year until the completion of their work on the manual. They did so because of the perception that the authors of the previous versions of the manual have had close ties to the pharmaceutical industry and therefore might have been biased toward creating labels and diagnoses that would serve to benefit the pharmaceutical industry.
After all, pharmaceutical companies market drugs to treat these “illnesses.” The more illness there are, the larger the potential market for drugs . . .
Although it is nice that the manual’s authors will limit their income from industry during the time they work on the diagnostic manual, several questions remain: Will anyone question the manual’s authors’ self disclosures and/or investigate their actual income from such sources? Secondly, even if the authors personally adhere to the self imposed limits, how much pharmaceutical funding is being funneled into the authors’ respective departments by way of lectureships, endowed chairs, or sponsored research? For example, some of the authors chair departments of psychiatry that collectively receive substantial sums of money annually from pharma. Furthermore, given that many of the authors have received substantial payouts in the recent past from industry—and are free to do so again after the manual is published—is there any question that their judgment might be influenced by their past pharmaceutical payouts or the possibility of more in the future?
Why is this significant? Apart from what these diagnoses potentially mean for the pharmaceutical industry or the insurance industry—which in part bases payment for treatment upon the diagnostic label used–labels carry with them power, especially when they are couched in scientific terminology and possess an air of objectivity.
I hope to explore the dynamics of power in future posts