In a move that is likely to be closely scrutinized, the American Psychiatric Association todaynamed its new task force for overseeing development of its 5th edition of the Diagnostic and Statistical Manual of Mental Disorders, or DSM-V. The DSM is the handbook used by psychiatrists and other mental health professionals to diagnose and classify mental disorders. The task force has 27 members, who rep scientists from psychiatry and other disciplines, clinical care providers, and consumer and family advocates.
This task force, which will revise the DSM over the next five years, holds a great deal of sway, since their actions influence prescribing habits in the US and elsewhere. But it's more than that. The DSM is where a condition is officially sanctioned as a disorder, which of course, also determines treatment. For these reasons, the APA has come under fire - as have other doctors - for ties to industry.
Of the 27 task force members, the APA says eight had no relationship with industry and 19 disclosed relationships with industry during any of the 36 months leading up to their nomination. The APA made all task force membersâ€™ disclosures available - look here - and maintains that "several otherwise highly qualified individuals were ruled ineligible for task force appointments due to their competing interests."
â€œThe APA Board of Trustees established limits on relationships with industry that are more stringent than federal agency limits,â€ says APA president Carolyn Robinowitz. â€œWhat makes the DSM powerful is its value in clinical practice. Patients deserve a diagnostic manual based upon the latest science and free of conflicts of interest.â€
The APA, by the way, has been embroiled in the controversy over antidepressants and Black Box warnings, which the FDA mandated in early 2005 after the drugs were linked to suicide in youngsters. Since then, the APA has repeatedly urged regulators to rethink their position over concerns that patients and doctors are being scared away from using meds. As a result, though, some patient advocates charge the APA is too quick to side with industry.