Conflicts of interest and disclosure in the American Psychiatric Association's Clinical Practice Guidelines.
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.
Cosgrove
Lisa
L
Department of Counseling and School Psychology, University of Massachusetts, Boston, MA 02125-3393, USA. lisa.cosgrove@umb.edu
Bursztajn
Harold J
HJ
Krimsky
Sheldon
S
Anaya
Maria
M
Walker
Justin
J
D001319:Authorship; D001714:Bipolar Disorder / Q000188:drug therapy; D016265:Conflict of Interest; D003865:Major Depressive Disorder / Q000188:drug therapy; D030881:Disclosure / Q000941:ethics*; D004345:Drug Industry / Q000941:ethics; D004992:Ethics, Medical; D019317:Evidence-Based Medicine / Q000941:ethics; D006801:Humans; D017410:Practice Guidelines as Topic; D011570:Psychiatry / Q000941:ethics*; D011619:Psychotropic Drugs / Q000627:therapeutic use; D012559:Schizophrenia / Q000188:drug therapy; D012955:Societies, Medical / Q000941:ethics*; D014481:United States
D011619:Psychotropic Drugs