LOS ANGELES - TelAve -- A recent British Medical Journal study has revealed that more than half of the doctors who contributed to the latest edition of the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) had conflicts of interest with the pharmaceutical-health industry, collectively receiving $14.2 million. The DSM, often referred to as psychiatry's "billing bible," not only serves as a tool for obtaining reimbursement in mental health treatment but also plays a central role in approving new psychiatric drugs and is used for clinical drug trials.[1] The Citizens Commission on Human Rights International, a watchdog in the mental health industry, has been campaigning for over two decades to advocate for the public disclosure of financial ties between pharmaceutical companies and mental health care practitioners. The group emphasizes that conflicts of interest have the potential to influence clinical results with bias.
The researchers in the study include Lisa Cosgrove, a professor from the University of Massachusetts-Boston, Department of Counseling and School Psychology, who has conducted previous studies exposing conflicts of interest for DSM-IV and DSM-5. The current study addresses the latest revision, DSM-5-TR, published in 2022. The percentage of panel members with industry support was similar between DSM-5-TR and DSM-5.

The study identifies 168 individuals who served as either panel or task force members of the DSM-5-TR, of which 92 were based in the U.S. and subject to disclosure of their interests in the Open Payments Program. Of these 92, 55 (60%) received payments from industry.

Open Payments is a Centers for Medicare & Medicaid Services publicly accessible database that identifies monies given by pharmaceutical and device companies to individual physicians and institutions. Since 2013, under the Physician Payments Sunshine Act, all drug and device manufacturers are required to disclose these payments.

Such transparency is not available or easily accessible in other countries. Therefore, as the researchers point out, the study only used information provided by Open Payments, which does not include payments to physicians based outside the U.S. That's a substantial number of experts unaccounted for. According to the APA, approximately 21% of the participants in DSM-5-TR were international experts.[2]

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Congruent with previous studies, "panel members of the DSM who received the most remuneration from drug companies were those working in diagnostic areas where drug interventions are often the standard treatment…."

The top 5 DSM disorders for financial disclosures determined from Open Payments, are:

• Medication-induced movement disorders: $8,443,468
• Sleep-wake disorders: $1,892,430
• Disruptive, impulse, and conduct disorders: $1,059,910
• Obsessive Compulsive Disorder: $973,851
• Depressive disorders: $875,373

CCHR says the amount given to drug-induced movement disorders contributors is shocking because the disorders largely derive from psychiatric drugs. Brain damage due to psychiatric drugs has a devoted section in the DSM. For example, Neuroleptic-induced Parkinsonism, Neuroleptic Malignant Syndrome, Medication-Induced Acute Dystonia, Medication-Induced Acute Akathisia, and Tardive Dyskinesia (TD, meaning, "abnormal movement of muscles") to name a few.[3]

Neuroleptic malignant syndrome was listed as a mental disorder in DSM-IV. Patients can exhibit NMS symptoms within 2 weeks and nearly all within 30 days of taking an antipsychotic.[4]

Neuroleptics cause involuntary movement of the lips, tongue, jaw, fingers, toes and other body parts, known as Tardive Dyskinesia (TD). CCHR says it's a "revolving door" effect: antipsychotics are prescribed, cause a disfiguring condition, which is, in turn, diagnosed as another mental disorder, for which a second or third drug is prescribed—with more side effects.[5]

Common adverse effects of one approved TD-treatment drug include: trouble with balance, coordination or walking, drooling, irregular heartbeat, and restlessness, inability to sit still, need to keep moving, and trembling and shaking of the fingers or hands—similar symptoms to the antipsychotics themselves.[6]

There are 12 psychiatrists listed as members of the DSM-5-TR medication-induced movement disorders Work Party, headed by a former APA president. That psychiatrist came under federal Senate investigation in 2008 because of his undisclosed conflicts of interest with the pharmaceutical industry, when he had 15 links to drug companies, including stock ownership.[7] Between 2019 and 2022, Open Payments reported he received nearly $104,000 in industry payments.[8] A 2022 disclosure lists his financial ties to two pharmaceutical companies that manufacture antipsychotics that can cause medication-induced movement disorders.[9]

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In 2020, IQVia's Total Patient Tracker shows more than 11.1 million were taking antipsychotics. That equates to potentially 2.23 and 5.57 million Americans being permanently damaged from drug-induced movement disorders such as TD.[10]

Add to this the psychiatrist's financial association with the company COMPASS, which conducts psilocybin (magic mushrooms) psychedelic drug research.[11] Psychedelics can cause another DSM disorder: Hallucinogen-persisting Perception Disorder.[12]

The DSM is controversial because task force members vote to include a mental disorder in the manual. The disorders are not discovered in the way medical illnesses are. There are no physical tests or blood work to confirm a DSM disorder. After being voted into existence, a psychiatric drug can be prescribed for it.

Carl Elliott, a bioethicist at the University of Minnesota says: "The way to sell drugs is to sell psychiatric illness."[13]

Nearly 77 million Americans now take psychiatric drugs.[14]

CCHR recommends people read Mental Disorders: The Facts Behind The Marketing Campaign on its website and access its psychiatric drugs side effects database to become further educated on the issue.

About CCHR: CCHR was founded in 1969 by the Church of Scientology and the late Dr. Thomas Szasz, Professor of Psychiatry, and prolific author of books on psychiatry. It has helped achieve over 190 laws enacted that protect rights within the mental health system and bring to account violations of rights.

[1] www.bmj.com/content/384/bmj-2023-076902

[2] www.psychiatry.org/getmedia/5635958b-ee71-4352-b02a-fb24ecab86c6/APA-DSM5TR-ThePeopleBehindDSM.pdf

[3] www.cchrint.org/2017/02/27/experts-expose-troubling-facts-about-the-psycho-pharma-industry/; dsm.psychiatryonline.org/doi/10.1176/appi.books.9780890425787.Medication_Induced_Movement_Disorders

[4] www.ncbi.nlm.nih.gov/pmc/articles/PMC3726098/; www.ncbi.nlm.nih.gov/pmc/articles/PMC6478951/

[5] www.cchrint.org/2021/10/11/consumers-beware-of-antipsychotics-long-term-debilitating-effects/

[6] www.cchrint.org/2021/10/11/consumers-beware-of-antipsychotics-long-term-debilitating-effects/

[7] www.cchrint.org/2010/12/31/american-psychiatric-associations-interests-in-conflict/

[8] openpaymentsdata.cms.gov/physician/340355

[9] clinicaloptions.com/CE-CME/slideset:-potential-drugs-of-abuse-as-antidepressants/100008767

[10] www.cchrint.org/2021/10/11/consumers-beware-of-antipsychotics-long-term-debilitating-effects/

[11] compasspathways.com/

[12] www.ncbi.nlm.nih.gov/pmc/articles/PMC5870365/

[13] www.cchrint.org/issues/dsm-billing-bible/; www.washingtonpost.com/archive/politics/2001/07/16/drug-ads-hyping-anxiety-make-some-uneasy/8fe2eea2-b780-48cd-9872-1d3802e83147/

[14] www.cchrint.org/psychiatric-drugs/people-taking-psychiatric-drugs/