Millions of Dollars of Pharma Money Went to the DSM-5-TR Authors

About 60% of the authors had financial ties to industry, which are not disclosed in the DSM. Studies show that conflicts of interest lead to pro-industry decision-making.


In a new study, researchers found that about 60% of the authors working on the latest edition of psychiatry’s diagnostic bible (the DSM-5-TR) had financial ties to the pharmaceutical industry. In total, more than $14.2 million of pharma money went to the DSM-5-TR task force and review group members.

“The amount of money received from pharmaceutical companies by individuals with decision making authority over the revision process raises questions about the editorial independence of this diagnostic manual,” the researchers write.

The study was conducted by Lauren Davis and Brian Piper at the Geisinger Commonwealth School of Medicine and Lisa Cosgrove at the University of Massachusetts-Boston, as well as other researchers from both institutions. (Full disclosure: Cosgrove was my advisor in graduate school.)

Cosgrove has previously demonstrated that the majority of authors of the previous versions of the DSM also had financial ties to pharma, including 100% of the authors creating the diagnoses for depression, bipolar disorder, and schizophrenia in the DSM-IV.

The researchers note that although it is not possible in this case to prove that financial conflicts of interest influenced the DSM development process, there is copious evidence showing that receiving money from industry creates biased research literature and biased guideline development, with researchers across all specialties in medicine far more likely to come to pro-industry conclusions if they received industry money.

“The impact of financial conflicts of interest on the medical literature, including randomized clinical trials, meta-analyses, and clinical diagnostic and practice guidelines, has been well documented for more than two decades. Indeed, researchers have consistently shown that conflicts of interest lead to subtle but impactful pro-industry thinking and conclusions,” the researchers write.

Closeup on money being handed to a doctor

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  1. Who’d be surprised to learn that the authors of the DSM have ties to Big Pharma? It’s the reason psychiatry’s precious Book of Bullshit keeps getting bigger with every new edition. And psychiatry knows damn well that without their DSM they’d have nothing to sell the public, because no fictional “diagnoses” means no “meds”, and no “meds” means no money —

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  2. Reading this article was a waste of time as no one in their right mind should be surprised to learn that the authors of the DSM have ties to Big Pharma. It’s the reason psychiatry’s precious Book of Bullshit keeps getting bigger with each new edition! And psychiatry knows damn well that without their precious Book of Bullshit they’d have nothing to sell to the public because no fictional “diagnoses” means no “meds” and no “meds” means no money, which seems to be what “psychiatry” is all about.

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    • Birdsong, I’m delighted with your term”Book of Bullshit,” which I shall henceforth use as an acronym: BOB. This insidious psychiatric bible, as Thomas Szasz rightly noted, can be considered the modern counterpart of the medieval treatise “Hammer of Witches” that once served inquisitors as an infallible guide for classification and identification of the hapless women who incurred their misogynistic suspicion. And, like those sadistic churchmen, the modern drug dealers and electroshock hucksters known as biological psychiatrists (the notorious Dr. Jeffrey Lieberman, former head of the APA, comes to mind) torture their victims, not to redeem their eternal souls but to stabilize their “disordered” mental and emotional state.

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  3. I commend this review as very coherent. The original article seems somehow difficult to grasp.

    This is a great review of it. Thanks.

    One thing I think the original article might not cover is the fact that doing, elaborating a clinical guideline to address, even treat something without basis in reality, merely imaginations called constructs, that are unfalsifiable and therefore prone ONLY to confirmation bias, at least, is a bad, pseudoscientific, and anti-scientific way of doing medicine.

    So the reviewed article assumes there is a guideline that IS possible, which it is not, given at least the “construct” and intersubjective nature of the subject matter: mental “disorders”.

    There still is not, after centuries a gold standard to define mental illness/disorder/suffering. None at all. The DSM in concealed ways admits it thus.

    No guideline that is objective, and therefore useful in the scientific and empirical sense can come out of mere “constructs”: they have no basis in reality but on mere opinion. An expert’s fallacy sort of thing: no one can be an expert in something reputed scientific that has no basis in reality.

    Even abstract mathematics has more basis in reality, evident in it’s predictive power of something as counterintuitive as imaginary numbers and the invisibility of the circle’s center: it exists, but it’s invisible, being a point smaller than Planck’s length. Even though the definition and construction of a circle, ehem, depends on it.

    And therefore arguing there is a better way to build guidelines is a false statement: it has no basis in reality, but in “need” to address suffering. Mere need to address something is not enough to do anything…

    It speaks of a market in need of something, something that will be provided regardless it’s no different than ideology, politics, astrology, divination or religion. Even entertainment.

    And although might seem as critical “thinking”, to me, the sad fact is, is that it is not critical enough, and certainly not thinking enough: the whole mental “disorder” guidelines building is a charade, a fraud of the pseudoscientific kind.

    And in that sense I think, as my opinion, that despite it’s critical veneer, it’s critical patina, it still argues in favor for a pernicious status quo: arguing for the existence and reality of something that has not been proven as such in real scientific terms.

    It’s instead a market offer to preserve the market in suffering of “mental” suffering, arguing there is a need without further ado.

    Like black markets given a patina of “expert” knowledge. Which is no more expert than astrologer’s ones…

    “A key step to creating trustworthy clinical guidelines is ensuring that they are developed by experts who are free of industry ties…”, ditto: said paragraph assumes guidelines ARE possible, which they are not, scientifically. And it makes trustworthinesss THE value that makes them, somehow NECESSARY: a circularity.

    Without arguing WHY those are the cases: possible and necessary, at least. Let alone effective, efficient or counter-productive.


    And therefore it moves the discussion from the “there are not, there can’t be no basis” of ANY guideline in THAT field, to a presumed existence of a “better” way of doing guidelines: a trustworthy one. An expert fallacy in which expertise is not possible in the scientific sense, or not usefully…

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  4. Here’s my humble prognostication: the psychiatrists who write the DSM are the authors of psychiatry’s eventual demise which, most likely, will happen due to an unprecedented increase in the number of people suffering iatrogenic harm from its ever-increasing number of poisonous “medications” for its ever-increasing number of fictional “diagnoses”. But (unfortunately?) by that time most of them will either be retired or dead.

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  5. We live in a heavily drugged world. Psychiatry has largely made itself irrelevant by focusing on drugs that any doctor or even nurse practitioner (in the USA) can prescribe. They not only don’t do therapy they often refuse to waste their precious time even making polite small talk with patients.

    The newer major tranquilizers in particular fail to outperform the older drugs are prescribed by all sorts of doctors for all sorts of reasons and the outcomes for the do called severely mentally ill are only getting worse.

    At the state level state hospitals continue to shrink. Even ruby red states are officially embracing a cost cutting version of the recovery model, which emphasizes major tranquilizers into people by any means necessary. Even private hospitals are encouraging shorter hospital stays and using physicians assistants and nurse practitioners.

    The question is: why even bother with psychiatrists? The guild is making itself irrelevant.

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