Drug company ties
In his book
Anatomy of an Epidemic (2010),
Robert Whitaker described the partnership that has developed between the APA and pharmaceutical companies since the 1980s.
[14] APA has come to depend on pharmaceutical money.
[14] The drug companies endowed continuing education and psychiatric "grand rounds" at hospitals. They funded a
political action committee (PAC) in 1982 to lobby Congress.
[14] The industry helped to pay for the APA's
media training workshops.
[14] It was able to turn psychiatrists at top schools into speakers, and although the doctors felt they were independents, they rehearsed their speeches and likely would not be invited back if they discussed drug side effects.
[14] "Thought leaders" became the experts quoted in the media.
[14] As Marcia Angell wrote in
The New England Journal of Medicine (2000), "thought leaders" could agree to be listed as an author of
ghostwritten articles,
[15] and she cites Thomas Bodenheimer and David Rothman who describe the extent of the drug industry's involvement with doctors.
[16][17] The New York Times published a summary about antipsychotic medications in October 2010.
[18]
[edit] Controversies
Controversies have related to
anti-psychiatry and
disability rights campaigners, who regularly protest at American Psychiatric Association offices or meetings. In 1971, members of the
Gay Liberation Front organization sabotaged an APA conference in San Francisco. In 2003 activists from
MindFreedom International staged a 21-day hunger strike, protesting at a perceived unjustified biomedical focus and challenging APA to provide evidence of the widespread claim that mental disorders are due to chemical imbalances in the brain. APA published a position statement in response
[19] and the two organizations exchanged views on the evidence.
There was controversy when it emerged that US psychologists and psychiatrists were helping interrogators in
Guantanamo and other US facilities. The American Psychiatric Association released a policy statement that psychiatrists should not take a direct part in
interrogation of particular prisoners
[20] but could "offer general advice on the possible medical and psychological effects of particular techniques and conditions of interrogation, and on other areas within their professional expertise."
After previous controversy over APA's classification of homosexuality as a mental illness, there is also controversy regarding the remaining category of "sexual disorder not otherwise specified" which can include a state of distress about one's sexual orientation, as well as the diagnosis of "gender identity disorder" or gender dysphoria.
[21]
The APA's Standard Diagnostic Manual came under criticism from autism specialists
Tony Attwood and
Simon Baron-Cohen for proposing the elimination of
Asperger's syndrome as a disorder and replacing it with an
autism severity scale. Professor
Roy Richard Grinker wrote a controversial
editorial for the
New York Times expressing support for the proposal.
The APA president in 2005,
Steven Sharfstein, caused controversy when, although praising the pharmaceutical industry, he argued that American psychiatry had "allowed the biopsychosocial model to become the bio-bio-bio model" and accepted "kickbacks and bribes" from pharmaceutical companies leading to the over-use of medication and neglect of other approaches.
[22] In 2008 APA became a focus of congressional investigations regarding the way that money from the pharmaceutical industry can shape the practices of nonprofit organizations that purport to be independent in their viewpoints and actions. The drug industry accounted in 2006 for about 30 percent of the association’s $62.5 million in financing, half through drug advertisements in its journals and meeting exhibits, and the other half sponsoring fellowships, conferences and industry symposiums at its annual meeting. APA is considering its response to increasingly intense scrutiny and questions about conflicts of interest.
[23] The APA president of 2009-2010,
Alan Schatzberg, has also come under fire after it came to light that he was principal investigator on a federal study into a drug being developed by Corcept Therapeutics, a company Schatzberg had himself set up and in which he had several millions of dollars’ worth of stock.
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