But Scully said the APA sought to have a balance.
“Our dilemma is: Do we not have the world’s experts, or do we have limits and disclosures [of their financial ties].” Scully said. “We decided to have some balance here. You could say absolutism should prevail, but then where are you going to get your experts?”
It’s hardly impossible to find medical experts without financial ties to industry, however, according to research.
A survey of academic researchers, for example, showed that 36 percent of full professors at medical schools report no financial connections to the industry in the previous year.
The idea “that every expert in the field has industry relationships is not supported by the data,” said Eric Campbell, a medical professor at Harvard University, who conducted the surveys. Instead, he said, such claims are rather “propagandist in nature.”
APA relies on industry
Through the publication of its Diagnostic and Statistical Manual of Mental Disorders, or DSM, the American Psychiatric Association plays a critical role in how psychiatry is practiced.
Basically a compendium of mental illnesses and their definitions, the DSM is one of the most important books in medicine, affecting treatment, insurance coverage and court decisions.
The association itself runs on a budget of about $50 million a year, and for years industry funding has been critical to its operations. Today, about 14 percent of the association’s budget comes from pharmaceutical companies, mainly in the form of advertising at annual meetings and publications.
The portion of the APA budget that came from the industry had been as high as 34 percent in 2006, but has dropped, partly because of the recession and partly because in 2008 the association banned industry support for its education programs.
Revising the DSM is a multiyear, $25 million process. Several committees of psychiatrists and other specialists — unpaid, and typically expert in their fields — handle various aspects of mental health.
Among the most important aspects of the DSM is how it handles major depression, which affects nearly 15 million American adults in any given year, according to figures from the National Institute of Mental Health. In 2011, consumers spent more than $10 billion on antidepressants, according to figures from IMS Health, a health-care technology and information company.
About 80 percent of the prescriptions for antidepressants are written by primary-care physicians and others, not psychiatrists, a fact that makes the APA handbook particularly important. Faced with a patient complaining of depression-like symptoms, a general practitioner may be likely to rely on the association’s handbook for advice.