Is money well spent on mental health research?

A New York Times article suggests that an entire psychiatric textbook was ghostwritten by a writing company funded by a drug company. Perhaps we shouldn't be too surprised by this. As another New York Times article points out, ghostwriting has not been that uncommon in medical journal articles.

Doctors are not always neutral agents in the marketing of pharmaceutical drugs. Understandably, maybe, they want to find effective medications for their patients. Their promotion of these medications may well be biased. However, patients do look to their doctors to provide a balanced assessment of the effectiveness of medication, even if they may wish for a simple, quick and complete cure.

Academic psychiatrists may see their presentation of material in a textbook as scientific knowledge. From their point of view, it therefore doesn't matter too much who writes the chapters. After all, they sign off the final copy. They accept responsibility for what has been written. A press release from the American Psychiatric Association (APA) admits that editorial assistance from a writing company has not been that uncommon and insists this isn't ghostwriting by a drug company. From their point of view, it's merely compiling and checking facts. The problem is that "facts" in psychopharmacology are usually open to interpretation. I suppose it depends how much of the "compiling" has been done by the writing company as to whether it should be seen as "ghostwriting". Actually, perhaps what the APA is more objecting to is that technically it wasn't the drug company doing the ghostwriting - which is what it says the original NYT article implied (it's been amended since) - it was a writing company paid by the drug company.

What the authors of the book don't mention is that they have been paid handsomely to put their name to such a book. The NYT article actually implies that they didn't tell their publisher about the writing company (but anyway, according to the APA press release, the publisher wouldn't have been too bothered if it had known). Nor is the book likely to have very high quality scientific content, in the sense of critically and independently examined and reviewed. It's these researchers that obtain large research grants, and have been shown up before for not disclosing their interests to their University (eg. see another NYT article).

The Project On Government Oversight (POGO) takes a keen interest in strengthening the integrity of federally funded science and has written to the National Institutes of Health (NIH)  I think NIH are the right target here. The funding they put into mental health research and medical research in general is very significant. Such vested interests do encourage a biomedical bias (eg see my article) within psychiatry. Challenging the myth that a biological basis of mental illness will be elucidated by further research undermines the basis for these large NIH grants. Losing research funding is what biomedical psychiatry finds difficult to accept. Academic standing to obtain research grants can be improved by writing a textbook, and it's even easier if a writing company does it for you, and money can be made out of it.


(With thanks to posting on Mad in America blog)