Industry Sponsorship and Financial Conflict of Interest in the Reporting of Clinical Trials in Psychiatry

Review of Perlis, R., Perlis, C., Wu, Y., Hwang, C., Joseph, M. & Nierenberg, A. (2005).  “Industry Sponsorship and Financial Conflict of Interest in the Reporting of Clinical Trials in Psychiatry.”  Am. J. Psychiatry 162(10), 1957 – 1960.

For many years the issue of medical professionals accepting remuneration from pharmaceutical firms in consideration for testing and possibly recommending their products was unproblematic.  There came a time however when this became a point of contention.  In many contexts physicians now are prohibited or discouraged from accepting drug company money.  At the very least there is a strong ethical mandate to disclose all such relationships.  The reason why this is important is to alert the user of a study of potential research bias.  Whenever a scientist is funded by industry there is at least a theoretical possibility the scientist will skew results so the trial will be successful, thereby inducing industry to supply additional funding, thereby keeping the scientist in business.  Still there remain several vexing questions.  Who else is there to furnish funding for objective, third-party testing of new drug combinations, which may benefit patients in need?  Is there an actual conflict of interest, or is this more of a theoretical concern?

In this article the authors examined funding sources and financial conflicts of interest in all clinical trials published in several psychiatric journals over a period of several years.  They identified 397 clinical trials in all.  239 of them (60%) reported receiving drug company funding and 187 (47%) included at least one researcher who reported a financial conflict of interest.  The authors also examined 162 randomized, double-blind placebo-controlled studies.  Those where there was a conflict of interest were 4.9 times more likely to report positive results.  The authors concluded that conflict of interest appears to be prevalent among psychiatric clinical trials and is associated with a greater likelihood of reporting a drug to be superior to a placebo.  The authors did not explain just how this happened in a double-blind placebo study.  This is an even more worrisome outcome because it suggests the experimental protocol for double-blind placebo trials – supposedly the “gold standard” of experimental research – somehow was transgressed.