still on the radar screen…

Posted on Tuesday 5 April 2011

What good timing. Just as I finish writing about that Pharma campaign to turn mental illness into a set of symptoms treated in the General Practice offices and mention Drs. Schatzberg’s and Nemeroff’s infamous text, Recognition and Treatment of Psychiatric Disorders: A Psychopharmacology Handbook for Primary Care [see a “quintessential resource”…roaches…, a worthy cause…, enter the lawyers…], the whole issue of their ghostwritten textbook lights back up on our radar. POGO‘s first report was evidence enough [POGO Letter to NIH on Ghostwriting Academics], but Schatzberg and Nemeroff retaliated and defused things for a bit with the help of the APA [APA Statement: Psychiatric Book Not Ghostwritten].

Today, POGO published a letter from Dr. Bernard Carroll M.D., Robert Rubin M.D., and Leemon B. McHenry, Ph.D. to the Psychiatric Newsletter about the issue that was refused publication:

Text’s Provenance Remains in Dispute

Writing for the American Psychiatric Association (APA), Mark Moran claimed “APPIDocuments Refute Claims About Text’s Authorship” (Psychiatric News 21 January 2011; Vol46/2, p.1). The nominal authors of the book (Recognition and Treatment of Psychiatric Disorders: A Psychopharmacology Handbook for Primary Care) are Charles Nemeroff and Alan Schatzberg. We remain unconvinced of their authorship, for the following reasons.

Mr. Moran quoted another APA spokesperson, Mr. Ron McMillen, to the effect that Drs.Nemeroff and Schatzberg were actively involved “in every stage of the book’s development.”Note, however, that he did not venture to say they wrote the initial drafts – or indeed any drafts. The released 49-page sample chapter draft provided by Diane Coniglio and Sally Laden,employees of Scientific Therapeutics Information, Inc (STI), is largely reproduced verbatim in the Handbook. That there are drafts with the nominal authors’ margin notes does not establishwho actually wrote the Handbook. It is standard procedure for the ghostwriting company,Scientific Therapeutics Information (STI), to provide initial drafts that are reviewed by the contracting corporation (here, SmithKlineBeecham, now GlaxoSmithKline – GSK) before being released to the nominal authors.

STI is a commercial service entity, not a scientific institute. Their stated mission is to maximize credibility for their clients’ products. It is, therefore, no surprise that efforts to reach STI by Psychiatric News were not successful. The APA’s spokespersons, Dr. James Scully and Mr. RonMcMillen, quoted in Mr. Moran’s article, have reached premature closure based on limited evidence. To bring into full view the most significant evidence for this debate would require de-designation of numerous confidential documents from both GSK and STI, as part of Paxil litigation. GSK, however, regularly invokes the Trade Secrets Act to ensure that the documents remain confidential and that their key opinion leaders are protected from exposure.

Finally, we take issue with the claim in Mr. Moran’s article that Drs. Nemeroff and Schatzberg“were not remunerated by GSK for any of this work.” Note that there is no mention of any indirect payments they may have received through the “unrestricted educational grant” to STI. Such arrangements are quite common.

We call on the APA/APPI to release all the key documents. The contract between STI and GSK will reveal how much influence GSK had on the content and tone of the book, and the role of GSK in approving drafts. Correspondence between Drs. Nemeroff and Schatzberg and STI will make it clear whether they followed the contract. Transparency also requires release of any GSK marketing/business plans for the Handbook; the legal release form transferring ownership from GSK to the ‘authors’ and APPI; marketing activities of GSK sales representatives detailing the Handbook; and correspondence among all parties regarding the “unrestricted” educational grant.

This case highlights the need for disclosure if we ever are to understand the scale of corporate influence on academic publishing. We look forward to Congressional action to require the release of these documents.

I’m a late arrival having actually had something else going this morning, but the blogsphere is already alive on the topic:
And there will be more. I hope the APA, Dr. Schatzberg, and Dr. Nemeroff realize that this one isn’t just going to pass through the news cycle and disappear. Those days are behind them. Dr. Nemeroff has already been burned smooth-talking his way from jam to jam when he was at Emory. Both of these men are former Chairmen of prestigious Psychiatry Departments after being investigated by Congress. I expect they think they can avoid a bunch of pesky bloggers and slip into the sunset as KOLs extrordinaire. I kind of doubt it. By their own hands, they’ve thrust themselves into the role of banner-carriers for a whole era of infamy in the history of Psychiatry. Each has amassed a resume of hundreds of articles without making any particularly notable contribution to the field. Each has held editorships and high office and used the attendant power unwisely. Each has had a shot at entrepreneurship without success. They wanted to make it to the top, to have high visibility, and they succeeded. We’re all looking now, but we’re not pleased with what we see…
  1.  
    April 7, 2011 | 11:53 AM
     

    Excellent post, Mickey! Just one minor correction: my blog name is Alison Bass, with one l, not 2 ls. Thanks!

  2.  
    July 21, 2011 | 10:00 PM
     

    […] partners in a ghostwritten textbook. The issue resonated with many people, including Daniel Carlat, John Nardo, the POGO blog, Alison Bass, Ed Silverman, and others. The APA has not seen its way clear to […]

  3.  
    August 1, 2011 | 4:48 AM
     

    […] partners in a ghostwritten textbook. The issue resonated with many people, including Daniel Carlat, John Nardo, the POGO blog, Alison Bass, Ed Silverman, and others. The APA has not seen its way clear to […]

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