I wrote that speakers had an average of 5 ties, not that every speaker had 5 ties. If Nemeroff spoke, he alone would skew the whole sample, given his galaxy wide ties to drug companies. Then again, Forbes magazine called him the most influential psychiatrist in America, which underscores the reach of the drug companies.
On a deeper level, you point out that populism does not engage in self-critique and self-reflection. I agree that there are simplistic and even vituperative tones in critiques of psychiatry. However, the profession will forever be vulnerable to them until it fully and publicly acknowledges the titanic role that corporations play in shaping it.
If history is a guide, that will not happen in my lifetime. It was only after the death of all the German psychiatrists who set up gas chambers in psychiatric hospitals, that German psychiatry finally started acknowledging its' role in the Holocaust. Eugenics was finally discredited, and that terrible virus of an idea (which was propagated by psychologists as well) was finally stopped.
But WWII had an end-date. Industry influence does not, as Johnson and Johnson's dreadful studies of esketamine and political machination to get it approved carry on to this day. I respect that you admit psychiatry has multiple flaws. But I fear that like Sisyphus, your efforts to change the profession will roll back on you as you push upward against a mountain of corporate dollars.
The question from my perspective is: after we critically take into account the corrupting influence of the pharmaceutical companies, is there still a legitimate role left for psychiatric medications (including recent meds like esketamine) in the treatment of psychopathology that is backed by clinical and scientific evidence. My assessment is yes, there is a legitimate role. (This is also the sentiment in the psychiatric community at large.)
When each speaker at APA 2008 had financial ties with an average of 5 different drug companies, it is not a populist belief that psychiatry colludes with Big Pharma. It is an indisputable fact. The vast majority of the research is funded by Pharma, the expert guidelines are written by people with fCOI, the DSM is written by many people with fCOI, the CME is dominated by drug companies, etc. Until psychiatry grapples with that reality, and makes profound changes, everything it says and does will be viewed through that lens.
Physician-pharma relationships certainly exist, and pharmaceutical influence has certainly had very detrimental consequences, but they exist across all medical specialties (psychiatry isn’t an exception in this regard) and it’s easy to take this line of thinking into a sort of “paranoid” territory that bluntly delegitimizes the entire profession. I do accept that there are more careful arguments to be made about the negative influence of pharmaceutical industries, and I’m shocked at many things that have transpired. My impression is that 1990-2010 was particularly egregious when it comes to pharma influence on psychiatry. But a lot of what we know about psychiatric medications survives a critical reassessment that takes industry influence into account.
At face value, I find it implausible that *every* speaker at 2008 APA had so many financial ties. I have spoken multiple times at APA in recent years, including at 2023 APA, and I didn’t have financial ties with pharma, nor did most of my co-presenters.
I wrote that speakers had an average of 5 ties, not that every speaker had 5 ties. If Nemeroff spoke, he alone would skew the whole sample, given his galaxy wide ties to drug companies. Then again, Forbes magazine called him the most influential psychiatrist in America, which underscores the reach of the drug companies.
On a deeper level, you point out that populism does not engage in self-critique and self-reflection. I agree that there are simplistic and even vituperative tones in critiques of psychiatry. However, the profession will forever be vulnerable to them until it fully and publicly acknowledges the titanic role that corporations play in shaping it.
If history is a guide, that will not happen in my lifetime. It was only after the death of all the German psychiatrists who set up gas chambers in psychiatric hospitals, that German psychiatry finally started acknowledging its' role in the Holocaust. Eugenics was finally discredited, and that terrible virus of an idea (which was propagated by psychologists as well) was finally stopped.
But WWII had an end-date. Industry influence does not, as Johnson and Johnson's dreadful studies of esketamine and political machination to get it approved carry on to this day. I respect that you admit psychiatry has multiple flaws. But I fear that like Sisyphus, your efforts to change the profession will roll back on you as you push upward against a mountain of corporate dollars.
The question from my perspective is: after we critically take into account the corrupting influence of the pharmaceutical companies, is there still a legitimate role left for psychiatric medications (including recent meds like esketamine) in the treatment of psychopathology that is backed by clinical and scientific evidence. My assessment is yes, there is a legitimate role. (This is also the sentiment in the psychiatric community at large.)
When each speaker at APA 2008 had financial ties with an average of 5 different drug companies, it is not a populist belief that psychiatry colludes with Big Pharma. It is an indisputable fact. The vast majority of the research is funded by Pharma, the expert guidelines are written by people with fCOI, the DSM is written by many people with fCOI, the CME is dominated by drug companies, etc. Until psychiatry grapples with that reality, and makes profound changes, everything it says and does will be viewed through that lens.
Physician-pharma relationships certainly exist, and pharmaceutical influence has certainly had very detrimental consequences, but they exist across all medical specialties (psychiatry isn’t an exception in this regard) and it’s easy to take this line of thinking into a sort of “paranoid” territory that bluntly delegitimizes the entire profession. I do accept that there are more careful arguments to be made about the negative influence of pharmaceutical industries, and I’m shocked at many things that have transpired. My impression is that 1990-2010 was particularly egregious when it comes to pharma influence on psychiatry. But a lot of what we know about psychiatric medications survives a critical reassessment that takes industry influence into account.
At face value, I find it implausible that *every* speaker at 2008 APA had so many financial ties. I have spoken multiple times at APA in recent years, including at 2023 APA, and I didn’t have financial ties with pharma, nor did most of my co-presenters.