The Hoffman Report: The Investigation into the American Psychological Association (APA)

The Hoffman Report is the informal name for the 2015 investigation into the American Psychological Association’s (APA) practices regarding its relaxing of ethical standards for psychologists involved in torture interrogations. The full name for the report is, Independent Review Relating to APA Ethics Guidelines, National Security Interrogations, and Torture. It was authored by attorneys David Hoffman, Danielle Carter, Cara Viglucci Lopez, Heather Benzmiller, Ava Guo, Yasir Latifi and Daniel Craig of the law firm, Sidley Austin, LLP.

It was an extensive investigation spanning 6 months that reviewed over 50,000 documents and conducted over 200 interviews with 148 people.

The report notes that,

“Although most individuals were quite cooperative and willing to meet with us, that sentiment was not universal, and there were several individuals who declined to meet with us or did not respond to our requests.”

Also,

“This inquiry is made more difficult by the amount of time that has elapsed since the important events occurred. The key events relating to the APA task force report occurred 10 to 11 years ago, and the events relating to the ethics code revision occurred 13 to 19 years ago.”

The independent investigation resulted in a 542-page final report. It is available for download here

Independent Review Relating to APA Ethics Guidelines, National Security Interrogations, and Torture (PDF)

Another ethics scandal for the University of Minnesota Dept. of Psychiatry

From a Report on Fox 9 News Video available at the link

The University of Minnesota has another ethics scandal on its hands. And once again it involves the Department of Psychiatry. This latest case of research misconduct involves falsifying records.

Dr. Ken Winters is a Psychologist who has worked at the U of M for 26 years. He was about to begin a new study for the National Institute on Drug Abuse on ways to stop teenagers from taking drugs, but before proceeding, a University review board wanted Winters to get something in writing from the federal government.

It would have been a legal document that would protect researchers from having to disclose confidential information about study participants should those participants ever get into trouble with the law. Winters told the Fox 9 Investigators he got tired of waiting for the paperwork to arrive so he falsified his own version and turned it in to the University so the study could begin.

He declined an on camera interview but agreed to have his voice recorded.

"Poor judgement on my part," Winters said. "It was a terrible thing I did, so I have no real explanation. I've got no defense. My own stupidity, poor judgement."

Winters also said within hours of turning in the phony documents, he fessed up after being approached by concerned staff members. His misconduct is yet another slam for the school's Department of Psychiatry.

Earlier this spring, a legislative audit, prompted by a Fox 9 Investigation, found serious ethical concerns and conflicts of interest relating to the death of a research participant in a Psych Department drug trial.

"It is a serious ethical breach. It is another indication that there are issues and problems in the drug trials at the University Department of Psychiatry that need attention," Legislative Auditor Jim Nobles said.

The National Institute on Drug Abuse told the Fox 9 Investigators "it takes allegations of research misconduct seriously." But wouldn't comment on what, if anything, it’s doing about this case.

Winters said he hasn't been disciplined by the University for falsifying the document. Instead, he was given the option to retire at the end of the month.

Recruitment for Psychiatric Treatment Trials: An Ethical Investigation

Abstract of the Report (Paid Access for full article)

This article is about ethics, specifically, the myriad of unethical practices characterizing recruitment for psychiatric trials.

Using a case study approach, honing on recruitment material, and examining the typical, the author explores recruitment in two studies—one involving electroconvulsive therapy, the other, a psychiatric drug. The bulk of the article is on these trials.

The ethical problems which surface include

• minimization of risk;
• euphemism;
• lack of transparency;
• false and misleading claims,
• unfair inducement;
• failure to mention most of the common and serious negative effects;
• and a predatory quality.

The author also identifies some worrisome new trends. Of special interest to the humanistic counselor is the attempt to implicate people’s own counselors and therapists in recruitment.

The article ends with reflections on the onus that such practices place on all practitioners striving to be ethical.

The author concludes that it is critical that counselors and therapists not be complicit and beyond that they take it on themselves to confront and expose. Concrete practice suggestions include adopting an explicit policy against such referrals, alerting any clients who may be considering such trials of the danger, and countering false claims.

Gay Conversion Therapy Trial: New Jersey Nonprofit Group In Fraud Trial For Claiming To Cure Homosexuality

Another case where Shrinks do not know what they are doing, and end up getting sued for it. From a report from the International Business Times (Warning, autoplay video on website)

A major challenge to “gay conversion” therapy is ramping up in New Jersey, in a case that critics of the controversial treatments hope will set a precedent for fighting the practice around the country. A group that offered the so-called therapy is scheduled to go on trial for fraud Wednesday in the state, one of only three to have banned licensed therapists from offering treatments that purport to change a person’s sexual orientation.

Four men and two of their mothers are suing the nonprofit group Jews Offering New Alternatives for Homosexuality, or Jonah, on the grounds that it fraudulently claimed that it could change patients’ sexual orientation and for characterizing homosexuality as a mental disorder, the Associated Press reported. The plaintiffs have accused the group of engaging in “unconscionable practices,” including making patients strip naked during therapy sessions and subjecting them to slurs regarding their homosexuality.

Lawyers for the group have countered that scientists are still debating the nature of sexual orientation, including whether it is fixed or changeable, as well as whether conversion therapies are actually harmful. They have also accused the plaintiffs of seeking to "shut down the debate by making one viewpoint on the issue literally illegal," the AP said.

[...]

In recent years, several states have moved to ban the therapy over fears that it could subject young people to psychological damage but only New Jersey, California, Oregon and Washington, D.C., have succeeded in passing and implementing bans. But the current bans apply only to licensed therapists who practice gay conversion therapy on minors, which is why prosecuting Jonah for consumer fraud could set an important precedent, according to Jack Drescher, a New York psychiatrist and one of the most vocal critics of these therapies.

“A win by the plaintiffs will undoubtedly have a chilling effect on practitioners of SOCE [sexual orientation change efforts] beyond the borders of New Jersey,” Drescher said in an interview with the Huffington Post. “A win would also expand the ban on SOCE embodied in existing legislative bans in CA, NJ, OR and DC: They only apply to licensed professionals who do SOCE with minors. Consumer fraud laws can be used against non-licensed practitioners and protect adult patients as well.”

Long Island woman says psych ward doctors believed she was delusional for insisting Obama follows her on Twitter

From the New York Daily News

A Long Island woman’s insistence that President Obama follows her on Twitter made doctors at the Harlem Hospital psych ward think she was delusional and suffering from bipolar disorder — but she was actually telling the truth, a lawsuit charges. Kam Brock’s frightening eight-day “One Flew Over the Cuckoo’s Nest” ordeal at the mental facility included forced injections of powerful sedatives and demands she down doses of lithium, medical records obtained through her suit filed in Manhattan Federal Court show. They also indicate that doctors didn’t believe the leader of the free world followed her on Twitter — though @BarackObama follows over 640,000 accounts, including hers. They were also skeptical she worked at a bank, records show.

“I told (the doctor) Obama follows me on Twitter to show her the type of person I am. I’m a good person, a positive person. Obama follows positive people!” Brock, whose Twitter handle is @AkilahBrock, said.

A “master treatment plan” from Harlem Hospital backs up the Astoria Bank worker’s story.

“Objective: Patient will verbalize the importance of education for employment and will state that Obama is not following her on Twitter,” the document reads.

It also notes “patient’s weaknesses: inability to test reality, unemployment.”

Adding insult to insanity, the hospital hit Brock with a bill of $13,637.10, she charges in her suit seeking unspecified damages.

The bizarre experience began Sept. 12, when the NYPD seized her prized 2003 BMW 325Ci in Harlem because they suspected she was high on weed, her attorney, Michael Lamonsoff, said. Cops found no marijuana but confiscated her ride anyway, he said. The NYPD declined to comment.

The following day, Brock walked into the NYPD’s Public Service Area 6 stationhouse in Harlem to retrieve her car, her suit charges. Brock — an eccentric 32-year-old born in Jamaica with dreams of making it big in the entertainment business — admitted in an interview she was “emotional,” but insisted she in no way is an “emotionally disturbed person.” Nevertheless, cops cuffed her and put her in an ambulance bound for the hospital, her suit charges.

“Next thing you know, the police held onto me, the doctor stuck me with a needle and I was knocked out,” Brock said, tearing up. “I woke up to them taking off my underwear and then went out again. I woke up the next day in a hospital robe.”

Lamonsoff said race may have been a factor in the way Brock was treated. “How would you act if you were being told you were crazy?” he said. For eight days, she attended group therapy, endured injections of sedatives, and took lorazepam and lithium, medical records show, according to Lamonsoff.

When she was finally let go, the doctors didn’t tell her why she was being allowed to leave, Brock said. Harlem Hospital declined to comment. The city Law Department said the suit would be reviewed.

The Corrupt Relationship Between Big Pharma and Doctors

A Editorial by Jessica Smith News Editor of the Western Herald Excellent Writing, worth checking out the original article in full

While watching one of my new favorite satirical news shows, “Last Week Tonight with John Oliver” on HBO, Oliver delivered a humorous rant with serious undertones on the questionable and unethical relationship between doctors and pharmaceutical representatives.

What I find unethical about these relationships is many doctors are being paid by the same drug companies whose medicine they prescribe, according to a ProPublica investigation conducted in 2013.

In that same “Last Week Tonight with John Oliver” segment, Oliver discussed how some pharmaceutical sales reps “use sex appeal and free food to peddle drugs.”

It’s no secret that Big Pharma is a business looking reap profits off of consumers. However, the distance that pharmaceutical companies are willing to go remains shady.

Oliver said $329.2 billion was spent on prescription drugs in 2013. Oliver also mentioned drug companies spend “an estimated $24 billion marketing directly to doctors.” He compared the companies to “high school boyfriends” and quipped, “they’re much more concerned with being inside you than being effective once you’re in there.”

All jokes aside, this is a highly unethical action and a reality the public should be aware of.

As a social work student, I am obligated to abide by the National Association of Social Workers Code of Ethics. The American Medical Association (AMA) also has a Code of Medical Ethics, which doctors are supposed to abide by.

In the AMA’s Code of Medical Ethics under Opinion 8.06 - Prescribing and Dispensing Drugs and Devices, it states, “(2) Physicians may not accept any kind of payment or compensation from a drug company or device manufacturer for prescribing its products. Furthermore, physicians should not be influenced in the prescribing of drugs, devices, or appliances by a direct or indirect financial interest in a firm or other supplier, regardless of whether the firm is a manufacturer, distributor, wholesaler, or repackager of the products involved.”

By this standard, doctors receiving payments or compensation from a drug company or device manufacturer are in violation of the AMA Code of Medical Ethics.

Some doctors receive perks such as lunches, and dinners. While some make hundreds of thousands of dollars consulting or speaking at medical conferences, sponsoring a large pharma company.

I find this practice to be unethical and not in the best interest of their patients treatment.

[..]

I believe some doctors are overprescribing or inaccurately prescribing medications to their patients due to their relationship with large drug companies.

A lack of insight about what these medications may be doing to the human condition, due to government deregulation of the FDA’s ability to research new drugs without Big Pharma financiering research of their own drug, has led to hastily prescribed patients.

Drug companies are now required to disclose any perks they give to doctors, which are posted to a federal website. If you are interested in finding out if your doctor is receiving perks, I strongly encourage you to visit http://OpenPaymentsData.CMS.Gov.

Medical malpractice is not limited to surgery, and the case of Paul Lozano illustrates this better than any other example.

Item #2 from the List Verse Article 10 Horrible Cases Of Medical Malpractice

Medical malpractice is not limited to surgery, and the case of Paul Lozano illustrates this better than any other example. Lozano had been sexually abused by his mother as a child, and his psychiatrist, Margaret Bean-Bayog, decided to try a form of therapy known as “reparenting”, where the psychiatrist simulates the different stages of lifespan development in an attempt to “reprogram” the patient. She coddled him, read him stories, called him “baby”, made him call her “mother”, and made him learn cue-cards off by heart. One such card read “I’m your mom and I love you and you love me very much. Say that 10 times”. Other cards were more sexual, and more notes were found that appeared to be erotica featuring Lozano and his doctor. It was also reported that they did in fact have sexual relations. After about five years, he committed suicide.

When Bean-Bayog's graphic love notes were discovered, two other therapists informed state authorities. But no investigation was launched until Lozano's suicide made newspaper headlines. Even then, other psychoanalysts circled the wagons, claiming their colleague was the victim of the affair.

QUESTION: Where in the world could you go to find a place where half of all women are raped? ANSWER: Australia’s psychiatric hospitals.

Came across this news item from last year.

Still worth posting about

That’s the shocking conclusion of a new report from the Victorian Mental Illness Awareness Council (VIMIAC).

Their survey of women who have been in psychiatric wards in Victorian hospitals paints a shocking picture.

A terrifying 85 per cent said they had felt unsafe, with most saying they reported it to doctors and nurses and felt nothing was done. About 45 per cent had been sexually assaulted in hospital.

Just imagine the terror. You are alone, in a foreign place, completely under the control of medical staff, many of whom you have only just met, and surrounded by very disturbed people.

Even worse, you are disturbed: so depressed you unable to defend yourself, or perhaps already being tortured by fears, feelings or voices. There is a good chance you have a previous history of being assaulted, as such attacks vastly increase your chance of developing a mental illness.

It’s sickening. It’s happening now. And we are standing by and doing nothing.

“We expect people with mental illness to tolerate what no-one else would tolerate,” says Isabell Collins from VIMIAC. “It would only need to happen once in a general hospital ward and it would be fixed immediately.”

Yet, says Collins, she has been working in mental health for 25 years, “and sexual assault has been a problem for 25 years”.

Her survey included about 50 women from Victoria, but Collins says it does not overestimate the problem.

“If anything it underestimates it,” she says. “If you did the exact same survey in any state you would expect the same results”.

How could this be? How can we allow our most vulnerable people to be treated in this way? It’s hard not to agree with Collins that the answer is that society would rather just ignore mental illness, scared off by stigma and misinformation and a desire to sweep difficult problems under the carpet.

The incoming head of the Royal Australian and New Zealand College of Psychiatrists, Mal Hopwood, says that while he can’t be sure on the exact proportion of women raped in care, there is clearly a problem that exists around the country.

“Certainly the numbers in that report suggest it’s not an insignificant problem,” he says.

He wants hospitals to be properly funded to enforce female-only areas and support women who are assaulted.

But he says fixing buildings and allocating spaces won’t be enough: an attitude change is needed as well.

You also have to wonder if our over-reliance on medication and biological psychiatry have helped downplay the importance of creating positive environments in psych hospitals.

After all, if mental illness is just a brain disease that needs the right medication, then surely a stark, busy, hospital environment will make no difference?

But mental illness is closely linked to both our personal experiences and the culture we are living in, and putting people in scary, loud and under-resourced hospitals cannot be helping.

I couldn’t have more admiration for many of the hard-working doctors and nurses working in public hospital psychiatric units, yet the truth is that most of these places are awful to be in.

Rape is the terrible tip of a huge problem that we have been ignoring for far too long.

Psychiatrist and Fox News Channel analyst Keith Ablow freely mixes psychiatric assessments with political criticism, a unique twist in cable news commentary that some medical colleagues find unethical.

Commentary by David Bauder as seen on the Website for Channel 10 WISTV in Columbia, South Carolina.

Here are some snippets from the column, with my own brief comment. I recommend that you read it in full at the link above

[...]

He's been a Fox contributor since 2007 after hosting a failed syndicated talk show. Identified as a member of the Fox News Medical A-Team, he hosts a regular segment about behavior titled "Normal or Nuts?" on the "Fox & Friends" morning show. There were published reports this fall that the network had extended his contract.

Rival news networks CNN and MSNBC say they don't have a psychiatrist-commentator under contract. CNN said the closest thing it has to something similar is when profilers come on the air to discuss the mental characteristics of people who commit dramatic crimes, for example. The network said medical experts don't get into politics, but others can have different interpretations. The MRC's Graham said opinion often drifts in when television medical correspondents comment on aspects of Obama's health care plan.

Ablow clearly enjoys being provocative, and his commentaries don't stick to his areas of medical expertise. Within the past two weeks he called for an "American jihad," saying the country should urge all nations to adopt a government form based on the U.S. Constitution. His comment this summer that Michelle Obama "needs to drop a few" pounds was widely noticed.

[...]

Dr. Jeffrey Lieberman, chairman of psychiatry at Columbia University's College of Physicians and Surgeons, said Ablow seems more interested in entertaining than in reflecting well on his profession. Lieberman is past president of the American Psychiatric Association, which discourages members from speculating on psychiatric characteristics of non-patients.

"It is shameful and unfortunate that he is given a platform by Fox News or any other media organization," Lieberman said. "Basically he is a narcissistic self-promoter of limited and dubious expertise."

Ablow isn't an APA member, having resigned in 2011 in a dispute over transgenderism.

It's not unusual for there to be an uncomfortable relationship between the medical community and doctors who get into television. Talk show hosts Dr. Phil and Dr. Oz have their critics. Dr. Drew Pinsky took heat for exposing rehab patients to the pressure of a televised recovery.

While doctors are entitled to political opinions like anyone else, the way Ablow tries to connect his views to medical analysis "is really just irresponsible and it's embarrassing for physicians in general," said Ford Vox, a staff physiatrist at the Shepherd Brain Injury Rehabilitation Center in Atlanta.

Ablow has occasionally taken heat from Fox colleagues about his commentaries. Greg Gutfeld of "The Five" said that "we should probably avoid blaming people for tragedies," in response to Ablow's criticism of Obama on Ebola. And the four women co-hosts of "Outnumbered" clearly didn't appreciate the attack on the first lady's weight, made in context of her efforts to promote healthy eating.

Keith Ablow is a doctor without ethics, and is likely accusing President Obama of the the very things that Mr. Ablow is suffering from himself. Things like "severed himself from all core emotions." and so much more. Mr Bauder has done a great service in pointing out the professional hypocrisy and lack of ethics of Mr. Ablow. Too bad that Fox news has decided to profit from his lack of ethics instead of upholding professional standards.

We also note several followup columns on Mr. Ablow such as these

The strange case of Dr. Keith Ablow [Politico]

White House Foolishly Ignores Insights Of Fox ‘Dr.’ Keith Ablow, World’s Worst Psychiatrist [Wonkette]

Fox’s Keith Ablow Doubles Down on Psychoanalyzing Obama as a ‘Narcissist’ [Mediate]

Which is hilarious since Mr. Ablow is ever so likely to be a Narcissist himself.

Of course, he had to something to defend himself, not that it did him any good

Fox’s Keith Ablow fires back after fellow psychiatrists denounce him as a hack

Media Matters posted a mashup of some of Ablow’s past commentaries on Friday, which can be seen below.



On the basis that he is guilty of what he is accusing the President of, Keith Ablow is Toxic, and it is dangerous for your mental health to believe Keith Ablow.

While there may be plenty of legitimate reasons to dislike and and disagree with President Obama, those of discredited psych Keith Ablow are dangerous to American Politics.

Update: The Prosecution of Psychiatrist Dr. Alan Beitel

We have an update on the prosecution of psychiatrist Allan Beitel. Essentially, the charges were dropped for a number of practical reasons as seen in the article below.

1. He wasn't going to get anymore jail time than what he had already served while waiting for trial, and
2. the victim was moving out of the country, and would not be available to give testimony.

These circumstances are not a clean verdict such as acquittal, and leaves a cloud of suspicion over the doctor's head. This is also not a clean statement of innocence by the prosecutor, although the original charges were a little convoluted. The psychiatrist still faces other criminal charges, according to the report. As reported in The Hamilton Spectator.

Charges of accessing and possessing child pornography against a psychiatrist who formerly practised in Hamilton and Burlington have been stayed by the Crown.

Dr. Allan Beitel, who now practices in Toronto, had been facing the charges since 2003.

The Crown also stayed a charge of possession of stolen property and two counts of failing to comply against Beitel.

The Crown's prosecutor concluded that it was no longer in the public's interest to continue prosecution of the case, according to a spokesperson for Ontario's Ministry of the Attorney General.

"Even if Dr. Beitel had been found guilty of all charges, it was unlikely that he would serve a single additional day in jail beyond the time he had already served in pre-trial custody," the spokes-person indicated.

"Given that completing the trial would have required significant amounts of additional court time and resources, the Crown concluded that it was not in the public interest to continue."

Beitel had spent a number of months in custody last year related to other charges.

A charge of sexual assault against Beitel has also been withdrawn by the Crown after concluding there was no longer a reasonable prospect of conviction.

"The victim was moving out of the country and would not be returning for the trial," the ministry spokesperson indicated.

Beitel is still facing a number of other charges, including perjury, fraud under $5,000, two counts of theft under $5,000 and six counts of fail to comply with a recognizance.

Beitel remains an active member of the College of Physicians and Surgeons of Ontario, with no past disciplinary findings against him.

UPDATE: see also this Blog Post by David Akin

Trial for psychiatrist Dr. William Ayres, accused of molestation begins

Report from the San Mateo County Times

After two years of events worthy of a prime time legal drama, embattled child psychiatrist Dr. William Ayres will finally stand trial Monday. He is accused of molesting seven of his young male patients.

Ayres, 77, was a prominent member of the San Mateo medical community and served as president of the American Academy of Child and Adolescent Psychiatry.

He also performed physical examinations and inspected the genitalia of many of his juvenile psychiatric patients.

The once well-respected doctor was arrested in April 2007 and charged with 14 counts of lewd and lascivious acts with three victims, ages 9, 11 and 12 at the time of the alleged abuse.

The case's publicity brought forward four more accusers, bringing the number of Ayres' felony molestation counts to 20. He was freed on $750,000 bail.

The shocking story made international headlines, and the trial beginning Monday is expected to draw more public attention.

"We are exceedingly pleased that we are now on the doorstep of getting justice," San Mateo County Chief Deputy District Attorney Steve Wagstaffe said Friday.

A trial judge will be selected by Judge James Ellis in San Mateo County Superior Court in Redwood City on Monday morning.

Wagstaffe predicted jury selection and pretrial motions would take two weeks, but that the entire trial would last eight to 10 weeks.

Ayres practiced for decades in San Mateo County, seeing patients referred to him
through local school districts and the county's juvenile court, in addition to his private practice.

[...]

Police first began investigating him in 2002 after being told by a man who was a patient of Ayres in the 1970s that the doctor had molested him on multiple occasions. But the case had to be dropped after a U.S. Supreme Court ruling effectively changed the statute of limitations on such cases.

Childhood molestation can only be brought by victims who are younger than 29 or whose alleged abuse occurred after Jan. 1, 1998.

The San Mateo Police Department reopened the case in March 2006, at the urging of a friend of one of the victims to seek out other possible victims who fell within the legal statute of limitation.

That friend was New York-based freelance writer Victoria Balfour, who made it a personal crusade to unearth possible molestation victims of Ayres and help authorities build a case against him.

A search warrant was executed for Ayres' records, and a list was compiled of more than 800 patients.

Prosecutors believe they know of at least 39 former patients of Ayres who had been molested by him, but most did not fall under the state's statute of limitations.

After seven months of exhaustive and painful interviews with patients on the list, police took Ayres into custody at his San Mateo home on April 5, 2007.

Ayres' medical license was suspended, and has since expired.

On April 28, 2007, the child psychiatrist accused of molesting dozens of pre-adolescent boys in San Mateo County for decades declared his innocence of the multiple counts against him.

Now, more than two years later, the once-prominent child psychiatrist's fate will likely be left to a jury.

[...]

Ayres was known nationally as one of the country's top child psychiatrists; he was just as well respected on the Peninsula where he ran a private practice for decades.

He was probably one of fewer than 10 San Mateo County psychiatrists with a subspecialty in child and adolescent psychiatry, according to San Mateo County Medical Association Executive Director Sue Malone.

He told colleagues he performed medical examinations because that was the way he had been trained. He had done his residency in the early 1960s at the Judge Baker Center in Boston, one of the country's premier centers for the study of child psychology.

While most child psychiatrists admit that administering physical exams to patients is uncommon today, many professionals defend the practice as another instrument in a psychiatrist's toolbox.

A spokeswoman from the American Academy of Child and Adolescent Psychiatry, of which Ayres was president for more than a decade, told MediaNews that performing physicals on patients in a psychiatric setting can be "consistent with good medical practice."

Wagstaffe said he expected attorneys on both sides to present expert opinions on the matter.

While the passing of time between charges and trial can often damage prosecutors' cases, Wagstaffe said all their witnesses were ready to go.

"This case is more than ripe for trial," he said.

A Celebrity Patient's Backing Turns Sour for Drug Company

The Wall Street Journal has published a revealing story about one of the seamier sides of the drug industry's marketing campaigns: paying patients to offer testimonials about their drugs. Despite side effects one man had to continue because the money way so good. He is now writing a book about his experience. Here's the Video.




I note in the video that they show the complete original testimonial, which sort of defeats the purpose of the original news story. Way to go WSJ!

(the embedded player is a little funky, you might have to pause and push play an extra time or to to get past the intro)

Why people should be concerned with the impending revision of the DSM

An excellent but long post from the fine folks at feministing.com, with only a portion quoted below

The Diagnostic and Statistical Manual of Mental Disorders (DSM) has been called the "bible of mental illness" because it lists and defines all of the "official" psychiatric diagnoses according to the American Psychiatric Association. The DSM is in the early stages of undergoing its 5th major revision; each previous revision has seen the total number of mental disorders recognized (some might say invented) by the APA greatly increase. Last year, trans activists were particularly concerned to learn that Ken Zucker and Ray Blanchard had been named to play critical lead roles in determining the language of the DSM sections focusing on gender and sexuality, especially given that these researchers are well known for forwarding theories and therapies that are especially pathologizing and stigmatizing to gender-variant people.

Blanchard has recently presented some of his suggestions to revise the "Paraphilia" section of the DSM. In the past, this section has generally received little attention from feminists, as it has been primarily limited to several sexual crimes (e.g., pedophilia, frotteurism and exhibitionism) and a handful of other generally consensual but unnecessarily stigmatized sexual acts (such as fetishism and BDSM) that are considered "atypical" by sex researchers. However, there are two aspects of the proposed Paraphilia section revision that should be of great concern to feminists, as well as anyone else who is interested in gender and sexual equality.

Expanding "Paraphilia"

First, Blanchard is proposing a significant expansion of the DSM's definition of "paraphilia" to include:

"any intense and persistent sexual interest other than sexual interest in genital stimulation or preparatory fondling with phenotypically normal, consenting adult human partners."

The first concern here is the term "phenotypically normal" (meaning "normal" with regards to observable anatomical or behavioral traits). Thus, according to this definition, attraction to any person deemed by sex researchers to be "abnormal" or "atypical" could conceivably be diagnosed as paraphilic. So, do you happen to be attracted to, or in a relationship with, someone who is differently-abled or differently-sized? Or someone who is gender-variant in some way? Well congratulations, you may now be diagnosed with a paraphilia!

Seriously.

Blanchard and other like-minded sex researchers have coined words like Gynandromorphophilia (attraction to trans women), Andromimetophilia (attraction to trans men), Abasiophilia (attraction to people who are physically disabled), Acrotomophilia (attraction to amputees), Gerontophilia (attraction to elderly people), Fat Fetishism (attraction to fat people), etc., and have forwarded them in the medical literature to denote the presumed "paraphilic" nature of such attractions.

This tendency reinforces the cultural belief that young, thin, able-bodied cisgender women and men are the only legitimate objects of sexual desire, and that you must be mentally disordered in some way if you are attracted to someone who falls outside of this ideal. It's bad enough that such cultural norms exist in the first place, but to codify them in the DSM is a truly terrifying prospect.

Another frightening aspect of Blanchard's proposal is that any sexual interest other than "genital stimulation or preparatory fondling" is now, by definition, a paraphilia.

In his presentation, he claimed that paraphilias should include all "erotic interests that are not focused on copulatory or precopulatory behaviors, or the equivalent behaviors in same-sex adult partners." Copulatory is defined as related to coitus or sexual intercourse (i.e., penetration sex). So, essentially, all forms of sexual arousal and expression that are not centered around penetration sex may now be considered paraphilias.

So, do you and your partner occasionally role-play or talk dirty to one another over the phone? Or engage in arousing play that is not intended to necessarily lead to "doing the deed"? Do you masturbate? Do you get a sexual charge from wearing a particularly sexy outfit or performing any act that falls outside of "genital stimulation or preparatory fondling"? Well, then congratulations, you can be diagnosed with a paraphilia!

3 Skilled Nursing Facility staff arrested for drugging deaths of patients

Report from thje Kern Valley Sun

Attorney General Jerry Brown today announced the arrests of a nurse, physician, and a pharmacist of the Kern Valley Healthcare District's Skilled Nursing Facility for “forcibly administering psychotropic medications for their own convenience, rather than for their patients’ therapeutic interests.” The Attorney General said these actions are alleged to have resulted in the deaths of three residents.

Taken into custody earlier today, Feb. 18, by California Department of Justice special agents were Gwen Hughes, the former Director of Nursing at the Skilled Nursing Facility of the Kern Valley Healthcare District in Lake Isabella, on charges of elder abuse and assault with a deadly weapon; Debbi Hayes, the former pharmacist at KVHD, on charges of elder abuse and assault with a deadly weapon; and Dr. Hoshang Pormir, a staff physician at Kern Valley Hospital, who was serving as the medical director of the Skilled Nursing Facility, on charges of elder abuse.

“These people maliciously violated the trust of their patients, by holding them down and forcibly administering psychotropic medications if they dared to question their care,” Attorney General Brown said. “This is appalling behavior, which amounts to assault with a deadly weapon.”

According to the statement issued by the Attorney General's office, Hughes, upon taking over as Director of Nursing in September 2006, ordered that Alzheimer’s and other dementia patients be given high doses of psychotropic medications to make them more tranquil and easy to control. It goes on to say, “She ordered the administration of these medications to patients who argued with her, were noisy, or who were otherwise disruptive.” Two patients who resisted were held down and forcibly given injections.

The complaint also alleges that Hughes directed Debbi Hayes, the hospital pharmacist, to fill prescriptions for these psychotropic medications. Hayes wrote and filled these prescriptions without first obtaining a doctor’s approval, the complain said.

According to complaint, Pormir approved these psychotropic medications only some time after they had been administered and without examining the patients first and determining whether these psychotropic medications were medically necessary.

Investigators allege that several of these patients had medical complications as a result of being given these psychotropic medications, including lethargy and the inability to eat or drink properly. It is believed that that three patients died and one patient suffered great bodily injury as a result.

The case came to the attention of authorities in January 2007, when an ombudsman reported to the Bakersfield office of the California Department of Public Health that a patient in the Skilled Nursing Facility had been held down and given an injection of psychotropic medication by force.

The Department of Public Health immediately sent an investigative team with a doctor, a nurse, and a doctor of pharmacology. They determined that 22 patients, including some who were suffering from Alzheimer’s at the Skilled Nursing Facility, were being given high doses of psychotropic medication not for therapeutic reasons, but to simply control and quiet them for the convenience of the staff.

The Department of Public Health issued a Certificate of Immediate Jeopardy which resulted in the immediate dismissal of the Ms. Hughes. The matter was then turned over to the California Department of Justice, Bureau of Medi-Cal Fraud and Elder Abuse.

Special Agents from the Bureau of Medi-Cal Fraud and Elder Abuse began a year-long investigation, with the co-operation and assistance of the Department of Public Health and the administration of the Kern Valley Healthcare District.

Pamela Ott, CEO at the time, left the district in May 2007. Current KVHD Board of Directors Chair Kay Knight said, “A lot of people don't understand that this happened more than two years ago and is not going on now.”

Chet Beedle, Chief Financial Officer, reported that CEO Rick Carter and Board of Directors spokesperson Victoria Alwin were unavailable. He added that he was prohibited from commenting on the arrests and that a formal statement was coming.

A search warrant was served on the facility in August 2008, resulting in the seizure of 36 patients' medical files and records.

Criminal charges were filed in Kern County Superior Court and the defendants are being held in Kern County Jail in Bakersfield. Pormir is charged with one felony count of causing harm/death of an elder of dependent adult. He is being held on $400,000 bail. Hughes and Hayes are each charged with two felony counts, one count of causing harm/death of an elder of dependent adult and another felony count of assault with a deadly weapon other than a firearm of great bodily force. The trio will be arraigned in Superior Court in Bakersfield Friday morning. If convicted, the defendants could face up to 11 years in prison.

The case is being prosecuted by the Attorney General’s Bureau of Medi-Cal Fraud and Elder Abuse, with the co-operation and assistance of the Kern County District Attorney’s Office.

More than half of all foster children in Texas above 6 are drugged, 41,3% of those who receive medication receive 3+ different classes of medicines

Who are the real child abusers here? More than half of all foster children in Texas above 6 receive psychotropic medication, 41,3% of those who receive medication receive 3+ different classes of medicines. A study published in Pediatrics, the Official Journal of the American Academy of Pediatrics

Psychotropic Medication Patterns Among Youth in Foster Care

Julie M. Zito, PhD a,b,
Daniel J. Safer, MD c,
Devadatta Sai, MS a,
James F. Gardner, ScM a,
Diane Thomas, BA d,
Phyllis Coombes, MA d,
Melissa Dubowski, BS d and
Maria Mendez-Lewis, MPA d

Departments of

a Pharmaceutical Health Services Research
b Psychiatry, University of Maryland, Baltimore, Maryland
c Department of Psychiatry and Pediatrics, Johns Hopkins Medical Institutions, Baltimore, Maryland
d Office of the Texas Comptroller of Public Accounts, Austin, Texas

---

ABSTRACT

CONTEXT. Studies have revealed that youth in foster care covered by Medicaid insurance receive psychotropic medication at a rate >3 times that of Medicaid-insured youth who qualify by low family income. Systematic data on patterns of medication treatment, particularly concomitant drugs, for youth in foster care are limited.

OBJECTIVE. The purpose of this work was to describe and quantify patterns of psychotropic monotherapy and concomitant therapy prescribed to a randomly selected, 1-month sample of youth in foster care who had been receiving psychotropic medication.

METHODS. Medicaid data were accessed for a July 2004 random sample of 472 medicated youth in foster care aged 0 through 19 years from a southwestern US state. Psychotropic medication treatment data were identified by concomitant pattern, frequency, medication class, subclass, and drug entity and were analyzed in relation to age group; gender; race or ethnicity; International Classification of Diseases, Ninth Revision, psychiatric diagnosis; and physician specialty.

RESULTS. Of the foster children who had been dispensed psychotropic medication, 41.3% received ≥3 different classes of these drugs during July 2004, and 15.9% received ≥4 different classes.

The most frequently used medications were antidepressants (56.8%), attention-deficit/hyperactivity disorder drugs (55.9%), and antipsychotic agents (53.2%).

The use of specific psychotropic medication classes varied little by diagnostic grouping.

Psychiatrists prescribed 93% of the psychotropic medication dispensed to youth in foster care. The use of ≥2 drugs within the same psychotropic medication class was noted in 22.2% of those who were given prescribed drugs concomitantly.

CONCLUSIONS. Concomitant psychotropic medication treatment is frequent for youth in foster care and lacks substantive evidence as to its effectiveness and safety.

Full Study at the Link

Fourteen psychiatric patients have been sterilised in the Perm region of Russia against their will and without an appropriate court ruling.

As reported in Russia Today

This was the striking discovery made by the region’s human rights committee over the course of a two-year investigation, revealing numerous grave offences.

After receiving more than 50 complaints from patients of the 15 psychiatric asylums in the Perm region, an investigation was launched to analyse living conditions in these institutions. After two years of detailed study, a series of shocking discoveries was made.

Read more

Fourteen young women, born in the 1970s and 1980s were sterilised against their will, without the signed permission of their families or any appropriate court ruling. As the report states, the most poignant justification of these actions came from an unnamed asylum staff member. They did it so that the women “would not give birth to lunatics”.

In the Russian legislation, sterilisation of legally capable women is only permissible with their accord and when they’re aged over 35, or already have two children. When the woman is not legally capable, the signed permission of two gynaecologists and a court ruling are required.

There exists, however, an appendix to the law, which states that sterilisation can be carried out based purely on medical reasons if there exists “a threat to the woman’s life or health”. Staff have tended to interpret this appendix at will, using it to cover many sterilisations.

According to the human rights commission, the staff at the institutions were not even aware that a court decision was required to conduct the procedure. They based their decision simply on the advice of the institution’s administration.

Other infringements

It was discovered that the shocking cases of unlawful sterilisation were not the only cases of severe breaches of human rights in these psychiatric institutions. The official report drafted by Tatyana Margolina outlined three main areas of severe infringements of human rights in these institutions: medical care, the right to housing and the right to fair employment.

Perhaps the most fundamental malpractice in the institutions is the lack of adequate healthcare provision. According to the report some psychiatric institutions do not even have an appropriate medical licence.

Despite being state organisations, the institutions need to renew their medical licence every few years. Of those whose license had expired, the most recent renewal was in 2001. Since then, no new medical or diagnostic supplies were provided and no new medical personnel had been taken on.

“In several institutions medical attention was not provided and people simply died,” Margolina pointed out in the report. “Their death was a result of appropriate measures not being taken in due course.”

The lack of a medical licence resulted in the absence of basic medicines and diagnostic equipment. This has resulted in several deaths due to negligence in the last two years alone. The report refers to a number of unnamed cases. The causes of death named by coronary analysis include untreated and misdiagnosed pneumonia, a stomach ulcer and meningitis.

The last case is given specific attention. The patient was admitted to an institution and passed away only days later. The orderly simply gave the patient medicines against flu-like symptoms and proceeded to ignore the case for the next two days, during which the patient’s condition steadily worsened. Renewed medical attention was only given when the patient was on his deathbed, but it was too late. Even then, an appropriate diagnosis was not made.

Staff members point out that they don’t even call ambulances for the patients since the medics simply refuse to drive out to the institutions. In most places, no individual rehabilitation programmes were developed for patients. Some do not even have a stock of the required anti-psychotic drugs.

As a result, the patients’ abilities are not developed to their fullest potential. According to the report, some of the patients would have had the chance to do basic manual work and provide for themselves if given the appropriate training. Nevertheless, such fundamentals as sports equipment, professional and educational training and development programmes simply do not exist in Perm region institutions.

The living space provided for the patient is often far less than the basic minimum required by the Russian state. Some patients live in as few as three square metres of individual space with no access to privacy – nurses often break through locked doors and into restrooms as well as shower facilities.

The report points out that the conditions in the institutions breach several clauses of the UN charter and the human rights declaration: the patients do not have access to medical care, individual space, basic dignity, employment and personal development. Nevertheless, the report only goes as far as “advising” the local administration and the relevant institution to take these facts into account.

Regional problem?

Despite the gravity of the problem and its deep-rooted nature, the local administration appears to be inert in dealing with it. RT tried to get information of what the regional government is planning to do in order to resolve this shocking breach of basic human rights.

“Tatiana Margolina is refusing to give any comments on the situation, referring to the fact that it is a regional problem and the report was released regionally,” the human rights commissioner’s press office told RT.

When the local administration’s press office was contacted directly, RT was told that the general office does not have the competence to comment on such issues, and the human rights commission should be contacted.

As a result, no official comment was given on how the living conditions of the psychiatric patients will be ameliorated. So, despite the severe cases of human rights breaches and even abuse from state care providers being brought to public light, it remains unclear what will be done.

Pennsylvania judges accused of jailing kids for cash

As seen in this report

For years, the juvenile court system in Wilkes-Barre operated like a conveyor belt: Youngsters were brought before judges without a lawyer, given hearings that lasted only a minute or two, and then sent off to juvenile prison for months for minor offenses.

The explanation, prosecutors say, was corruption on the bench.

In one of the most shocking cases of courtroom graft on record, two Pennsylvania judges have been charged with taking millions of dollars in kickbacks to send teenagers to two privately run youth detention centers.

"I've never encountered, and I don't think that we will in our lifetimes, a case where literally thousands of kids' lives were just tossed aside in order for a couple of judges to make some money," said Marsha Levick, an attorney with the Philadelphia-based Juvenile Law Center, which is representing hundreds of youths sentenced in Wilkes-Barre.

Prosecutors say Luzerne County Judges Mark Ciavarella and Michael Conahan took $2.6 million in payoffs to put juvenile offenders in lockups run by PA Child Care LLC and a sister company, Western PA Child Care LLC. The judges were charged on Jan. 26 and removed from the bench by the Pennsylvania Supreme Court shortly afterward.

No company officials have been charged, but the investigation is still going on.

This fits into a larger pattern nation wide of sending kids away for "treatment" whenit is really for profit.

Top 10 Evil Human Experiments

As seen on the List Universe.

Human experimentation and research ethics evolved over time. On occasion, the subjects of human experimentation have been prisoners, slaves, or even family members. In some notable cases, doctors have performed experiments on themselves when they have been unwilling to risk the lives of others. This is known as self-experimentation. This is a list of the 10 most evil and unethical experiments carried out on humans.

[WARNING] This list contains descriptions and images of human experimentation which may cause offense to some readers.]

We are only posting the link above; the full list is too long to copy here.

SSRI Pushers under Fire

We now have another excellent story by Evelyn Pringle, as seen in the Scoop Independent News, and elsewhere.

SSRI Pushers under Fire

By Evelyn Pringle

Throughout the 1990's, most doctors who attended conferences, medical seminars and other events were not aware that the so-called "key opinion leaders" encouraging them to prescribe the new generation of antidepressants for everything under the sun, including to children as young as infants, were nothing more than highly paid drug pushers for Big Pharma.

For years, the research that showed SSRI antidepressants (selective serotonin reuptake inhibitors) were dangerous and practically useless was kept hidden, while the studies published and presented to potential prescribers painted a glowing picture of success. These days, a person would be hard pressed to find someone who does not have a family member or friend labeled mentally ill and taking drugs like Prozac, Paxil, Zoloft, Lexapro and Celexa, or their chemical cousins Effexor, Cymbalta and Wellbutrin.

About once a year, a new round of headlines about all the money made by the SSRI pushers comes and goes; but nothing really ever seemed to stick, until now.

The Senate Finance Committee, with the ranking Republican, Senator Charles Grassley, leading the charge, is investigating GlaxoSmithKline regarding new revelations in a report filed in litigation showing that the company manipulated the numbers on adverse events related to suicidality in clinical trials back in 1989, to make it appear that Paxil did not increase the risk of patients experiencing suicidal behavior when, in fact, trial subjects on Paxil were eight times more likely to attempt or commit suicide than patients taking placebos.

Quite a few of the top pushers are also under investigation by the Committee due to revelations that millions of dollars has changed hands between the SSRI makers and the academics who signed off on some of the most fraudulently reported research in the history of modern medicine. A full list of names is easy to compile by scanning the literature on SSRI studies conducted on children. The same names appear repeatedly.

In alphabetical order, the Fortune 500 team of pushers, at a minimum, includes Drs Joseph Biederman, David Brent, Jeffrey Bridge, Daniel Casey, David Dunner, Graham Emslie, Daniel Geller, Robert Gibbons, Frederick Goodwin, Martin Keller, Andrew Leon, John Mann, John March, Charles Nemeroff, John Rush, Neal Ryan, David Shaffer, and Karen Wagner.


Truth Buried in Litigation Graveyard

On February 6, 2007, the world famous historian on psycho-pharmacology, Dr David Healy, published a commentary entitled, "Why you should never trust new wonder drugs," in the UK's Daily Mail stating:

"Ten years ago, I sat faced with boxes and boxes that contained a dirty secret. Inside were thousands of confidential internal company documents about Prozac."

"The secret they revealed was that public statements about the safety of the drug were a lie; that the company knew Prozac was responsible for a raised risk of suicide and was only slightly more effective than a placebo."

Several years later, Dr Healy recounts, he was faced with the secrets of Paxil. "No one outside the two companies, and few within them," he writes, "knew what those boxes contained; I saw them because I was an expert witness in a court case."

"Documents prised out of companies by American court cases," he says, "have become the main way we have of discovering the truth about some of our best-selling drugs."

"The scientific literature, the very place doctors would look for a warning," he writes, "contained barely a hint of problems.”

"What's more, no one seems likely ever to have to answer for what appears to be fraud," he points out.

"In other organizations when evidence of disregard for public safety emerges, heads roll," Dr Healy said. "But there have been no resignations following these drug disasters - barely a flicker of embarrassment."

The UK's medicines “watchdog,” the British Medicines and Healthcare Products Regulatory Agency, he reports, "has never taken any action against the academics who make fraudulent claims in ghostwritten articles, nor doctors working for the companies who repeat such claims, even when they have been shown to be untrue."

"And no one in Britain," he points out, "has any means of finding out why their husband or child might have died."

Seven years before Dr Healy wrote this commentary, in a Prozac case for which he served as an expert witness, the plaintiff's legal team learned that Eli Lilly had withheld evidence in a jury trial when the May 7, 2007 Boston Globe reported that Lilly had agreed to pay $20 million for the rights to a patent on a new version of Prozac that would reduce "akathisia," the very side effect long believed to increase the risk of suicidal behavior, three months before the trial began.

While testifying under oath, Lilly researcher, Gary Tollefson, had told the jury, "there is absolutely no medically sound evidence of an association between any antidepressant medicine, including Prozac, and the induction of suicidal ideation or violence."

When in fact, the wording in the patent for the new formula stated "fluoxetine (Prozac) produces a state of inner restlessness (akathisia), which is one of its more significant side effects," and the "adverse effects which are decreased by administering the R(-) isomer of fluoxetine include but are not limited to headaches, nervousness, anxiety, insomnia, inner restlessness (akathisia), suicidal thoughts and self mutilation."

Patients who lived to talk about a failed suicide attempt have described the SSRI-induced akathisia, as being so unbearable that their only option for relief seemed to be death.


America’s Most Wanted

Dr Daniel Casey was a major player in the SSRI drug-push and useful in many ways to the companies promoting the drugs. He was the chairman of the very first FDA advisory committee that met in 1991, to decide whether a warning about the increased risk of suicide should be added to the label of Prozac, the first SSRI approved in the US, and voted it down. He was also the chairman of the advisory panel that voted to approve Zoloft for Pfizer later that same year.

Bob Sorenson was a sales representative for Pfizer for 21 years. He moved to Oregon shortly before Zoloft was approved. During the first week at his new location, Pfizer’s chief of marketing at the time told him he needed to start calling on a doctor by the name of Dr Daniel Casey at the V.A. in Portland because he was very important to the company.

Dr Casey worked at the V.A., but never treated patients for depression, Mr Sorenson says. "His expertise [was] psychotropic drugs and experimentation."

The chief of marketing said he was interested in finding out what Dr Casey thought of the company's new drug, Zoloft. The company tried to call on him that day, but Dr Casey was not in. Mr Sorenson called on him later in the week and learned that Dr Casey was the lead investigator on Zoloft, which was up for approval by the FDA advisory committee Dr Casey chaired.

"He said I shouldn't be there, but I did ask how it looks for the drug and he said very well," Mr Sorenson recalls.

Dr Casey ended up making a ton of money from Zoloft. "He told me personally one time that he made enough from Pfizer in one year to purchase two cars," Mr Sorenson reports.

Dr Casey became a member of Pfizer's Advisory Board for Zoloft, which meant "all expense paid trips," including honorariums, to anywhere Pfizer wanted him to advise, at any location in the world, Mr Sorenson explains.

"Many speakers were sought out that would only give lectures that put Zoloft in a positive light," he notes, "there was no room for a balanced lecture."

"Dr Casey later became one of the most sought after speakers for the Pfizer promotion of Zoloft," he says, "the reps loved him because of his positioning of Zoloft."

Mr Sorenson was often told to take information to speakers, "including Dr Casey, to have them add the information to their lectures," he reports. "I look back at it now and see how wrong it was," he states.

"As far as the suicide issue," Mr Sorenson says, "the standard company line was that parents and doctors should be monitoring these kids because after being on Zoloft they finally feel good enough that they can carry out their suicide tendencies."

"Another tactic was to blame Paxil and Effexor," he recalls, "it was those drugs that caused suicidal tendencies, not Zoloft."

"Finally," he notes, "the statement was made that if they didn't take Zoloft, they probably would have committed suicide anyway."

Sales reps would practice and rehearse these statements at sales meetings to be able to respond to concerns or objections raised by Doctors about Zoloft’s relationship to suicidality, he says. "There would be contests as to who could detail the drug the best with objections," he recalls.

Pfizer was able to get rid of employees and still keep them quiet, he says, by offering severance packages of up to a year's salary, while forcing them to sign a confidentiality agreement, in which they promised not to sue, or speak adversely about Pfizer, as part of the deal.

Many people were so surprised at being terminated that they felt forced to sign because Pfizer kept the pressure on, he explains. They feared they wouldn’t find another job before financial problems set in, but regretted signing the agreement later, he says.

Mr Sorenson did not sign an agreement when he was fired. His young son had developed cancer, but Pfizer expected him to continue to attend out-of-town meetings and refused to believe that his son was terminally ill, he recalls. After 20 years with the company, Mr Sorenson was let go when he insisted that he needed to remain near his dying son and distraught wife. The Sorenson's son passed away on April 1, 2005.


Going rate for Legal Drug Pushers

SEC filings for Cypress Bioscience provide a good source for estimating how much money legal drug pushers can make each year, from each company, because the names of several appear in these filings. According to its website, “Cypress Bioscience is committed to developing and commercializing pharmaceutical products and personalized medicine laboratory services that allow physicians to serve unmet medical needs.”

Drs Martin Keller and Charles Nemeroff, two of the most prolific depression-mongers, have served on the company’s board of directors, on its scientific advisory board and as consultants for this company. Under their 2004 Consulting Agreements, Cypress was required to pay them $50,000 per year for services rendered up to and including “two days per fiscal quarter.” In addition, the company could request additional services at a rate of $5,000 per day.

During 2003, Dr Nemeroff was paid $19,000 for additional services under his agreement, and Dr Keller was paid an extra $18,000. But they were only making $2,000 per day that year. As members of the Psychopharmacology Advisory Board, Dr Nemeroff earned $19,000 and Dr Keller $18,000 in 2003.

For their service as directors of the company in 2002, they each received $24,000. They were also offered stock options regularly. Cypress is only company. A bio on Dr Keller in a July 25, 2002 agenda for an annual meeting states that he is also a consultant to, "Bristol-Myers Squibb, Eli Lilly, Forest Laboratories, Janssen, Merck, Inc, Organon, Otsuka Pharmacia/Upjohn, Pharmastar, Pfizer, Inc. and Wyeth-Ayerst Laboratories."

It also shows he serves on the scientific advisory boards of, "Bristol-Myers Squibb, Cephalon, Cyberonics, Inc., Eli Lilly, Forest Laboratories, Merck, Inc, Mitsubishi, Organon, Pfizer, Sepracor, Scirex, SmithKline Beecham, Somerse, Vela Pharmaceuticals and Wyeth-Ayerst."

Dr David Dunner and a few more of the usual suspects appear in the Cypress SEC filings as advisory board members as well.

Dr Nemeroff's role in the prostitution of research is legendary. In April 2004, Shannon Brownlee, author of, "Overtreated," wrote an article in the Washington Monthly entitled, "Doctors Without Borders," after he was caught failing to disclose his financial ties to the companies whose treatments he promoted in a paper in Nature Neuroscience, and noted:

"With financial ties to nearly two dozen drug and biotech companies, Dr. Charles B. Nemeroff may hold some sort of record among academic clinicians for the most conflicts of interest.

"A psychiatrist, a prominent researcher, and chairman of the department of psychiatry and behavioral science at Emory University in Atlanta, Nemeroff receives funding for his academic research from Eli Lilly, AstraZeneca, Pfizer, Wyeth-Ayerst--indeed from virtually every pharmaceutical house that manufactures a drug to treat mental illness.

"He also serves as a consultant to drug and biotech companies, owns their stocks, and is a member of several speakers' bureaus, delivering talks--for a fee--to other physicians on behalf of the companies' products."

Dr Nemeroff stood to "reap as much as $1 million in stock" from just one company that manufactured one of the products in his Nature Neuroscience paper, she noted.

"But the drug industry's most powerful means of boosting the bottom line is funding research," Ms Brownlee writes, "which allows companies to control, or at least influence, a great deal of what gets published in the medical journals, effectively turning supposedly objective science into a marketing tool."

She notes how companies are able to routinely delay or prevent the publication of data and specifically how the majority of studies which found antidepressants to be no better than placebos, "never saw print in medical journals."

In conclusion, she states, "I'm struck more than anything by the apparent lack of shame among clinicians when it comes to this issue."

Two years later, on July 19, 2006, the Wall Street Journal reported that the journal, Neuropsychopharmacology, published by the American College of Neuropsychopharmacology (ACNP), planned to publish a correction of a favorable review of a new depression treatment device because it failed to list the ties of the eight academic authors to the device maker, Cyberonics, including lead author Dr Nemeroff, the editor of Neuropsychopharmacology at that time. The FDA had approved the VNS device in July 2005 over the objections of "more than 20" FDA scientists, Bloomberg reported a day earlier on July 18, 2006.

"This is about as classic an example as you'll ever find of conflict of interest and manipulation by thought leaders who are beholden to corporations," Dr Bernard Carroll, a member of the ACNP, told Bloomberg. "This article is a piece of a slick, skillfully coordinated PR campaign directed by the corporation," he said.

Ten days before the Wall Street Journal article, Cyberonics had sponsored a little noticed symposium on treatment-resistant depression at the annual Collegium Internationale Neuro-Psychopharmacologicum Meeting. The main presenters at the July 9, 2006 event were Drs Nemeroff, Dunner, and Keller (the lead author of the infamous Paxil “Study 329” on adolescents).

"In recent years, new treatment modalities have emerged, among them, the only FDA-approved treatment option specifically designed for this patient population, VNS Therapy," Dr Dunner stated in a press release for the event.

Dr Dunner was one of the authors vouching for the new device in the Neuropsychopharmacology paper. However, a “stamp of approval” from this guy should be taken with a grain of salt. Back in March 1995, he also vouched for Paxil as lead author of a study titled, "Reduction of suicidal thoughts with paroxetine in comparison with reference antidepressants and placebo," in the journal of European Neuropsychopharmacology. However, he later admitted that he never reviewed any of the actual data from that study.

Dr Nemeroff apparently learned nothing from the public embarrassment of the previous scandals. Last week, he was forced to step down as Chair of Emory’s psychiatry department. According to a December 23, 2008 posting by Ed Silverman, on the popular blog, Pharmalot:

"Under pressure from a US Senate Finance Committee investigation, renowned psychiatrist Charles Nemeroff is giving up the post he held for 17 years and must follow new restrictions on his outside activities, according to an Emory University statement.”

“Emory’s own investigation found Nemeroff received more than $800,000 from Glaxo, which paid Nemeroff more than any other drugmaker, but he never reported the fees. There were more than 250 speaking engagements between 2000 and 2006.”

"Moreover, Emory will not submit any National Institutes of Health grant or other sponsored grant or contract requests in which Nemeroff is listed as an investigator or has any other role for a period of at least two years,” Pharmalot reports.

All total, Dr Nemeroff earned more than $2.8 million from drug companies between 2000 and 2007, but failed to disclose at least $1.2 million to Emory, according to the Senator.

Dr Keller’s disclosure records are under investigation as well He also appears center stage in a new book by former Boston Globe reporter, Alison Bass, called, "Side Effects: A Prosecutor, a Whistleblower, and a Bestselling Antidepressant on Trial," The book contains a treasure trove of insider revelations with specifics on Dr Keller's endless conflicts of interest, along with other academics on the take. However, Ms Bass first broke the Keller story back on October 4, 1999, in the Globe, when she reported that he was forced to forfeit "hundreds of thousands of dollars" in state grant money in 1998.

She explained how in the same year that Dr Keller authored a review article in "Biological Psychiatry," and concluded that the newer antidepressants Zoloft, Bristol-Meyer’s Serzone, and Wyeth’s Effexor were more effective, he received $77,400 in personal income and $1.2 million in research funding from Bristol-Myers, as well as $8,785 in personal income from Wyeth.

In "Side Effects," she notes that Dr Keller did not report any income to the IRS from Glaxo for 1998, but says he did receive money from the Paxil maker, and also earned $62,500 from Celexa maker Forest Labs that year.

Dr Keller published 3 studies, "with colleagues," in the Journal of the American Medical Association and the Journal of Clinical Psychiatry, touting the efficacy of Zoloft in 1998, and received $218,000 in personal income and more than $3 million in research funding from Pfizer the same year, Ms Bass reports.

The "colleagues," referred to include the all-time champion of child drugging, Dr Joseph Biederman, the main promoter of the bogus epidemic of childhood bipolar disorder. He too is under investigation for taking $1.6 million from drug companies between 2000 and 2007, and only disclosing a fraction of that amount to Harvard. On December 30, 2008, Harvard’s teaching hospital, Massachusetts General announced that Dr Biederman was no longer participating in several industry-funded trials and had agreed to “not to participate in any outside activities that are paid for or sponsored by industry, such as consulting activities or speaking engagements.”

In most of the SSRI trials conducted on children, "colleagues," will also include Dr Graham Emslie of Prozac fame, and the Zoloft Czar, Dr Karen Wagner, both from the University of Texas.

Back in April 2004, the British Medical Journal published a paper by a research team led by Dr Jon Jureidini, head of the department of psychological medicine at Women's and Children's Hospital in Australia, after a review of the clinical trial data on the safety and efficacy of antidepressant use with children. The review included the published trials, along with some unpublished data made public by the Committee on Safety of Medicines in the UK.

The Australian team was extremely critical of the published papers on the major trials of Prozac, Paxil and Zoloft, with Emslie, Wagner and Keller listed as lead authors. "In discussing their own data," the team wrote, "the authors of all of the four larger studies have exaggerated the benefits, downplayed the harms, or both."

"It is vital," they wrote, "that authors, reviewers, and editors ensure that published interpretations of data are more reasonable and balanced than is the case in the industry-dominated literature on childhood antidepressants."

Seven months later, the New York Times ran a report by Barry Meier on November 29, 2004, throwing another spotlight on the trail of corruption within the SSRI research factories, and zeroed in on Dr Wagner. He noted that, from 1998 to 2001, she was one of several researchers participating in more than a dozen industry-funded pediatric trials of antidepressants and other drugs, and that some of the results were published, but many were not.

In her Zoloft study, Dr Wagner acknowledged that she had received "research support" from several drug makers including Pfizer, which paid $80,000 to the center in connection with the test, Mr Meier reports. But she did not state that she received “sizable payments” from Pfizer for work related to the study, he says.

The same month that patients were first recruited for the Zoloft trial, in a financial filing with the school in December 1992, Dr Wagner reported that she received more than $10,000 from Pfizer, with no further details. A lawyer for the school told Meier that Dr Wagner said Pfizer had paid her $20,500 during the course of the Zoloft trial. But records for payments she received in speaking and consulting fees could not be located.

In September, Dr Wagner’s name was added to the Senator Grassley’s investigative roster, along with Dr John Rush. Between 2000 and 2005, Glaxo alone paid Dr Wagner $160,404, but only $600 was disclosed to the University, according to the Senator. She was also paid over $11,000 in 2002, by Eli Lilly, and that money was not disclosed either. Lilly paid Dr Rush $17,802 in 2001, but he only reported $3,000, Senator Grassley said.

Dr Emslie’s financial trail to the drug makers gained media attention last summer due to his prominent role in the “Texas Children's Medication Algorithm Project,” and the creation of a drug formularies for children. He was chairman of the panel that wrote guidelines instructing doctors to prescribe SSRIs off-label to kids for depression in 1998. On August 18, 2008, the Dallas Morning News ran the headline: “Conflict of interest fears halt children's mental health project.”

“A state mental health plan naming the preferred psychiatric drugs for children has been quietly put on hold over fears drug companies may have given researchers consulting contracts, speakers fees or other perks to help get their products on the list,” the News reported. University disclosure forms indicate that Dr Emslie “has made at least $130,000 in drug company speakers fees and consulting contracts since 2002,” the paper noted.

In discussing the investigation of Dr Wagner on the Senate floor, Dr Grassley pointed out that she was a co-author on Paxil Study 329. In 2001, when the study was published, Glaxo “reported paying her $18,255,” he said. “Study 329 was cited in a New York case where GlaxoSmithKline was charged with ‘repeated and persistent fraud,’” the Senator added.

Dr Emslie was also a co-author on the Paxil study and a check of the full list for 329, reveals that 5 of the co-authors appear with Dr Emslie on the guidelines for the “Children's Medication Algorithm Project,” including Karen Wagner, Boris Birmaher, Barbara Geller, Neil Ryan and Michael Strober. Dr Rush’s name is also on the Texas guidelines but he moved to Singapore last August.

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Evelyn Pringle

epringle05@yahoo.com

(Written as part of the SSRI Litigation Round-Up, Sponsored by Baum, Hedlund, Aristei & Goldman’s Pharmaceutical Litigation Department at http://www.baumhedlundlaw.com)

(Evelyn Pringle is a columnist for Scoop Independent News and an investigative journalist focused on exposing corruption in government and corporate America)

The Diagnostic and Statistical Manual of Mental Disorders is being revised under a cloak of secrecy

As seen in the LA Times

[...] An update is underway for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, known as the DSM, which defines the emotional problems for which doctors prescribe drugs and insurance companies pay the treatment bills. Psychiatrists working on the new edition were required to sign a strict confidentiality agreement.

Critics contend that the American Psychiatric Assn. should allow outside observers to review the scientific debate behind new and revised diagnoses.

Among the most prominent to speak out is the editor of the manual's third edition, Dr. Robert Spitzer, hailed by peers as the most influential psychiatrist of his generation. If the DSM is often called the profession's bible, then the DSM-III is the King James Version. Released in 1980, it set the standard by which others are measured.

Recently, Spitzer broke ranks by publishing an open letter to the profession protesting the confidentiality mandate.

"If you don't know what goes on at someone's meetings, they're suspect of having a conflict of interest," the Columbia University professor said in an interview.

The profession is already confronting that issue through revelations that academics in the field are earning tens of thousands of dollars in consulting fees from drug companies. The financial links between the drug industry and the psychiatric community have sparked a congressional investigation headed by Sen. Charles E. Grassley (R-Iowa).

Officials with the APA counter that the psychiatrists working on the DSM revision are limited to $10,000 annually in fees from drug companies. The association says "transparency" is the byword of those overseeing the process.

Darrel Regier, who heads the APA's research arm, said the critics are failing to recognize progress in the field. "The field of psychiatry has gone from an ideology to a scientific pursuit," he said. The DSM grew out of a guidebook used by the military during World War II. Afterward, it was revised for general use and subsequently enlarged.

When it first appeared in the 1950s, psychiatry was dominated by Freud's model of psychological suffering, one that was resolvable by talking out the conflict with a therapist. Yet even then, drugs were appearing for relief of psychotic symptoms, and leadership in the profession has since passed to psychiatrists with an alternative model: biology and genetics as the source of emotional problems.

As the field has changed, the number of disorders in the DSM has tripled to 300, an increase paralleled by the rise in sales of drugs that pharmaceutical companies and psychiatrists tout as remedies for emotional suffering.

Some critics suspect that a quest for profits has encouraged the field to create mental illnesses out of personality quirks.

In his recent book, "Shyness: How Normal Behavior Became a Sickness," Christopher Lane traces how shyness morphed from a character trait into a pathological condition called "social phobia," which the DSM defines as "fears that he or she may do something or act in a way that will be humiliating or embarrassing." With disorders so broadly drawn, Lane wonders, who among us is sane?

It's an apt criticism, says David Kupfer, who is shepherding the DSM's revision.

"One of the raps against psychiatry is that you and I are the only two people in the U.S. without a psychiatric diagnosis," said Kupfer, head of the psychiatry department at the University of Pittsburgh.

Kupfer said he hopes to reduce the number of diagnostic categories in the forthcoming edition of the DSM, scheduled to appear in 2012.

He argues that scientific progress comes from formulating ideas, then seeing if others can shoot them down. If currently listed maladies fail that test, they'll be dropped, Kupfer said.

Meanwhile, Lane -- who has become something of a thorn in the side of the psychiatric community -- has irked some by obtaining the working papers of psychiatrists who produced the DSM-III and making plans to post them on his website.

Some of his finds read less like scientific discourse than like shtick from a Catskills comedian.

One syndrome under discussion at the time was "chronic complaint disorder."

Its supposed sufferers were largely "of Eastern European ancestry" and revealed their malady when asked how things are going.

"In those cases," the psychiatrists wrote, "the pathognomonic expression becomes, 'Oy vey, don't ask.' "