Furious Seasons

September 16, 2009

American Journal Of Psychiatry Ignores Unreported Conflicts In Its Journal

Earlier this month, I noted that Washington University psychiatry professor Joan Luby appeared to have possible unreported conflicts of interest on three separate papers, including one on "early childhood depression" that appeared in this month's issue of the American Journal of Psychiatry. I queried the AJP's editor and the American Psychiatric Association about the situation, asking if they look into the matter and make whatever correction was appropriate. I got no reply from either the editor or the APA's press office.

Luby had reportedly received monies from AstraZeneca in 2003 and 2004. AZ makes Seroquel, an atypical antipsychotic that is being widely used off-label in children (and adults) as a treatment for depression and agitation. Since Luby's research bailiwick is so-called preschool bipolar disorder and preschool depression the AZ monies would seem to be worthy of disclosure, as might be monies she also reportedly got from Shire (makers of Adderall) and Janssen/J&J, makers of Risperdal. When I queried Luby about all of this I got no reply.

Yesterday, I again queried the AJP's editor and the APA's press office on the matter. I also copied APA president Alan Schatzberg.

So far, I've gotten no answer from any of them.

What a contrast to the response from the editor of the Archives of General Psychiatry, who pledged to look into possible non-disclosure problems with a Luby paper published in his journal in August.

I'm not sure what the AJP and APA's problem is, but they appear to not care very much about the proper reporting of financial conflicts in their journal. Their silence speaks volumes.

Posted by Philip Dawdy at September 16, 2009 12:01 AM

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Comments

Yeah, Alan Schatzberg, one of the kings of conflicted interests is REALLY going to respond to this. Hilarious.

Posted by: CL Psych at September 16, 2009 05:07 AM

Joan Luby is on the CABF (Child Adolescent Bipolar Foundation) Professional Advisory committee, alongside Joseph Biederman, and Melissa DelBello, 2 of the most conflicted researchers in the KOL list.

If a person looks close enough at the way children are being dx younger and younger and placed on psych meds, it is clear who the target market is for big pharma, and off-label use is standard practice, as it seems COI is with the big wigs.

http://www.bpkids.org/site/PageServer?pagename=ppl_advisory

"Joan Luby, M.D.
Associate Professor of Child Psychiatry
Director - Early Emotional Development Program
Washington University School of Medicine in St. Louis"

It would seem that CABF would want to give their parents an advisory panel free and clear of conflicted professionals, but then again, maybe not.

Posted by: Stephany at September 18, 2009 07:50 AM

One area concerning the atypical antipsychotic induced conditions of hyperglycemia and diabetes as well as the other myriad of metabolic disturbances brought on by these drugs, is the area of what is exactly the nature of these disturbances. One report in the February 2004 Journal of American Psychiatry is the article by Oliver D. Howes et al. called: A Prospective Study of Impairment in Glucose COntrol caused by Clozapine without changes in insulin resistance.
In this study he notes that people who lose glucose control on clozapine had insulin resistance levels in the upper quintile of the healthy range for insulin resistance. People who had insulin resistance levels below this upper quintile appeared to keep normal glucose control. These findings need to be expanded in further studies and further characterized, in my belief. The study appears to imply that people who lose glucose control on the atypicals already have negative energy balance phenomena occuring in their physiology. In any case, its a significant finding. THe actual quote from the article: "(1) Baseline Insulin resistance level was within the upper quintile of the range of insulin resistance levels seen in healthy control subjects."

On the other side of the issue Schizophrenia Bulletin August 14, 2008 edition carried an article where researchers thought the glucose control mechanism was altered by the drugs in the sympathetic nervous system. That view is counter somewhat to the Howes findings. Yet these are two views on AAP induced metabolic disturbances that illustrate the condition is yet to be final in its understanding.

Posted by: Harry Horton at September 22, 2009 02:37 PM