Transparency and conflicts of interest in the May 2011 Mental Health in Infancy, Childhood and Adolescent Conference, Perth.

The theme of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) conference – “Growing up solid: Integrating emotional and mental health throughout infancy, childhood and adolescence” – has never been more relevant or frightening. Australia has one of the highest psychotropic drug uses in the world – third highest for cocaine-like stimulants prescribed children. Between 2002-09 there has been a staggering 87% increase in stimulant prescribing in Australia. The escalating trend of drugging young children promoted at conferences such as this can potentially increase the risk of not just youths, but also infants and toddlers being prescribed these dangerous drugs.

Consider that 12-month-old babies in Australia have been prescribed powerful antipsychotics that put them at risk of blood disorders, blood-sugar abnormalities, cardiac arrest, diabetes, liver failure, muscle twitching, pancreatitis (inflammation of pancreas), restlessness or pacing, seizures, convulsions, and Neuroleptic Malignant Syndrome-a potentially fatal toxic reaction.

Nearly 10,000 Australian children under 18 (almost 300 aged 6 years and under) are prescribed antipsychotics. Already there are 15 DEATHS linked to antipsychotics for children under 19. In 2008, the PBS/RPBS paid out over $3.4 million for antipsychotics prescribed to children.

Since 2006 the number of prescriptions for antidepressants rose by 382,738 to more than 12 million prescriptions in 2009, while studies show the drugs are no more effective than placebo. By June 2008 $3.2 million had been spent on antidepressants for those under 18 years old.

“What is of major concern is the lack of transparency with no public disclose of any conflict of interest between psychiatrists speaking at this conference and the pharmaceutical industry,” states Shelley Wilkins, Executive Director of the Australian National Office of the iCitizens Commission on Human Rights “This month The Medical Journal of Australia highlighted how we need anti-fraud and conflicts protections similar to that in the U.S. ¹ where psychiatric conferences have a full disclosure policy. U.S. government investigations have found that this conflict of interest has fuelled a 40-fold increase in the number of children labelled with “bipolar disorder” and drugged with antipsychotics and such conflicts need to be disclosed. We don’t want Australia to go down that path, but based on statistics we are fast becoming a drug fuelled nation.”

Consider the conflict of interest independently found on this RANZCP conference:

• The RANZCP received $757,000 between 2006 and 2010 for sponsorship and exhibitor fees for their conferences from pharmaceutical companies.
• Keynote speaker: UK psychiatrist Professor Robin Murray has received honorariums for speaking at meetings organised by most producers of antipsychotic drugs and his research group has received funding from Eli Lilly and Astra Zeneca.” ²

Prof Murray is an advocate of “early intervention” treatment of mental disorder. Prof. Murray is an associate of Australia’s Prof. Patrick McGorry, the “father” of “Psychosis Risk Syndrome” (PRS), which has drawn international criticism. Essentially it is an arbitrary list of behavioural symptoms, which psychiatrists, claim they can “predict” the onset of “psychosis.” Often seen at age 12-14, psychiatrists drug the adolescent with mind-altering antipsychotics (that can induce psychosis) to “prevent” the disorder. Professors McGorry and Murray’s peers have said the following about it:

• Allen Frances, professor of psychiatry and taskforce chair of the Diagnostic and Statistical Manual for Mental Disorders (DSM), called PRS “ill conceived and potentially harmful.” Further, “1) it would misidentify many teenagers who are not really at risk for psychosis; 2) the treatment they would most often receive (atypical [new] antipsychotic medication) has no proven efficacy; but, 3) it does have definite dangerous complications.” ³ The false positive rate in predicting psychosis is between 70-90%, “meaning that between two and nine youngsters would be misidentified for every one accurately identified.” ⁴ PRS is “a bonanza for the pharmaceutical industry,” for which patients would pay the “high price [of] adverse effects, dollars, and stigma.” ⁵
• Dr. Richard Warner, professor of psychiatry at the University of Colorado, counters the idea that science drives McGorry’s pre-disorder assessment, stating that the screening instrument he uses “is not that accurate in routine use.” Further, “McGorry speculates that a variety of interventions may be effective in preventing schizophrenia in high-risk cases…. Given the expected number of false positives, the potential for harm is significant,” stated Dr. Warner. ⁶
• Dr. Jerald Block, psychiatrist writing in Bioethics Forum, reported that “preventive pharmacology” is “ethically questionable territory” because “you are potentially harming people.” The symptoms used to identify them as at risk of schizophrenia are “also remarkably common…adolescence is a period of life that is normally marked by tumultuous changes in personality.” ⁷
• Melissa Raven, psychiatric epidemiologist and policy analyst, adjunct lecturer in Public Health at Flinders University, South Australia, and David Webb, board member of the World Network of Users and Survivors of Psychiatry wrote: “McGorry’s campaign is part of a wider push to promote the medicalisation of mental health (for which psychosocial wellbeing is a better term).” “Further doubts must be raised about McGorry’s agenda when you see the substantial funding his organization (Orygen Youth Health) receives from the pharmaceutical industry&ellipsis; ⁸
• Prof. McGorry has received unrestricted research grants from Janssen-Cilag, Eli Lilly, Bristol Myer Squibb, Astra-Zeneca, Pfizer and Novartis. He has acted as a paid consultant for, and has received speaker’s fees and travel reimbursement from all or most of these companies. ⁹

“While infants and children can suffer from emotional trauma, parents are not told that unlike for medical conditions, there are no blood or urine test, brain scan (MRI, PET scan) or any physical or genetic test to scientifically/medically confirm the existence of the mental disorders children are labelled with. Mental problems, while very real, are not physical diseases and we need complete transparency and fully informed consent for all treatment being offered to parents,” says Shelley , Wilkins Executive Director of the Australian National Office of the Citizens Commission on Human Rights.

“Further we want parents to be informed of medical and educational solutions that do not rely upon heavy, mind-altering drugs. Pharmaceutical conflicts of interest do not serve children who need help and parents and those attending the conference have a right to know of any conflicts of interest connected to this conference.”

Contact: Shelley Wilkins (02) 99649844

CCHR was established in 1969 by the Church of Scientology and Professor of Psychiatry Dr Thomas Szasz to investigate and expose psychiatric violations of human rights.

1. http://www.mjainsight.com.au/view?post=jane-mccredie-getting-away-with-fraud&post_id=4355&cat=comment
2. Schizophrenia, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1914490/
3. Allen Frances, M.D., “DSM5 ‘Psychosis Risk Syndrome’–Far Too Risky,” Psychology Today, http://www.psychologytoday.com/blog/dsm5-in-distress/201003/dsm5-psychosis-risk-syndrome-far-too-risky
4. http://www.psychologytoday.com/blog/dsm5-in-distress/201007/psychosis-risk-syndrome-just-risky-new-name
5. Gary Greenberg, “Inside the Battle to Define Mental Illness,” Wired Magazine, 27 Dec. 2011.
6. Richard Warner, MB, DPM, is director of Colorado Recovery in Boulder, Colorado, and professor of psychiatry at the University of Colorado, “Early intervention in psychosis: Future or fad?,” Centre for Addiction and Mental Health website, http://www.camh.net/Publications/Cross_Currents/Winter_2007-08/futureorfad_crcuwinter0708.html.
7. http://www.ahrp.org/cms/index2.php?option=com_content&do_pdf=1&id=386; http://ww.bioethicsforum.org/ethics-of-preventive-psychopharmacologic-treatments.asp.
8. David Webb, Melissa Raven, “McGorry’s ‘early intervention’ in mental health: a prescription for disaster,” Online Opinion, http://www.onlineopinion.com.au/view.asp?article=10267.
9. http://www.bmj.com/cgi/content/full/337/aug04_1/a695