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28 January 2011

Carolyn B. Robinowitz

Interim Editor,

Psychiatric News

Letter to Editor

Texts Provenance Remains in Dispute

Writing for the American Psychiatric Association (APA), Mark Moran claimed APPI

Documents Refute Claims About Texts Authorship (Psychiatric News 21 January 2011; Vol

46/2, p.1). The nominal authors of the book (Recognition and Treatment of Psychiatric

Disorders: A Psychopharmacology Handbook for Primary Care) are Charles Nemeroff and Alan

Schatzberg. We remain unconvinced of their authorship, for the following reasons.

Mr. Moran quoted another APA spokesperson, Mr. Ron McMillen, to the effect that Drs.

Nemeroff and Schatzberg were actively involved in every stage of the books development.

Note, however, that he did not venture to say they wrote the initial drafts or indeed any drafts.

The released 49-page sample chapter draft provided by Diane Coniglio and Sally Laden,

employees of Scientific Therapeutics Information, Inc (STI), is largely reproduced verbatim in

the Handbook. That there are drafts with the nominal authors margin notes does not establish

who actually wrote the Handbook. It is standard procedure for the ghostwriting company,

Scientific Therapeutics Information (STI), to provide initial drafts that are reviewed by the

contracting corporation (here, SmithKlineBeecham, now GlaxoSmithKline - GSK) before being

released to the nominal authors.

STI is a commercial service entity, not a scientific institute. Their stated mission is to maximize

credibility for their clients products. It is, therefore, no surprise that efforts to reach STI by

Psychiatric News were not successful. The APAs spokespersons, Dr. James Scully and Mr. Ron

McMillen, quoted in Mr. Morans article, have reached premature closure based on limited

evidence. To bring into full view the most significant evidence for this debate would require de-

designation of numerous confidential documents from both GSK and STI, as part of Paxil

litigation. GSK, however, regularly invokes the Trade Secrets Act to ensure that the documents

remain confidential and that their key opinion leaders are protected from exposure.

Finally, we take issue with the claim in Mr. Morans article that Drs. Nemeroff and Schatzberg

were not remunerated by GSK for any of this work. Note that there is no mention of any

indirect payments they may have received through the unrestricted educational grant to STI.

Such arrangements are quite common.

We call on the APA/APPI to release all the key documents. The contract between STI and GSK

will reveal how much influence GSK had on the content and tone of the book, and the role of

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GSK in approving drafts. Correspondence between Drs. Nemeroff and Schatzberg and STI will

make it clear whether they followed the contract. Transparency also requires release of any GSK

marketing/ business plans for the Handbook; the legal release form transferring ownership from

GSK to the authors and APPI; marketing activities of GSK sales representatives detailing the

Handbook; and correspondence among all parties regarding the unrestricted educational grant.

This case highlights the need for disclosure if we ever are to understand the scale of corporate

influence on academic publishing. We look forward to Congressional action to require the

release of these documents.

Bernard Carroll, M.B., Ph.D.

Professor and Chairman Emeritus

Department of Psychiatry and Behavioral SciencesDuke University Medical Center

Durham, NC 27710

E-mail bcarroll@duke.edu or bcarroll@redshift.com

Telephone 831-626-1467

Robert T. Rubin, M.D., Ph.D. * Dr. Rubin is corresponding author.*

Distinguished Professor and Vice Chair

Department of Psychiatry and Biobehavioral Sciences

David Geffen School of Medicine at UCLA

Los Angeles, CA 90073

Distinguished Life Fellow

American Psychiatric Association

E-mail robert.rubin@va.gov

Telephone 310-268-3319

Leemon B. McHenry, Ph.D.

Department of Philosophy

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California State University, Northridge

Northridge, CA 91330-8253

E-mail leemon.mchenry@csun.edu