BMJ  2003;327:870 (11 October), doi:10.1136/bmj.327.7419.870

Letter

Separation of anxiety and depressive disorders

Maybe pharmaceutical failure has created culture of niche diagnosis

The first 150 words of the full text of this article appear below.

EDITOR—Shorter and Tyrer provide an important case study in the way that medicine and science can become subverted by commercial pressures.1 On one hand, new patents for drugs for mood and anxiety disorders have dwindled to almost nothing from a high point in the 1960s and 1970s. On the other, niche diagnoses have proliferated, apparently as a result of collusion between experts and the pharmaceutical industry. In the absence of new drugs for existing conditions, it seems, a good commercial alternative is to market the existing drugs as being effective for new diagnoses.

However, if we accept the existence of this association, the direction of causation is unclear. The authors believe that the failure to advance the treatment of anxiety and depression is related to the wrong classification—with the implication that use of a superior categorisation that no longer separates the two diagnoses would stimulate pharmaceutical innovation. But . . . [Full text of this article]

Michael Joffe, reader in epidemiology

Department of Epidemiology, Imperial College, St Mary's Campus, London W2 1PG m.joffe@imperial.ac.uk


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Relevant Article

Separation of anxiety and depressive disorders: blind alley in psychopharmacology and classification of disease
Edward Shorter and Peter Tyrer
BMJ 2003 327: 158-160. [Extract] [Full Text] [PDF]

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