Letters DSM-5: a fatal diagnosis?

Academic psychiatry, research ethics, and the drug industry

BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f3655 (Published 11 June 2013) Cite this as: BMJ 2013;346:f3655
  1. Derek A Summerfield, honorary senior lecturer1
  1. 1Institute of Psychiatry, London SE5 8BB, UK
  1. derek.summerfield{at}slam.nhs.uk

In his article on DSM-5 (the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders), Gornall mentions Charles Nemeroff, a professor at Emory University.1 Nemeroff concealed huge payments made covertly to him by GlaxoSmithKline, makers of the antidepressant paroxetine, while lead investigator on a National Institutes of Health (NIH) study of that very drug.2 Nemeroff was obliged to resign from Emory but was then appointed chair of psychiatry at the University of Miami. The US Senate Committee on Finance wrote to NIH to ask why it had granted Nemeroff $400 000 (£261 560; €306 160) a year for five years when he remained under federal investigation.3

None of this seems to worry the Institute of Psychiatry, King’s College London, Europe’s largest psychiatric research centre. The institute has invited Nemeroff to give the inaugural annual lecture of its new Centre for Affective Disorders on 17 June 2013, describing him as “one of the world’s leading experts in the neurobiology of depression.”

This case tells us about how the biomedicine driven research world works. Nemeroff was appointed to another chair of psychiatry when the case against him was not closed, he received substantial new grants, and the Institute of Psychiatry in London continues to laud him as “one of the world’s leading experts.” All of this shows how psychiatric academe sails blithely on as if such revelations raise no broader questions about its supposed scientific independence, research ethics, and how conflicts of interest contaminate the research data informing scientific publications.

Finally, no clinically meaningful “neurobiology of depression” has been discovered. This is not surprising when “depression” is merely a syndromal category, subsuming a heterogeneous range of patients whose understanding of their distress points more often to social space than to mental space.4


Cite this as: BMJ 2013;346:f3655


  • Competing interests: None declared.