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Amid ongoing concerns over conflicts of interest, a new study found that 60% of the physicians who served as panel and task force members for the American Psychiatric Association’s official manual of psychiatric disorders received payments from industry totaling more than $14 million. And the authors argue the findings raise questions about the editorial independence of the reference book.

The analysis examined financial relationships between industry and 92 U.S.-based physicians who helped assemble a recent revision of the Diagnostic and Statistical Manual of Mental Disorders, which is often referred to as the bible of psychiatry. This latest revision, known as the DSM-5-TR, was prepared between 2016 and 2019, and published in 2022.

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The researchers found that, of the 55 physicians with ties to a pharmaceutical company, 91% accepted food and beverages, and 69% received compensation for travel and consulting, according to the analysis published in the BMJ. Half of the physicians received research funding, although the $9.9 million that was paid out represented 70% of the total amount of money paid to the physicians.

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