Friday, May 27, 2011

Professor Patrick McGorry - too influential and too much influenced?

Are the ideas of early intervention in general and the idea of proactive and interventionist treatment of mental illness two incredibly popular intellectual fads in Australia? Yes.

Has the former Australian of the Year Professor Patrick McGorry received support from pharmaceutical companies that produce drugs used for mental illnessess for which Prof. McGorry advocates a greater level of diagnosis? Yes, he has.

Does Prof. Patrick McGorry have many conflicting interests? Yes.

Has Prof. Patrick McGorry many times failed to declare conflicting interests in journal papers in which he is a co-author? It appears that the answer is yes.

Is that shonky? Well, what do you think? There are very good reasons why medical journals ask their authors to declare conflicting interests.

Has there been serious criticism of the idea of early or preemptive identification of psychosis/schizophrenia in youth from psychiatric professionals from around the world, an idea advocated emphatically and repeatedly by Prof. McGorry? YES.

Was the Rudd Government right to refuse some of the funding sought by Prof. McGorry for his empire of clinics for the preemptive and early identification of psychosis in youth? Yes.

Was the Gillard Government wrong to cave-in to pressure to meet Prof. McGorry's well-publicised and emotive demands? Yes.

Why is a suburban housewife writing about this? Because Australian journalists aren't.

Why aren't Australian journalists covering this issue? You tell me! Maybe Australian journalists are clueless or useless.

A list of drug companies from which Prof. Patrick McGorry has received a research grant

Janssen - Cilag - producer of the drugs:

Concerta which is prescribed for ADHD

Haldol which is prescribed for Schizophrenia

Invega Sustenna which is prescribed for Schizophrenia

Invega which is prescribed for Schizophrenia

Risperdal Costa which is prescribed for Schizophrenia

Risperdal & Quicklet which is prescribed for Schizophrenia

Eli Lilly - producer of the drugs:

Cymbalta which is prescribed for Depression and Anxiety

Prozac which is prescribed for Depression, OCD and "premenstrual dysphoric disorder"

Strattera which is prescribed for ADHD

Zyprexa which is prescribed for Schizophrenia and Bipolar

Zyprexa Relprevv which is prescribed for Schizophrenia

Zyprexa IM which is prescribed for Schizophrenia and Bipolar

Bristol-Myers Squibb - producer of the drug:

Abilify which is prescribed for Schizophrenia, Bipolar, Depression and bothersome behaviour in autistic people

AstraZeneca - producer of the drugs:

Seroquel which is prescribed for Schizophrenia, Bipolar and Depression

Seroquel XR which is prescribed for Schizophrenia and Bipolar

Pfizer - producer of the drugs:

Geodon which is prescribed for Schizophrenia and Bipolar

Zoloft which is prescribed for Depression

Novartis - producer of the drugs:

Ritalin which is prescribed for ADHD

Ritalin LA which is prescribed for ADHD

Tofranil which is prescribed for Depression

"He has acted as a paid consultant for, and has received speaker’s fees and travel reimbursement from, all or most of these companies."

McGorry, Patrick (2008) Is early intervention in the major psychiatric disorders justified? Yes. British Medical Journal. August 4th 2008. 337:a695.

I have also taken information about the products from the websites of the pharmaceutical companies and from the Wikipedia.

An incomplete list of medical journal papers in which Prof. Patrick D McGorry was an author and failed to disclose competing interests
(check it yourself - papers available to read free in full text)

Alexandra G Parker, Sarah E Hetrick, Anthony F Jorm, Alison R Yung, Patrick D McGorry, Andrew Mackinnon, Bridget Moller, and Rosemary Purcell (2011) The effectiveness of simple psychological and exercise interventions for high prevalence mental health problems in young people: a factorial randomised controlled trial. Trials. 2011; 12: 76. Published online 2011 March 13.

Amresh Shrivastava, P. D. McGorry, Ming Tsuang, Scott W. Woods, Barbara A. Cornblatt, Cheryl Corcoran and William Carpenter (2011) “Attenuated psychotic symptoms syndrome” as a risk syndrome of psychosis, diagnosis in DSM-V: The debate. Indian Journal of Psychiatry. 2011 Jan-Mar; 53(1): 57–65. doi: 10.4103/0019-5545.75560.

Takahashi T, Wood SJ, Yung AR, Walterfang M, Phillips LJ, Soulsby B, Kawasaki Y, McGorry PD, Suzuki M, Velakoulis D, Pantelis C. (2010) Superior temporal gyrus volume in antipsychotic-naive people at risk of psychosis. British Journal of Psychiatry. March 2010 196: 206-211. doi: 10.1192/bjp.bp.109.069732

Jo Robinson, Sarah Hetrick, Sara Gook, Elizabeth Cosgrave, Hok Pan Yuen, Patrick McGorry and Alison Yung (2009) Study protocol: the development of a randomised controlled trial testing a postcard intervention designed to reduce suicide risk among young help-seekers. BMC Psychiatry. 2009; 9: 59. Published online 2009 September 23. doi: 10.1186/1471-244X-9-59.

Jo Robinson, Sara Gook, Hok Pan Yuen, Patrick D McGorry and Alison R Yung (2008) Managing deliberate self-harm in young people: An evaluation of a training program developed for school welfare staff using a longitudinal research design. BMC Psychiatry. 2008; 8: 75. Published online 2008 September 15. doi: 10.1186/1471-244X-8-75.

Patrick D McGorry, Eóin Killackey and Alison R Yung (2007) Early intervention in psychotic disorders: detection and treatment of the first episode and the critical early stages. Medical Journal of Australia. 2007; 187 (7 Suppl): S8-S10.

Michael Berk, Karen Hallam, Nellie Lucas, Melissa Hasty, Craig A McNeil, Philippe Conus, Linda Kader and Patrick D McGorry (2007) Early intervention in bipolar disorders: opportunities and pitfalls. Medical Journal of Australia. 2007; 187 (7 Suppl): S11-S14.

Andrew M Chanen, Louise K McCutcheon, Martina Jovev, Henry J Jackson and Patrick D McGorry (2007) Prevention and early intervention for borderline personality disorder. Medical Journal of Australia. 2007; 187 (7 Suppl): S18-S21.

Patrick D McGorry, Rosemary Purcell, Ian B Hickie, Alison R Yung, Christos Pantelis and Henry J Jackson (2007) Clinical staging: a heuristic model for psychiatry and youth mental health. Medical Journal of Australia. 2007; 187 (7 Suppl): S40-S42.

Alison R Yung, Patrick D McGorry, Shona M Francey, Barnaby Nelson, Kathryn Baker, Lisa J Phillips, Gregor Berger and G Paul Amminger (2007) PACE: a specialised service for young people at risk of psychotic disorders. Medical Journal of Australia. 2007; 187 (7 Suppl): S43-S46.

Patrick D McGorry (2007) The specialist youth mental health model: strengthening the weakest link in the public mental health system. Medical Journal of Australia. 2007; 187 (7 Suppl): S53-S56.

Patrick D McGorry, Chris Tanti, Ryan Stokes, Ian B Hickie, Kate Carnell, Lyndel K Littlefield and John Moran (2007) Headspace: Australia’s National Youth Mental Health Foundation — where young minds come first. Medical Journal of Australia. 2007; 187 (7 Suppl): S68-S70.

Annemarie Wright, Patrick D McGorry, Meredith G Harris, Anthony F Jorm and Kerryn Pennell (2006) Development and evaluation of a youth mental health community awareness campaign – The Compass Strategy. BMC Public Health. 2006; 6: 215.
Published online 2006 August 22. doi: 10.1186/1471-2458-6-215.

Berger, Gregor, Fraser, Richard, Carbone, Stephen & McGorry, Patrick (2006) Emerging psychosis in young people - part 1. Australian Family Physician. Vol. 35, No. 5, May 2006. p. 315-321.

And some journal papers in which Prof. McGorry did disclose conflicting interests

Patrick D McGorry, Sherilyn Goldstone (2011) Is this normal? Assessing mental health in young people. Australian Family Physician. March 2011 Vol 40, (3) 94-97.

McGorry, Patrick (2008) Is early intervention in the major psychiatric disorders justified? Yes. British Medical Journal. August 4th 2008. 337:a695.

Patrick D McGorry (2005) Evidence based reform of mental health care
Early, intensive, and home based treatments are the answer. British Medical Journal. 2005 September 17; 331(7517): 586–587.
doi: 10.1136/bmj.331.7517.586.

Yucel, Murat et al (2003) Morphology of the anterior cingulate cortex in young men at ultra-high risk of developing a psychotic illness. British Journal of Psychiatry. (2003) 182: 518-524.

Further Reading

Ahmed, Tanveer (2010) Mental health claims overblown. Sydney Morning Herald. August 12, 2010.

APANA Autistic People Against Neuroleptic Abuse

Attard, Monica (2010) Professor Patrick McGorry, 2010 Australian of the Year. Sunday Profile. ABC Radio National. January 31st 2010.

Dunleavy, Sue (2011) Schism opens over ills of the mind. Australian. June 16th 2011.

Dunleavy, Sue (2011) US expert slams Patrick McGorry's psychosis model. Australian. June 14, 2011.

Fitzsimmons, Hamish (2011) Mental health experts disagree on future of care. Lateline. ABCTV. August 18th 2011.

Francis, Allen J. (2011) Continuing Controversy On Australia's Mental Health Experiment: Seven questions for Dr McGorry. Psychology Today Blogs. June 13th 2011.

Francis, Allen J. (2011) Australia's Reckless Experiment In Early Intervention: prevention that will do more harm than good. Psychology Today Blogs. May 31st 2011.

Frances, Allen J. (2010) DSM5 'Psychosis Risk Syndrome'--Far Too Risky. Psychology Today. March 18, 2010.

McGorry's early intervention model slammed. Australian Doctor. June 14th 2011.

Marshall, M. and Rathbone, J. Early intervention for psychosis. The Cochrane Library. Cochrane Database of Systematic Reviews. 2011 Issue 6. page 24.
Art. No.: CD004718. DOI: 10.1002/14651858.CD004718.pub3.
[see "Other potential sources of bias" in the summary of findings]

Raven, Melissa and Jureidini, Jon (2010) Misleading claims in the mental health reform debate. On Line Opinion. August 9th 2010.

Speed Up & Sit Still (blog of Martin Whitely MLA)

Stark, Jill (2011) Drug trial scrapped amid outcry. The Age. August 21, 2011.

Stark, Jill (2011) McGorry accused of conflict of interest. Sydney Morning Herald.August 7th 2011

Stark, Jill (2011) Doctors in different headspace on suicide. Sydney Morning Herald. August 7th 2011

Webb, David and Raven, Melissa (2010) McGorry's 'early intervention' in mental health: a prescription for disaster. On Line Opinion. April 6th 2010.

Weber, David (2011) Mental health centres under attack. ABC News. May 12, 2011.

Weber, David (2011) Professor McGorry hits back at critics. The World Today. ABC Radio National. May 20 2011.

Whitaker, Robert (2010) Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America. Crown, 2010.

Williams, Daniel (2006) Drugs before diagnosis? Time. June 18th 2006.,9171,1205408,00.html

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