COMMENTARY

New Data on Bias in Depression Trials

Peter M. Yellowlees, MBBS, MD

Disclosures

March 02, 2017

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This is the Medscape Psychiatry Minute. I'm Dr Peter Yellowlees.

The possible effect of sponsorship bias has never been investigated for nonpharmacologic treatments, such as psychotherapy. Now, a team of investigators[1] from the University of Padova, Italy, have examined industry funding and author financial conflict of interest in a meta-analysis of 45 randomized controlled trials directly comparing psychotherapy and pharmacotherapy for depression.

They found that differences between industry and non–industry-funded trials were significant, with pharmacotherapy consistently showing more effectiveness over psychotherapy in industry-funded trials, whereas five instances were found where authors of the original trial article had not reported financial conflicts of interest. The researchers concluded that industry-funded trials for depression appear to favor pharmacotherapy over psychotherapy and that disclosure of all financial ties with the pharmaceutical industry should be encouraged.

This is an important article for all of us who value objective science. It is common sense that funding sources and research sponsorship should, almost inevitably, both consciously and unconsciously lead investigators down paths of thinking and ideas that are congruent with the needs of their funders, even though most investigators try their utmost to remain objective and honest.

Our current system of clinical trials is heavily commercially funded by pharmaceutical companies, with the result that there is, at the very least, an unconscious bias from those involved to attempt to find positive results of pharmacotherapy. The results of this clever study of depression treatment support this hypothesis. Perhaps we should be doing more studies with different styles of control groups—using alternative therapies whenever possible—–rather than other drugs or placebo preparations, and insisting on industry funding of nonbiological or related trials as part of their community obligations.

Thank you for listening to this Medscape Psychiatry Minute. Do enjoy your practice.

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