Publications

Undisclosed financial conflicts of interest inDSM-5-TR: cross sectional analysis

Davis, L. C., Diianni, A. T., Drumheller, S. R., Elansary, N. N., D’Ambrozio, G. N., Herrawi, F., ... & Cosgrove, L. (2024). Undisclosed financial conflicts of interest in DSM-5-TR: cross sectional analysis. BMJ, 384.

Objective: To assess the extent and types of financial ties to industry of panel and task force members of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, fifth edition, text revision (DSM-5-TR), published in 2022.

Design: Cross sectional analysis.

Setting: Open Payments database, USA.

Participants: 92 physicians based in the US who served as members of either a panel (n=86) or task force (n=6) on the DSM-5-TR with information recorded in the Centers for Medicare and Medicaid Services Open Payments database during 2016-19. This period was chosen to include the year that development of the DSM-5-TR began and the three years preceding, a time consistent with previous research on conflicts of interest and consistent with the American Psychiatric Association’s disclosure requirements for the fifth revision (DSM-5) of the manual.

Main outcome measures: Type and amount of compensation the panel and task force members of DSM-5-TR received during 2016-19.

Results: After duplicate names had been removed, 168 individuals were identified who served as either panel or task force members of the DSM-5-TR. 92 met the inclusion criteria of being a physician who was based in the US and therefore could be included in Open Payments. Of these 92 individuals, 55 (60%) received payments from industry. Collectively, these panel members received a total of $14.2m (£11.2m; €13m). One third (33.3%) of the task force members had payments reported in Open Payments.

Conclusions: Conflicts of interest among panel members of DSM-5-TR were prevalent. Because of the enormous influence of diagnostic and treatment guidelines, the standards for participation on a guideline development panel should be high. A rebuttable presumption should exist for the Diagnostic and Statistical Manual of Mental Disorders to prohibit conflicts of interest among its panel and task force members. When no independent individuals with the requisite expertise are available, individuals with associations to industry could consult to the panels, but they should not have decision making authority on revisions or the inclusion of new disorders.

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“Reducing the Treatment Gap” Poses Human Rights Risks

Cosgrove, L., Montenegro, C., Yarcia, L. E., D’Ambrozio, G., & Hannah, J. (2024). “Reducing the treatment gap” poses human rights risks. Health and Human Rights Journal.

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Full List of Publications

Cosgrove, L., Montenegro, C., Yarcia, L. E., D’Ambrozio, G., & Hannah, J. (2024). “Reducing the treatment gap” poses human rights risks. Health and Human Rights Journal.

Boussageon, R., Meunier, PY, Chanelière, M., Shaughnessy, AF, & Cosgrove, L. (2024). Is the ADA 2022-2023 clinical practice guideline for the management of type 2 diabetes reliable?. Medicine, 20(3).

Cosgrove, L. (2024). Financial conflicts of interest in the DSM—a persistent problem. BMJ, 384.

Cosgrove, L., Patterson, E. H., & Bursztajn, H. J. (2024). Industry influence on mental health research: depression as a case example. Frontiers in Medicine, 10, 1320304.

Boussageon, R., Meunier, P. Y., Chanelière, M., Shaughnessy, A. F., & Cosgrove, L. (2023). Are American Diabetes Association's new guidelines reliable?. Journal of Evaluation in Clinical Practice.

Lyus, R., Buamah, C., Pollock, A. M., Cosgrove, L., & Brhlikova, P. (2023). Global Burden of Disease 2017 estimates for Major Depressive Disorder: a critical appraisal of the epidemiological evidence. JRSM open, 14(9), 20542704231197594. https://doi.org/10.1177/20542704231197594

Cosgrove, L. & Shaughnessy, A. (2023). Becoming a Phronimos: Evidence-Based Medicine, Clinical Decision Making, and the Role of Practical Wisdom in Primary Care (2023). Journal of the American Board of Family Medicine. doi: 10.3122/jabfm.2023.230034R1

Herrawi, F., Marsico, C., Gamio Cuervo, Á, & Cosgrove, L. (Aug 2023). Possibilities for well being: Examining the resettlement experiences of Muslim women. Journal for Social Action in Counseling & Psychology, 15(1), 51-69 https://doi.org/10.33043/JSACP.15.1.51-69

R. Lyus, C. Buamah, A.M. Pollock, L. Cosgrove, P. Brhlikova. (Sept 1 2023). Global Burden of Disease 2017 estimates for Major Depressive Disorder: a critical appraisal of the epidemiological evidence. Journal of the Royal Society of Medicine, Open. DOI: 10.1177/20542704231197594/

Cosgrove, L., D'Ambrozio, G., Herrawi, F., Freeman, M., and Shaughnessy A (2023) Why psychiatry needs an honest dose of gentle medicine. Front. Psychiatry 14:1167910. doi:10.3389/fpsyt.2023.1167910

Criste, I., Halvorsen, I., Cosgrove, L., Naudet, F., (November 2022). New treatments for mental disorders should routinely be compared to psychotherapy in trials conducted for regulatory purposes. Lancet Psychiatry.

D'Ambrozio, G., Cosgrove, L., Lilly, S., & McCarthy, T. (2022). Harm reduction, humanistic psychology, and the CRPD. Journal of Humanistic Psychology.

Logan, J., & Karter, J. M. (2022). Psychiatrization of Resistance: The Co-option of Consumer, Survivor, and Ex-patient Movements in the Global South. Frontiers in Sociology, 7.

Logan, J. (2022). A confusion of tongues: Trauma, fantasy, and dissociation in Lacanian theory and the imperative for social change. Theory & Psychology, 32(5), 777-788.

Cosgrove, L., Mintzes, B., Bursztajn, H. J., D’Ambrozio, G., & Shaughnessy, A. F. (2022). Industry Effects on Evidence: A case study of long-acting injectable antipsychotics. Accountability in Research.

Barry, H. C., Cosgrove, L., & Slawson, D. C. (2022). Where Clinical Practice Guidelines Go Wrong. American family physician, 105(4), 350–352.

Cosgrove, L., Herrawi, F., & Shaughnessy, A. (2021). Financial conflicts of interest in psychopharmacology textbooks. Community Mental Health Journal.

Mintzes, B., Tiefer, L., & Cosgrove, L. (2021). Bremelanotide for low sexual desire in women: the fallacy of regulatory precedent. Drugs and Therapeutics Bulletin

Cosgrove, L., Logan, J. & Herrawi, F. (2021). Institutional corruption in psychiatric research and practice: Implications for humanistic psychology (accepted) The Humanistic Psychologist.

Herrawi, F., Logan, J., Cheng, C.-P., & Cosgrove, L. (2021). Global health, human rights, and neoliberalism: The need for structural frameworks when addressing mental health disparities. Journal of Theoretical and Philosophical Psychology.

Cosgrove, L., Mintzes, B., Bursztajn, H., Shaughnessy, A. (2021). Long-Acting Antipsychotics: Is What We Know Really So? Lancet Psychiatry.

Cosgrove, L., & Herrawi, F. (2021). Beware of equating increased access to mental health services with health equity: The need for clinical and epistemic humility in psychology. The Humanistic Psychologist. https://doi.org/10.1037/hum0000227

Cosgrove, L., Morrill, Z. & Karter J. (2021). Digital aripiprazole as a human technology. Economy and Society. https://doi.org/10.1080/03085147.2021.1908767

Cosgrove, L., Morrill, Z., Karter, J.M., Valdes, E., Cheng, C. (2021). The Cultural Politics of Mental Illness: Toward a Rights-Based Approach to Global Mental Health. Community Ment Health J. https://doi.org/10.1007/s10597-020-00720-6

Cosgrove, L., Naudet, F., Hogberg, G., Shaughnessy, A.S., Cristea, I. (2021) The reconceptualization of “treatment-resistant depression” as “difficult-to-treat depression.” The Lancet Psychiatry. DOI: https://doi.org/10.1016/S2215-0366(20)30416-8

Cosgrove, L., Karter, J.M., McGinley, M., Morrill, Z. (2020). Digital Phenotyping and Digital Psychotropic Drugs: Mental Health Surveillance Tools That Threaten Human Rights. Harvard Health and Human Rights.

Torgerson, T., Wayant, C., Cosgrove , L. et al (2020). Ten years later: a review of the US 2009 institute of medicine report on conflicts of interest and solutions for further reform. British Medical Journal Evidence-based Medicine. http://dx.doi.org/10.1136/bmjebm-2020-111503

Cosgrove, L., Karter, J., Morrill, Z., McGinley, M. (2020). Psychology and Surveillance Capitalism: The Risk of Pushing Mental Health Apps During the COVID-19 Pandemic. Journal of Humanistic Psychology. https://doi.org/10.1177/0022167820937498

Elder, K., Turner, K., Cosgrove, L., Lexchin, J., Shnier, A., Moore A., Straus, S., Thombs, B. (2020). Reporting of financial conflicts of interest by Canadian clinical practice guideline producers: a descriptive study. Canadian Medical Association Journal DOI: https://doi.org/10.1503/cmaj.191737

Cosgrove, L. & Shaughnessy A. (2020). Mental Health as a Basic Human Right and the Interference of Commercialized Science. Harvard Health and Human Rights. https://www.hhrjournal.org/volume-22-issue-1-june-2020/

Cosgrove, L., Morrill, Z., Yusif, M., Vaswani, A., Cathcart, S., Troeger, R., and Karter, J.M. (2020). Drivers of and solutions for the over-use of antidepressant medication in pediatric populations. Frontiers, Psychiatry. DOI: 10.3389/fpsyt.2020.00017

Gliklich, R., Leavy, M., Cosgrove, L. et. al (2020). Harmonized Outcome Measures for Use in Depression Patient Registries and Clinical Practice. Annals of Internal Medicine https://doi.org/10.7326/M19-3818

Cosgrove, L. & Vaswani, A. (2020). Fetal rights, the policing of pregnancy, and meanings of the maternal in an age of neoliberalism. Journal of Theoretical and Philosophical Psychology 40(1):43-53DOI: 10.1037/teo0000139

Cosgrove, L., Mills, C., Amsterdam, J. Heath, I. Akriti, Mehta; Kalathil, J., Shaughnessy, A. (2019). Global Mental Health. The Lancet. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)30945-6/fulltextt

Cosgrove, L. & Jureidini J. (2019). Why a rights-based approach to global mental health is not “anti-psychiatry.” Australian and New Zealand Journal of Psychiatry.

Cosgrove, L., Troeger, R., & Karter, J. M. (2019). “Do Antidepressants Work?” A Humanistic Perspective on a Long-Standing and Contentious Debate. The Humanistic Psychologist. http://dx.doi.org/10.1037/hum0000154

Cosgrove, L., Cristea, I., Shaughnessy, A., Mintzes, B., Naudet, F. (2019) Digital aripiprazole or digital evergreening? A systematic review of the evidence and its dissemination in the scientific literature and in the media. BMJ EBM 10.1136/bmjebm-2019-111204

Cosgrove, L., Mills, C., Karter, J. Mehta, A., Kalathil, J. (2019). A critical review of the Lancet Commission on global mental health and sustainable development: Time for a paradigm change. Critical Public Health. https://doi.org/10.1080/09581596.2019.1667488

Cosgrove, L., Erlich, D., Shaughnessy, A. (2019). No magic pill: A prescription for enhanced shared decision-making in the treatment of depression. Journal of the American Board of Family Medicine

Hess, C. Karter, J, Cosgrove, L. Hayden, L. (2018). Evidence-Based Practice: A Comparison of International Clinical Practice Guidelines and Current Research on Physical Activity for Mild to Moderate Depression. Translational Behavioral Medicine

Cosgrove, L. & Karter, J. (2018). The Poison in the cure: Neoliberalism and contemporary movements in mental health. Theory and Psychology.

Cosgrove, L. Karter, J. & Vaswani, A. Corruption in Psychiatry (2018). Social and Personality Psychology Compass.

Vaswani, A., Karter, J., Cosgrove, L. , Peters, S. Brodt, M. (2018). Depression Screening during pregnancy and the postpartum period: Enhancing informed consent practices. Women’s Reproductive Health.

Cosgrove, L. Peters, S. Karter, J. Vaswani, A. The Problem with Decontextualized Approaches: Response to Commentators. Women’s Reproductive Health (2018).

Vannoy S, Brodt M, Cosgrove L, Shaughnessy AF. Variation in analytic transparency in recent efficacy studies of antidepressant medication. BMJ Evidence-Based Medicine 2018; 23(5):177-182. PMID 29950314 DOI:10.1136/bmjebm-2018-110947

Cosgrove, L. Karter, J. Vaswani, A., Thombs, B. Unexamined assumptions and unintended consequences of routine screening for depression (2018). Journal of Psychosomatic Research.

Kamens, S. R., Cosgrove, L., Peters, S. M., Jones, N., Flanagan, E., Longden, E., …. & Lichtenberg, P. (2018). Standards and guidelines for the development of diagnostic nomenclatures and alternatives in mental health research and practice. Journal of Humanistic Psychology, 0022167818763862.

Cosgrove, L. Shaughnessy, A.S., Shanyefelt, T. (2018). When is guideline not a guideline? The devil is in the details. BMJ EBM.

Simons, P., Cosgrove, L., Shaughnessy, A. and Bursztajn, H. (2017). Antipsychotic Augmentation for Major Depressive Disorder: A Review of Clinical Practice Guidelines. International Journal of Law and Psychiatry.

Thombs, B; Saadat, N; Riehm, K.; Karter, J.; Vaswani, A.; Andrews, B. Simons, P.; Cosgrove, L. (2017). Consistency and Sources of Divergence in Recommendations on Screening: A Comparison of Recommendations from the Canadian Task Force on Preventive Health Care, UK National Screening Committee, and US Preventive Services Task Force, BMC Medicine.

Shaughnessy A, Vaswani A, Andrews B, D’Amico, F, Lexchin, J. and Cosgrove, L. (2017). Developing a clinician-friendly tool to identify useful clinical practice guidelines: G-TRUST. Annals of Family Medicine.

Cosgrove, L. Shaughnessy, A.S., Peters, S., Lexchin, J., Bursztajn, H., Bero, L. (2017). Conflicts of Interest and the Presence of Methodologists on Guideline Development Panels: A Cross Sectional Study of Clinical Practice Guidelines for Major Depressive Disorder. Psychotherapy and Psychosomatics.

Cosgrove, L., Krimsky, S. Wheeler, E., Peters, S. Brodt, M. Shaughnessy, A.S., (2016). Conflict of Interest Policies and Industry Relationships of Guideline Development Group Members: A Cross-Sectional Study of Clinical Practice Guidelines for Depression. Accountability in Research. DOI: 10.1080/08989621.2016.1251319.

Shaughnessy, A. S., Cosgrove, L. Lexchin, J. (2016). The need to regulate clinical practice guidelines. Journal of the American Board of Family Medicine. 29:644–8. doi:10.3122/jabfm.2016.06.160115

Cosgrove, L., Mintzes, B., Vannoy, S., Shaughnessy A. F., (2016). Under the influence: Industry, publishing, and drug regulation. Accountability in Research, 24, 1-23.

Whitaker, R. and Cosgrove, L. (2015). Long-term use of psychiatric drugs. The British Medical Journal, 350, h2953.

Cosgrove, L. et al. (2015). From Caveat Emptor to Caveat Venditor: Time to stop the influence of money on practice guideline development. Journal of Evaluation in Clinical Practice, 20, 809-812.

Cosgrove, L., Krimsky, S. Wheeler, E., Katz, J. Greenspan, S. DiPentima, N. (2014). Tripartite Conflicts of Interest and High Stakes Patent Extensions in the DSM-5. Psychotherapy and Psychosomatics, 83, 106-113.

Gordon, R. M. & Cosgrove, L. (2013). Ethical considerations in the development and application of mental and behavioral nosologies: Lessons from DSM-5. Psychological Injury and Law, 6, 330-335.

Cosgrove, L., & Wheeler, E. E. (2013). Drug firms, the codification of diagnostic categories, and bias in clinical guidelines. Journal of Law and Medical Ethics, 14, 644-653.

Cosgrove, L., Shaughnessy A. F., Erlich, D. R., Wheeler, E. E., Bursztajn, H. J. (2013). Conflicts of interest and the quality of recommendations in clinical practice guidelines. Journal of Evaluation in Clinical Practice, 19, 674-681.

Cosgrove, L., & Wheeler, E. E. (2013). Industry’s colonization of psychiatry: Ethical and practical implications of financial conflicts of interest in the DSM-5. Feminism & Psychology, 23, 93-106.

Cosgrove, L., & Krimsky, S. (2012). A comparison of DSM IV and DSM-5 panel members’ financial associations with industry: A pernicious problem persists. PLoS Medicine, 9(3), e1001190.

Gopal, A., Cosgrove, L., Shuv-Ami, I., Wheeler, E. E., Yerganian, M., & Bursztajn, H. J. (2012). Systematic review of the iatrogenic harms of SSRIs and SNRIs: Implications for the informed consent process. International Journal of Law and Psychiatry, 35, 392-397.

Cosgrove, L., Shaughnessy A. F., Kirsch, I, Wheeler, E. E., Austad, K. E., & Bursztajn, H. J. (2012). An analysis of the American Psychiatric Association’s guidelines on major depressive disorder. Psychotherapy and Psychosomatics, 81, 186-189.

Cosgrove, L. and Shaughnessy A. (2011). Conflicts of interest in clinical practice guidelines. International Journal of Person Centered Medicine 4, 507-513.

Cosgrove, L., Ling, S., Creasey, D., Anaya-McKivergan, MS; Myers, J. Huybrechts, MS. (2011). Antidepressants and breast and ovarian cancer risk: A systematic review of the epidemiological and pre-clinical literature and researchers’ financial associations with industry. PLoS ONE, 6, 1-8.

Cosgrove L. (2011). The DSM, Big Pharma, and Clinical Practice Guidelines: Protecting Patient Autonomy and Informed Consent. International Journal of Feminist Bioethics, 4, 11-25.

Gopal, A., Cosgrove, L. Bursztajn, H. (2010). The public health consequences of an industry-influenced psychiatric taxonomy: “Attenuated psychotic symptoms syndrome” as a case example. Accountability in Research, 17, 264-69.

Cosgrove, L. & Bursztajn, H. (2010). Undue pharmaceutical influence on psychiatric practice: Steps that can reduce ethical risk. Psychiatric Times 27, 36-38.

Cosgrove, L. & Bursztajn, H. (2010). Strengthening conflict-of-interest policies in medicine. Journal of Evaluation in Clinical Practice 16, 21-24.

Cosgrove, L. & Bursztajn, H. (2010). Pharmaceutical Philanthropic Shell Games: Has Industry Removed the Transparent and Replaced It with the Opaque? Psychiatric Times 27, 1-3.

Cosgrove, L., Bursztajn, H., Krimsky, S. (2009). Developing unbiased diagnostic and treatment guidelines in psychiatry. New England Journal of Medicine, 360, 2035-2037.

Cosgrove, L., Bursztajn, H., Krimsky, S., Anaya, M. & Walker, J. (2009) Conflicts of interest and disclosure in the American Psychiatric Association’s clinical practice guidelines. Psychotherapy and Psychosomatics, 78, 228-232.

Cosgrove, L. & Bursztajn, H. (2009). Toward credible conflict of interest policies in psychiatry. Psychiatric Times, 26, 40-41.

Pearrow, M. & Cosgrove, L. (2009). The aftermath of combat-related PTSD: Understanding transgenerational trauma. Communications Disorders Quarterly, 30, 77-82.

Cosgrove, L., Pearrow, M. & Anaya, M. (2008). Toward a new paradigm for psychiatric diagnoses and clinical research in sexology. Feminism & Psychology, 18, 457-465.

Cosgrove, L. & Konstam, V. Forgiveness is not forgetting—or is it? (2007). A critical analysis of the meaning of forgiveness. Journal of Mental Health Counseling, 30, 1-13.

Cosgrove, L. & Bursztajn, H. (2007) Undoing undue industry influence: Lessons from psychiatry as psychopharmacology. Journal of Organizational Ethics, 3, 131-133.

Cosgrove, L. (2007). Humanistic psychology and the crisis of reason. The Humanistic Psychologist, 35, 15-25.

Cosgrove, L., Krimsky, S., Vijayraghavan, M. & Schneider, L. (2006). Financial ties between DSM-IV panel members and the pharmaceutical industry. Psychotherapy and Psychosomatics, 75, 154-160.

Cosgrove, L. (2005). When labels mask oppression: Helping counselors in training to think critically about psychiatric diagnosis. Journal of Mental Health Counseling, 27, 283-296.

Cosgrove, L. & Flynn, C. (2005). Marginalized mothers: Parenting without a home. Analysis of Social Issues and Public Policy, 5, 127-143.

Cosgrove, L. (2004). What is postmodernism and how is it relevant to engaged pedagogy? Teaching of Psychology, 31, 171-177.

Cosgrove, L. (2004). The aftermath of pregnancy loss: A feminist critique of the literature and implications for treatment. Women & Therapy, 27, 107-122.

Cosgrove, L. (2003). Feminism, postmodernism, and psychological research. Hypatia: A Journal of Feminist Philosophy, 18, 85-112.

Cosgrove, L., & Riddle, B. (2003). Constructions of femininity and experiences of menstrual distress. Women & Health, 38, 37-58.

Davidson, L., & Cosgrove, L. (2003). Psychologism and phenomenological psychology revisited, Part II: The return to positivity. Journal of Phenomenological Psychology, 33, 141-177.

Cosgrove, L. (2002). Resisting essentialism in feminist therapy theory: Some epistemological considerations. Women & Therapy, 25, 89-112.

Cosgrove, L. (2000). Crying out loud: Understanding women’s emotional distress as both lived experience and social construction. Feminism & Psychology, 10, 247-267.

Cosgrove, L., & McHugh, M.C. (2000). Speaking for ourselves: Feminist methods and community psychology. American Journal of Community Psychology, 28, 815-838.

Davidson, L., & Cosgrove, L. (1991). Psychologism and phenomenological psychology revisited: The liberation from naturalism. Journal of Phenomenological Psychology, 22, 87-108.

Bolded Names = Current BEAHR Lab Members