Concerns increasingly have been raised about the influence of pharmaceutical companies on doctors and their practice of medicine. The pharmaceutical industry has grown in profitability and influence over the past twenty years and is now second only to armaments in the U.S. economy (Public Citizen, 2002). Guidance is available from most Royal Colleges on the appropriateness of using finances/gifts and other benefits from pharmaceutical companies. A declaration of conflict of interest is required for most journals, and evidence shows that there are signs of a small but increasing proportion of articles declaring competing interests in some journals (Hussein and Smith, 2001). Concerns are probably greater in psychiatry, as psychiatric research is particularly susceptible to the influence of vested interests because of the subjective nature of diagnosis and outcome, the variable course of most psychiatric disorders, and the importance of placebo effects, including the context of participating in a research project (Moncrieff et al., 2005).
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