Although mental-health-related websites are generally biased in favor of a biological explanation of mental illness and drug treatments, those owned or funded by pharmaceutical companies tend to be more biased than others and, thus, “cannot be considered an objective source of mental health information for the public or practitioners,” according to a study published this month in the journal Acta Psychiatrica Scandinavica.
“The pervasive international influence of the pharmaceutical industry in all aspects of mental health policy, practice and research now clearly extends to the internet,” the study concludes.
This finding has important significance for health consumers, including those who rely on information recommended to them by their physicians. For, as the study points out, the “recommendation of websites by health professionals has become standard practice and the industry, therefore, actively works to get them to recommend websites favorable to drug sales.”
A 2010 survey of Australian general practitioners found, for example, that 71 percent had been offered “enticements” by drug companies to recommend specific industry-sponsored websites to their patients, and some 62 percent of the practitioners had done so.
A bias toward medication
Led by clinical psychologist John Read of the University of Auckland, the new study began with a literature review of all previous studies from around the world that investigated the role of drug companies in mental-health-related websites. They found nine such studies — a “disappointingly small number,” notes Read, given the power of the Internet to shape public opinion on health matters.
Read is up front about the fact that he was a co-author of six of those studies. “Readers are therefore encouraged to examine and judge the evidence by accessing the six papers” themselves, he writes.
Some 42 percent of the websites investigated in the nine studies were either owned or openly funded by drug companies. Read then conducted a meta-analysis of the content of both those and the non-drug-company-connected sites. He found that the sites funded by a drug company were significantly more likely to promote a biological view of a mental-health problem and to emphasize drug treatments over talk therapy and other psychosocial interventions.
Such sites were, for example, 15 times more likely to emphasize medication rather than psychosocial interventions for attention deficit hyperactivity disorder (ADHD) and four times more likely to do so for depression.
“Despite research evidence that both biological and psychosocial factors play important roles in the development of most mental health problems, and that both medical and psychosocial interventions can be helpful, this review confirms that, overall, the information available on the internet is biased toward the biological,” Read concludes.
“This bias is significantly exacerbated by the pervasive involvement of the pharmaceutical industry,” he adds.
‘Excessive influence’
Read has some very strong words about the pharmaceutical industry’s influence on practitioners and patients alike:
Drug companies have been shown to exercise excessive influence in multiple mental health related domains, including drug trials, research funding in general, scientific journals, psychiatry conferences, professional organizations, medical training, government policy, clinical guidelines, drug regulation bodies and prescribing by individual doctors; and the industry uses this influence to promote a biological illness view of [the causes of mental illness] and to market its drugs.
Current examples include 69 percent of the current DSM-V Task Force having ties with the industry, and GlaxoSmithKline being fined $3 billion, in 2012, after ‘admitting a multiyear criminal scheme to hide unhelpful scientific evidence, influence articles in medical journals and lavish gifts on sympathetic doctors.’
The Internet, Read points out, offers drug companies an “ideal opportunity to shape public opinion in ways designed to increase sales,” either by funding its own websites or by funding those of cash-strapped non-profit organizations.
“A modest first step toward countering the misinformation promulgated by the industry,” he concludes, “might be for mental health practitioners to warn their patients about the bias of websites owned or funded by drug companies, and to recommend more balanced sites instead.”
Unfortunately, Read's study is behind a paywall.