Financial conflicts of interest and disclosure in clinical practice guidelines for bipolar disorder and major depressive disorder in Japan

Abstract

Abstract Clinical practice guidelines (CPGs) are essential for standardizing patient care based on evidence-based medicine. However, the presence of financial conflicts of interest (COIs) among CPG authors can undermine their credibility. This cross-sectional analysis of disclosed payments from pharmaceutical companies assesses the prevalence and magnitude of personal payments for lecturing, consulting, and writing to CPGs for bipolar disorder and major depressive disorder in Japan between 2016 and 2020. This study found that 93.5% of authors received payments over a five-year period, with total payments exceeding $4 million. The median payment per author was $49,422 (interquartile range: $7,792 – $111,567), with a notable concentration of payments among a small number of authors, including the CPG chairperson. Despite these extensive financial relationships, only a fraction of authors disclosed their COIs in the CPGs. These large amounts of personal payments were made by pharmaceutical companies manufacturing new antidepressants and sleeping aids listed in the CPGs. The findings highlight deviations from international COI management standards and suggest a need for more stringent COI policies for psychiatry CPGs in Japan.