IRCCS Santa Lucia Foundation, Rome, Italy.
Int Rev Psychiatry. 2010;22(3):281-7. doi: 10.3109/09540261.2010.484014.
Conflicts of interest may influence medical research. In particular, the study on psychotropic treatment of ageing subjects suffering from neurological disorders and comorbid neuropsychiatric phenomena may be hypothetically considered economically non-advantageous, or even of negative impact on drug reputation, because of the high probability of non-response or side effects. Thus, studies on this issue may be disregarded from industry. We aimed to verify whether the global commitment of medical research reflects the actual relevance of depression in the world ageing population, associated or not with neurological conditions. Here, we: 1) have reviewed the literature on this issue, 2) have examined world published data concerning population by age, burden of disease and frequency of depressive disorders and antidepressant therapies, and 3) have reviewed the frequency of published papers on depression and its treatment associated with three neurological conditions. The overall rate of papers about depressive disorders in ageing people reflects adequately the world population and the prevalence of depression in the elderly. However, the rate of papers concerning medical experimentation for antidepressant treatment in Alzheimer's disease, Parkinson's disease and stroke is quite inadequate with respect to the rate of depressive disorders associated to these conditions. Thus, innovative medical experimentation must be encouraged, also in areas apparently of dubious economical advantage but of undoubted clinical relevance and the adoption of strategies to limit the detrimental effect of conflicts of interest in research must be enhanced.
利益冲突可能会影响医学研究。特别是，对于患有神经障碍和共病神经精神现象的老年患者的精神药物治疗研究，由于无反应或副作用的可能性较高，可能在经济上处于不利地位，甚至对药物声誉产生负面影响。因此，该领域的研究可能会被制药行业忽视。我们旨在验证医学研究的全球投入是否反映了与神经状况相关或不相关的世界老年人口中抑郁症的实际相关性。在这里，我们：1）对该问题的文献进行了综述，2）研究了有关年龄、疾病负担和抑郁障碍及抗抑郁治疗频率的世界发表数据，3）审查了与三种神经状况相关的抑郁症及其治疗的已发表论文的频率。关于老年人群中抑郁障碍的论文总数充分反映了世界人口以及老年人中抑郁症的患病率。然而，关于与这些情况相关的抑郁障碍的医学实验治疗的论文比率与阿尔茨海默病、帕金森病和中风相关的抑郁障碍比率相比相当不足。因此，必须鼓励进行创新性的医学实验，即使在经济上看似没有明显优势的领域，也要考虑到其临床相关性。还必须加强限制研究中利益冲突不利影响的策略。
