U of Minnesota psychiatry chief steps down after concerns about research protocols
By Jeremy Olson
April 9, 2015
While Dr. Charles Schulz will continue clinical care and research in the department he has led since 1999, Thursday’s announcement that he is stepping down reflects a metamorphasis for a university that even a month ago was adamantly defending his department against claims of coercive recruiting of vulnerable patients into research.
“Changing one person — it’s not like switching a light switch” and problems will be fixed, said Leigh Turner, a U bioethicist who has demanded changes in administration due to problems with psychiatric research. “But there is a symbolic dimension to it. A chair is a symbolic face of a department. And this is a department that has been through a long period of controversy and questions about the conduct of its clinical trials.”
Much of the criticism has centered around the recruitment of Dan Markingson, who died by suicide in 2004 while enrolled in the university’s arm of a national study that compared the effectiveness of three antipsychotic drugs. Markingson was recruited at the time by Dr. Stephen Olson, a psychiatrist who was treating him, and running the study, and advising a judge on whether Markingson should be committed to a locked inpatient facility. Legislation following media coverage of this case in 2008 made this type of potentially coercive recruiting situation illegal.
Perceptions that this was a decade-old problem for the department were shattered in February when an external review, ordered by the university’s Faculty Senate, found that efforts to safeguard patients in psychiatric research were inadequate and do not “reflect the best efforts of a University of this caliber.”
A month later, Legislative Auditor James Nobles issued a report that was highly critical of the way Markingson was enrolled into the study and retained in it even after his mother expressed concerns that he was getting worse.
University President Eric Kaler responded last month by publicly apologizing to Markingson’s family and suspending recruitment to current psychiatric studies at the U until another independent review could assure they included sufficient patient protections and oversight.
On Wednesday, the university also announced a panel of experts to come up with a plan by mid-May to adopt the oversight and safety recommendations made by the Faculty Senate report.
None of this was reflected in Thursday’s statement by Dr. Brooks Jackson, the medical school dean, who commended Schulz and said the decision to step down was solely made by the psychiatrist to “clear the way for new leadership, and to allow him to focus more on clinical care.”
A 6- to 12-month search for a replacement will take place while Dr. Mark Paller, an associated dean of the medical school who is not a psychiatrist, serves as interim chairman of the department.
Schulz brought prestige and a track record for amassing research grants and studying the origins of schizophrenia when he took over the department 15 years ago. He had previously been psychiatry chairman at Case Western Reserve University in Cleveland, and chief of the schizophrenia research branch for the U.S. National Institute of Mental Health.
“It has been a privilege to lead a team of talented care providers who are committed to making a difference in the lives of patients and families dealing with mental illness,” Schulz said in a written statement provided by the university. “There is a great deal of work still to be done, and I look forward to supporting the new department head as we all work together to bring the best possible care to the patients we serve.”
Schulz has, like other doctors in recent years, been scrutinized for the thousands of dollars he has received from drug companies such as AstraZeneca, the sponsor of the study in which Markingson was enrolled. Schulz’ name surfaced in documents submitted in a lawsuit against AstraZeneca, indicating that back in 2000 he made statements about the superiority of the company’s new antipsychotic drug, Seroquel, that were more favorable than research indicated.
His departure from leadership won’t mean the end of scrutiny for the psychiatry department.
The FDA in 2005 had reviewed and cleared the university following Markingson’s death by suicide, but federal officials returned to campus last fall and revisited with Olson about that study. They also reportedly discussed the patient protections and oversight used in a similar federally funded comparison of antipsychotic drugs, and of a failed national clinical trial of a drug called bifeprunox for treatment of schizophrenia.