Plain-speaking or rude? Row over ‘disparaging’ psychiatry paper

UCL and King’s researchers clash over ‘sarky’ critique of paper that questioned root causes of depression

June 26, 2023
Source: istock

A bitter row has broken out after a professor claimed that harsh criticism of her study on the effectiveness of antidepressants had overstepped the conventions of scholarly disagreement.

The bust-up comes after Molecular Psychiatry published a comment on 16 June, “A leaky umbrella has little value”, which criticised a literature review published in the journal last year that had questioned whether there was strong evidence that depression was caused by low serotonin levels.

Antidepressants are thought to treat this chemical imbalance in the brain, but according to the 2022 study led by UCL psychiatry professor Joanna Moncrieff, the “serotonin theory of depression is not empirically substantiated”.

However, the recent comment signed by 36 leading scientists was highly critical of its findings. It drew attention to what it called the review’s “inherent methodological weaknesses” and the use of “antiquated” concepts of brain science. It also attacked “simplistic misinterpretation” of evidence, concluding that the study’s “methodology is inconsistent with an umbrella review, with substantial bias created by the authors’ chosen quality criteria, selective reporting, and interpretation of results”.

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The comment’s lead author, Sameer Jauhar, senior clinical lecturer in affective disorders and psychosis at King’s College London, claimed that the study made “fundamental errors pertaining to the scientific method”. Another co-author, David Nutt, head of the centre for neuropsychopharmacology at Imperial College London, told the Mail on Sunday that it was “full of flaws” and should be retracted.

However, Professor Moncrieff said she rejected the “untrue” claims, which she felt had been made in an unnecessarily disparaging way. “It’s written in a very sarky tone by leading figures who clearly did not want us to do this research and who are not used to being challenged,” she told Times Higher Education.

“It is quite normal for people to write letters to the editors of scientific journals, sometimes with points of disagreement, and for authors to reply – what is unusual here is the authors of the letter are trying to orchestrate a media campaign about a paper they don’t like.”

A statement published by King’s did not mention a detailed rebuttal of the comment’s arguments published on the same day, she added. “Anyone who read the press release would have had the impression that this was a new article raising criticisms that we had not, and maybe could not, respond to,” wrote Professor Moncrieff in a recent blog.

The “umbrella review” undertaken by Professor Moncrieff’s team followed established protocols on what type of literature would be excluded from the review, she added, although the critical researchers claim that it ignored relevant documents that contradicted her claims.

Carmine Pariante, professor of biological psychiatry at King’s and a co-author of the recent statement, defended the paper’s robust criticisms. “If the language matches the intensity of our criticism, this may help to rectify the message sent out by this paper,” said Professor Pariante.

Dr Jauhar told THE that the authors felt compelled to comment because Professor Moncrieff’s study appeared to suggest that antidepressants did not work, despite large amounts of supporting evidence. “The degree of certainty that the authors had just bowled us over – their conclusions were completely out of step with those who had actually done the research that the study reviewed,” he said.

The 2022 paper had set “unrealistic” constraints on the type of evidence that could be included in the review, given that studies using brain scans seldom involved more than 10 or so participants, added Dr Jauhar.

“It wasn’t just researchers who contacted us about this paper – we had lots of responses from the patient community who felt they were being shamed after being told they did not have a disorder,” he added.

“From a dispassionate scientific viewpoint, we also felt it was important that people knew about our concerns that this paper was making strong statements without evidence.”

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