Is Moncrieff’s Chemical Imbalance Paper a Decent Systematic Umbrella Review?

James Coyne


        My recent Substack article continues to build my case against what Joanna Moncrieff calls a systematic umbrella review of the serotonin theory of depression. In this installment, I introduce the formal criteria for an umbrella review. I set the stage for readers to scratch their heads and conclude her umbrella is not a decent one.

        Critiquing Moncrieff is a lonely process, in part because ours are intimidated by the hordes of ruthless followers she incited by a well-resourced and carefully planned campaign. I have a begrudging admiration for her success in confusing many people. She is largely seen as a psychiatrist who has principled objections to what other corrupt psychiatrists are doing to their profession, their patients and all of humanity.

        I do not have the luxury of simply going with my intuitions. I will be held to higher standards by those on both sides of what is essentially a political battle. I have to build a substantive, methodological and statistical case that might rescue some smart people who do not think critically enough.

        I urge you to click on the link and read my Substack. Please encourage family and friends and people sitting around the pool to open this link and hopefully then add your name to my growing free mailing list.

Is Moncrieff’s Chemical Imbalance Paper a Decent Systematic Umbrella Review? Part 1

        It’s easy to get lost in the flood of publicity that Joanna Moncrieff and her colleagues whipped up for her chemical imbalance systematic umbrella review. With obvious pride, Moncrieff reports her review smashed records for the immediate attention it received, like being accessed at the Nature Molecular Psychiatry website a phenomenal 413,000 times.

        This publicity campaign seriously distorts the search results anyone obtains by entering <serotonin> or < chemical imbalance> in an engine like Google Chrome. Articles and blogs and even tweets from whoever got swept up in Moncrieff’s anti-psychiatry/critical psychiatry parade dominate the results of a search, at least for a while.

        Moncrieff’s SUR team had to have started well before December 2020, the time-stamped registration date of her protocol for the review. Her group had lots of time to prepare nonacademic articles that would actually be more important for her surprise attack than the SUR in the prestigious Molecular Psychiatry itself.

        It is a mindless, unthoughtful frenzy on social media. Few of Moncrieff’s even most hardcore followers tweeting in the middle of the night have read the mind-numbing systematic umbrella review (SUR) on their smartphones, rather than just the tweets or the much lighter-weight articles about the SUR on The Conversation or The Guardian.

        Let’s get serious. Who really clicks on the links in Tweets and accesses and reads scientific articles before liking and retweeting tweets, despite Twitter’s lame warning that we should do so?

        The startled psychiatrists Moncrieff sought to embarrass can get off some kneejerk responses or maybe have some article lying around that was relevant that they could post.

        Otherwise, it takes time for any thoughtful response to be assembled. Patients, clinicians, and policymakers have to wait.

        To my knowledge, no one had yet addressed whether Moncrieff‘s SUR is even a decent effort. That is a vital question to answer before getting involved in serious discussion on social media where hateful trolls and bots are likely to have a lot of undue influence.  

        I decided to put together materials useful in assessing the aim and validity of a SUR. I will describe the steps involved so that my effort could be duplicated by anyone else.  Inevitably we will face another t such propaganda campaign disguised as a detached consideration of the biomedical literature.

An example of a systematic umbrella review

        I already had in my files a SUR article in BMJ from 2018.

        O’Sullivan JW, Muntinga T, Grigg S, Ioannidis JP. Prevalence and outcomes of incidental imaging findings: an umbrella review. BMJ. 2018:18;361.

        I recommend the article as a superbly done and well-described SUR, even if you have zero interest in incidental imaging findings.


October 13, 2022