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

James Coyne


James Coyne’s response to Jay Amsterdam


Dear Jay:

I am surprised that you consider Joanna Moncrieff's systematic umbrella review to be "excellent." I assume you are not being sarcastic.

You know a lot more about neuropsychopharmacology than I do. Hopefully, almost everyone to whom you sent this email does. But what I know about reviews of all kinds suggest that Moncrieff's review is that it is a crime against science.

I have done a lot of searching of systematic umbrella reviews on Google Scholar. I find none that remotely resembles it, although lots of admonitions not to anything that resembles it.

I have begun to write Substack articles to provide others with the tools to figure that out for themselves.

You do not have to open it. You know my forensic interrogation of a paper can be devastating. I will share some clues I have. 

The altmetrics for her Molecular Psychiatry paper indicate that it has been viewed 455,000 in a few weeks, which breaks all records for that journal and is in the .001 percentile for all papers in the same time period.

How do I establish that is not because of the brilliance of her science? 

The altmetrics indicate there were more than 7,000 tweets about the paper. I investigated them. A few of the Twitter accounts have more than 1 million followers, a rarity in itself. 

Below are screenshots from former U.S. House of Representative’s Tulsi Gabbard tweets. One is in reference to “Big Pharma.” (Note that it got 31,000 likes).  Another is Tulsi's Twitter description of herself as a 2020 Presidential candidate. She is a hero of the anti-vaxxers and conspiracy theorists. There are other prominent anti-vaxxers among the tweeters praising Moncrieff's Molecular Psychiatry article but no scientists or practicing psychiatrists. 

Jay, you would be interested in the many fans of Moncrieff’s paper with few followers. Many are obviously bots or fake accounts; others feel damaged by psychiatry. Many claim to have been diagnosed with bipolar 2 disorder and to have been horribly treated. I think we can all agree that is likely. There was almost no one who claimed they were diagnosed as schizophrenic, but a few who claimed that they were libeled with a diagnosis of borderline personality disorder. Apparently, there is a movement to sue psychiatrists for libel or defamation.

Moncrieff tells her followers how to interpret her review (obviously most will need help) in “How to take the news that depression has not been shown to be caused by a chemical imbalance.”

There are a lot of things said in the bulk of this blog post with which you and I would agree. Then she gets to the zinger that at least some of us in reading this email would consider bordering on criminal because it leaves patients in crisis with no options:

“Some people get very severely depressed. They might lose touch with reality and think everyone is against them (this is sometimes called ‘psychotic depression’) and some even try to take their own lives. It is tempting to think that in these cases medication is more effective, but this has not been shown to be the case.  The severity of depression has no effect or a small effect on people’s response to antidepressants in placebo-controlled trials and an analysis found that studies involving people in hospital who have the most severe forms of depression did not show antidepressants to be very effective. It is important to keep people safe in these situations, and to remember that the vast majority of people do recover from depression eventually – although it may take months and for some even a few years.”

Moncrieff carelessly left a note to her first-distribution list on the website of the Critical Psychiatry website, like a note on the refrigerator that should have been taken down. All of the names on the list have seriously harassed me and, while they were alive and fighting on social media, John “Mickey” Nardo and Bernard “Barney” Carroll.

One of Moncrieff's closest allies is John Read, known for organizing letter-writing campaigns to get psychiatrists fired or declared unfit to practice. A recent president of Royal College of Psychiatry, Wendy Burn resigned early and began tweeting about cooking because she could not take the stress.

Another, Robert Whittaker, in his paper “The Holocaust, Biological Psychiatry and a Shift Toward a More Humane Psychiatry Today,” argues that contemporary psychiatrists should ask forgiveness and stop what they are doing because they are intellectual descendants of Nazis.

Whittaker is actually summarizing John Read's article published in an obscure and more unsavory place. The Whittaker article is worth accessing if only for sick comments it elicited

And John Read and Jeffrey Masson’s “Biological Psychiatry and the Mass Murder of “Schizophrenics”: From Denial to Inspirational Alternative. Ethical Human Psychology and Psychiatry.”

I am very familiar with Read's warped analysis. All I will say here is that he fingers poor Franz Joseph Kallmann as a prominent Nazi. Actually, Franz was Jewish and barely escaped the gas chambers, settling at Columbia. Eugenics started in Virginia and California. Ironically, in California, people of Jewish descent were targeted for sterilization because their offspring were likely to be imbeciles or criminals. I am prepared to document these claims because they sound so crazy and would be willing to debate anyone in public.

I know, this is all circumstantial evidence, but sometimes such evidence can be substantial.

I will stop here. I hope reading this long email was useful to some. It will be repurposed as the basis for a Substack story.


November 24, 2022