Editor’s Note: This is the cover letter that Michael Corrigan and I sent to Niall Boyce, editor of Lancet Psychiatry, requesting that the journal retract Martine Hoogman’s study of “subcortical brain volumes” in those diagnosed with ADHD.
(Lancet Psychiatry’s response is below.)
Dear Niall Boyce:
As you may know, Mad in America Foundation has published a critique of Martine Hoogman’s study of “subcortical brain volumes” in those diagnosed with ADHD, which was published online by Lancet Psychiatry on February 15. We have also put up a petition calling for its retraction, which has now been signed by more than 800 people, including a number of researchers.
We are writing today to formally request that Lancet Psychiatry retract the study.
While there are many problems with this study, there are two scientific flaws that, in particular, argue for its retraction:
a) Hoogman and her collaborators write, in their abstract, that the “volumes of the accumbens, amygdala, caudate, hippocampus, putamen, and intracranial volume were smaller in individuals with ADHD compared with controls.”
The key phrase here is “individuals”, which was a phrase repeated in the text and in media headlines around the world. This study was said to show that individuals in the ADHD cohort had smaller brain volumes than normal.
As you know, the effect sizes for these five volume comparisons were small. This meant that the data showed that the distribution curves for individual brain volumes mostly overlapped. The fatal scientific flaw here is obvious: You cannot take a small difference in mean volumes from two groups and state that the small difference is characteristic of individuals in the two cohorts, and is thus a distinguishing feature of ADHD. The conclusion is false.
b) The authors state, in the abstract, that they “refute medication effects on brain volume suggested by earlier meta-analyses.”
This is a definitive claim about a controversial issue, particularly since they are touting their study as more compelling than the earlier meta-analyses. But they give no data in the article that supports their claim. They state that there was no significant difference in brain volumes in ADHD patients who never took stimulant medication and those who did at some point, but they don’t provide any comparative data, or tell readers anything meaningful about the medication-naïve and medication-exposed groups.
As such, they make a conclusive statement in the abstract that is unsupported by any supporting data in the text, and that goes against standard principles that govern publication in a scientific journal.
There are other problems with the study that provide reason to question the validity of even the small differences in mean brain volumes of the two groups, many of which we have set forth in our published critique.
We understand that the authors are now stating that the IQ scores they published in the appendix were in error (perhaps they spotted that error after we wrote about IQ scores in our critique and in the petition.) While their correction removes this element as a reason for retraction, the fact that it was misreported in the first place provides reason to question the accuracy of other reported data.
In sum, Lancet Psychiatry published a study that generated misleading media headlines around the world, which have served to misinform the public about what is known about ADHD. This misinformation will be profoundly stigmatizing to children so diagnosed, and cause parents of such children to think of them as having “smaller brains than normal.” As such, this is a case of a scientific journal, by publishing an article with a false conclusion, of “doing harm.” For that reason, we respectfully request that Lancet Psychiatry retract the study, and inform the media of the reasons why this retraction was necessary.
We look forward to your response.
Michael Corrigan, Ed.D.
Robert Whitaker, Mad in America Foundation
Response from Niall Boyce:
Many thanks for your email, Robert. We will be publishing a set of letters critiquing the paper with an author response online and subsequently in print. I anticipate that the authors will also address these points in their response.
All best wishes—
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.
Neurodiversity is an approach to learning and disability that argues diverse neurological conditions are result of normal variations in the human genome.
Allow those who are “non-neurotypical” to live their lives as they are, rather than being coerced or forced to conform to a clinical ideal.
ADHD/ADD, dyslexia, bipolarity and other neurotypes are natural human variation not pathology or disorder, reject the idea that neurological differences need to be (or can be) cured, as they are authentic forms of human diversity, self-expression, and being.
I am like the poster kid for so called ADHD, I don’t even think it is “neurological” its just the way I think almost like my computer has windows instead of Apple. Its my software not hardware, its just who I am.
I am just old enough to have finished school before the mass drugging of children that really started ramping up in the mid 1990s. They would have targeted me for sure. What difference would it have made if they drugged the hell out of me in school, if I was high on amphetamines for my entire childhood and got better grades ? My high-school GPA means nothing now, the school isn’t even there anymore, I don’t think its even possible to get a copy of my grades.
Amphetamines do “work” I have taken the ADHD drugs, you can study and do better on a test that day but take the same test a year later without preparation and you will find out its a real short term effect.
Neurodiversity is an interesting social movement however I have yet to see any data to back up the theory. If you have any please share.
I do however think that people with different personalities should not be give medical labels or offered medical treatment.
I said “so called” for a reason. And I think it would be good if that neurodiversity idea gains traction, then when psych calls everything neurological even if its fake science they will still look bad.
1 in 5 boys “has” ADHD, a DNA defect , whats next will dermatologists say that white people have defective skin when one in five people on earth fit this description ?
The overarching problem is of course that ADHD is not a real disease to begin with. People “diagnosed with” ADHD do NOT have something called ADHD. So any study which starts with such an assumption is inherently flawed. Where’s the so-called “evidence base”?
Nice letter, Bob.
Although, I believe Oldhead is correct that ADHD is not a real disease to begin with, and that arbitrarily assuming that some people “have it” based only on having several out of a checklist of subjectively judged behaviors is very problematic.
Please check out my comment in response to you on the blog about “spirituality.”
I’m not sure if I managed to share this information about another Lancet lie which they have been refusing to rescind for awhile now. It has taken the ME/CFS community years of fighting first of all to expose the cover-up of misinformation. But as in the case written about here, the misinformation has been broadcast so far and wide that it has caused extensive damage of immense proportions. I know it sounds dramatic when I say this, but it really has caused death, deterioration and debilitation which is immeasurable for countless patients.
Here’s a bread crumb https://www.healthrising.org/forums/threads/new-york-times-opinion-piece-slams-pace-trial-and-lancet.5328/
But, if for some reason links aren’t able to be posted in the comments here, I implore you to search the terms Lancet, PACE, ME/CFS, NY TIMES