There is no other, more gentle way to say it: The Journal of Attention Disorders (JAD)–the prestigious academic home for research on ADHD–withholds critical information from its readers. Devout readers of Mad in America probably recall that, back in 2020, the JAD published an article by Merzon and colleagues with multiple omissions and distortions that created a false impression as if ADHD increases the risk for COVID-19 infections, and as if ADHD medications can mitigate this risk. But back then, the depth of the scientific misconduct was unknown to us.
We also assumed that the JAD, as a distinguished representor of objective and unbiased science, would not take an active part in the misrepresentation of the evidence. How naïve we were; we are only now starting to understand. Our goal in the current short article is therefore to share the worrisome lessons we have learned from our two-year-long saga–lessons that should trouble every honest scientist and every mental health patient.
Lesson #1: Scientists avoiding their data-availability declarations may have something to hide.
On August 5, 2020, shortly after Merzon and colleagues published their 2020 study on ADHD and COVID-19 infections, we sent them several requests to receive access to their data. It was our (naïve) position that the best strategy to examine the validity of their conclusions would be by inspecting the original data file, replicating the reported analyses, and completing additional (missing) analyses. Unfortunately, we were not granted this access, so we had to investigate the written, and essentially limited, information that was available to us at that time (through three publications by the same authors, which relied on similar data, and which were published at the same time).
We submitted this critique to the JAD, but the editor-in-chief refused to consider it for publication. In the decision letter we received he wrote: “It has come to my attention that you have also submitted this paper to another publication and released a version prior to any peer review. Therefore I am rejecting your submission.”
Our efforts to convince the editor of the JAD that the contemporary and highly common practice of uploading preprint versions to designated servers (especially since the outbreak of the COVID-19) only contributes to scientific transparency (along with our friendly reminder that we were the ones who “brought this matter to his attention” in our initial submission) didn’t work, so we eventually ended up publishing it in the peer-reviewed journal of Ethical Human Psychology and Psychiatry (along with a shorter and easier-to-follow version in Mad in America).
Our detailed critique revealed severe methodological and representational biases that undermine the conclusions made by Merzon and colleagues in 2020, but the authors, to our knowledge, never responded to our critique. Instead, they published a second study on this topic, in the JAD. In this new study from 2021, they made an even more far-reaching claim: that the behavioral condition (ADHD) is associated with severe outcomes of the respiratory virus (COVID-19).
To settle this ongoing scientific debate, which has tremendous implications for the public health, we have sent Merzon and colleagues another set of data-availability requests. Considering our past experience, we decided this time to include the editor-in-chief of the JAD in the email correspondence. The JAD, which provided the Kosher Stamp for these studies, we assumed, has the most interest to ensure the quality of its publications. After all, Merzon and colleagues specifically declared in their JAD publications that the data used for their studies will be available upon request. Imagine then, how shocked we were to receive the following, three-word response from the corresponding author of these studies: “Beware, Scientology Related.”
Apparently, Prof. Iris Manor, the corresponding author of the two studies by Merzon and colleagues (2020, 2021) felt the need to warn the editor-in-chief of the JAD from our plain and respectful data request. As fate would have it, this ad hominem, blatant lie was sent to our email address, probably by mistake, in addition to the email address of the editor of the JAD. Needless to say, we do not belong to the scientology movement, but this false accusation triggered a fascinating email correspondence with multiple addressees that exposed the highly problematic happenings that usually take place behind the (unfortunately) closed academic curtains.
In the article you are reading now, we made a conscious decision not to release the actual letters we received from Prof. Manor and Dr. Merzon (although we are allowed to share them from a purely legal point of view). Nevertheless, it is crucial we discuss the content of these letters as they seem to include a variety of stalling tactics that ranged from shifting responsibility to the health care service holding the data, an absence of a data scientist in-charge, COVID-related delays, participants’ privacy considerations, and various technical restrictions. Dr. Merzon also informed us that the access to the data will require payment and be limited to selective portions of the data only.
But guess what? Even this selective access was not granted to us (or to anyone else, to our knowledge) to this very day, September 8, 2022–almost a year after our second round of data requests and more than two years after our first requests. We therefore cannot help but wonder: What are the authors afraid of? Is there something in the data that should be kept secret? A clue that might unravel this secret can be found in Lessons #3 and #4.
Lesson #2: Scientific gatekeepers (e.g., journal editors) may play a role in the concealment.
Once the editor-in-chief of the JAD realized that we are not given access to the data, and once we had sent him our detailed critique of Merzon et al.’s 2020 study on COVID-19 infections (the one he refused to consider for publication), he invited us to write up our concerns and submit a new critical article to the JAD. Complementing his proposal, we deepened our original evaluation, exposed additional troubling distortions and contradictions that appeared in the authors’ new study from 2021, and raised concerns that crucial information about outcomes of stimulant use during the COVID-19 was not disclosed to the scientific community.
This time, the editor was kind enough to send our new critique to further peer review, but eventually decided that JAD is “not the best placement” for its publication, despite his own original proposal to us, and despite his own judgement that our new critique is indeed “worthy of publication” (see Lesson #3 for more information).
Lesson #3: Scientific misconducts are hidden in the details (and it’s our role to expose them).
Following the decision letter from the JAD, we turned back to Ethical Human Psychology and Psychiatry–one of the few righteous journals in the conflict-of-interest city of Sodom–and published our new critique there. This new critique delves into the meat and bones of the studies by Merzon and colleagues and reveals seven severe discrepancies that do not allow us to trust their conclusions.
These discrepancies include inconsistencies in definitions and rates of ADHD; inadequate definition for treated individuals; omissions of crucial information; unsuitable analyses; and unmet declarations regarding conflicts of interests and data-availability. To avoid repetition, and to make a long story short, we highlight here two gaps only, which we believe would be of great interest to readers of Mad in America, but we urge readers to inspect our complete, and somewhat more technical article published in Ethical Human Psychology and Psychiatry because scientific biases are typically hidden in the methodological and representational details.
Moreover, aside from the specific critique of the topic at hand (i.e., the proclaimed relationships between ADHD and COVID-19), our detailed critical article also includes a fascinating appendix that provides a glimpse into the peer review process of the JAD. Using this appendix, readers can evaluate, for themselves, the quality and the appropriateness of the editor’s decision (for the second time) not to give voice to scholars who criticize studies published in his journal.
The first gap we wish to point out here concerns the authors’ declarations of interests. The very fact that conflicts of interests exist in a given study doesn’t necessarily mean that its findings were distorted. However, in the case of the ADHD and COVID-19 studies, something very strange happened. In both studies, the authors specifically declared that they have “no potential conflicts of interest.”
However, only a year before the publication of the 2020 study, its corresponding author declared that she served on the counseling and advisory boards of leading pharma companies, such as Janssen-Cilag, Teva, and Novartis. Moreover, the 2021 study on COVID-19 outcomes included an “author note” in which both the first author and the corresponding author reported of personal fees or reimbursements for travel and accommodation expenses from pharmaceutical companies. We are not sure why this information was not disclosed in the 2020 study and how it is possible that the authors can still declare “no potential conflicts of interest” in their 2021 study, despite this “author note.” However, we are sure that readers of the JAD must receive a complete and honest picture regarding the potential interests that might have been involved in the research, even if the authors believe that these interests did not impair their scientific work. This gap, by itself, can serve as grounds for retraction of an academic article, especially when these undeclared conflicts of interests are accompanied with questionable methodological and representational choices as described in the following gap.
The second gap we wish to highlight here concerns a sophisticated method to conceal unwanted information. Towards the end of the 2020 article on infections, the authors noted that “data regarding the presenting symptoms and severity of COVID-19 infection, as well as adverse clinical outcomes (hospitalization and mechanical ventilation) were not assessed.” This choice of words (“not assessed”) is misleading because the authors did have access to this critical information as they explicitly stated in the method section of this study.
“Well,” readers may rationalize, “perhaps the 2021 study compensates for this missing information?” This could have been the case if the results from the 2021 study were not misrepresented as well. The 2021 study that did assess severe outcomes of COVID-19, did not include any information about medications. Now this negligence is really disturbing because it is in complete contrast to the 2020 study, which aimed to show the protective role of the medications through a designated stratification of ADHD cases, to medically treated and untreated cases.
In fact, the corresponding author insisted in a recorded TV interview (in Hebrew), that the main headline from her 2020 study is that ADHD medications mitigate the risk for COVID-19 infections among ADHD individuals (a saved copy of this TV interview, in which she repeated this headline several times, is available upon request). Where did these life-saving medications disappear?
Lesson #4: Scientific misconducts might have real-life dangerous implications.
The nuanced, yet critical choice not to stratify the cases to treated and untreated ADHD cases in the 2021 study is also disturbing in light of what we know about stimulant medications (which are the treatment-of-choice for ADHD). Research on neurotoxins, such as methamphetamines, teaches us that psychostimulants can alter the blood-brain barrier permeability, thus perhaps increasing the risk for invasion of dangerous viruses into the brain. Prohibited stimulant drugs, as well as medically prescribed stimulant medications, may also have a negative impact on our natural immune system.
Finally, and probably most importantly, numerous studies have warned of cardiovascular outcomes of prescribed stimulant medications. In fact, all stimulants have FDA warnings on their consumer leaflets regarding potential cardiovascular implications, and even proponents of the medications do not dismiss this risk (for an elaborated description of the strong signal for cardiovascular reactions to stimulant medications, see the newly released book by the first author of the current article, ADHD Is Not an Illness and Ritalin Is Not a Cure: A Comprehensive Rebuttal of the (Alleged) Scientific Consensus.
We mention this known cardiovascular risk in this context, because a large body of research now links cardiovascular problems to severe COVID-19 outcomes, including mortalities. These links require us to ask: Is it really such a good idea to prescribe stimulant medications during an active pandemic? Together, the fact that the 2020 study reporting of medications does not report of severe COVID-19 outcomes, and the fact that the 2021 study reporting of severe COVID-19 outcomes does not report of medications, do not allow us to rule out the possibility that stimulant medications constitute an artifact that might explain the observed link between ADHD and severity of COVID-19 outcomes.
Of course, without transparent and open access to the data, we cannot examine the empirical support for this concern. Nevertheless, we cannot run away from contemplating the frighting option that stimulant use limits the person’s ability to cope with infectious viruses. We would be happy to see this concern proven wrong by receiving access to the data. But until full transparency is achieved, and until our scientific criticism stops being silenced by leaders of the field, we remain with the lessons brought in this article. The seemingly aesthetic, not to say “holy” scientific process is sometimes tainted by biases and foreign interests, and it is our ethical duty to inform the public of the ongoing debate and warn them from misinterpreting the distorted studies on ADHD and COVID-19.
Dear readers of Mad in America, beware!
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.
ADHD/Autism/Asperger’s/Neurodivergence is a hoax. Mental Illness/Brain Chemical Imbalance is a myth. They are closely related and depend on each other. We need to eradicate both movements and prosecute the practitioners.
With the way schizophrenia has been conceived, it is hard to imagine it in adolescents. So they have given us bipolar. And most of the diagnoses are for bipolar 2. And this seems to be a reworking of what they used to call dementia praecox.
And then since it is hard to imagine bipolar in younger children, they have also given us autism.
So because they want to establish that there is an objective basis for all of these afflictions, the whole thing has to hang together.
And so now when the CA a legislature has passed Newsom’s Care Courts, it was supposed to be pitched at the unhoused, but as it is worded it applies to anyone who could become unhoused because of severe mental illness. And so it applies to everyone.
And severe mental illness is supposed to be those on the Schizophrenia Spectrum, but the main diagnosis is bipolar and this is the core of this spectrum.
And then Sacramento Mayor Darrell Steinberg has been a central pillar of CA’s mental health phenomenon. He says that everyone is on some “Mental Health Spectrum”, and would do well with Mental Health Wellbeing checks. And he has set up an institute and put Thomas Insel in charge of it. Insel has a company, MindStrong which will give everyone these Wellbeing Checks via cell phone texting.
Darrell Steinberg had put his daughter into an out of state psychiatric hospital at the age of 13 years. And now in her 20’s, she still believes that she has “mental illness”.
Anyone who lives kind of on the edge and without a lot of social and emotional support could be labeled as having bipolar 2.
Particularly because this is all being done by government licensed medical practitioners, it all clearly falls within Nuremburg precedent. No one’s position or licensing puts them above International Law. No one can say that they are Just Following Orders or that they are Just Following the Law. And it is right that the Statue of Limitations has been lifted, and that the penalties have been extreme.
If they talk about Scientology, bring out a list of Christian Missionary based hospitals that have Psychiatry departments. There are plenty of them. They are both religions. It’s pathetic that either side has to stoop so low.
When I say “they are both religions”, I’m talking of Scientology and Christianity. Not Christianity and Psychiatry. I meant that Christianity and its funds being used for Psychiatry work is fine, but Scientology doing the same for those who have been hurt by psychiatry is not fine. This is a double standard.
“I am not, and never have been a Scientologist. I am not and never have been a fellow traveler. I am not, and never have been a supporter of, a member of or a sympathizer with any organization known to me to be, or suspected by me of being controlled or dominated by Scientologists”
“Looking for an issue that would get him re elected, he seized on the fears of millions and launched the squalid campaign that became known as …….[anti Scientology]
Its tactic, reckless and undocumented accusations against government employees.
Intimidation bred audacity, and audacity fed upon itself”
And when audacity means taking bold risks with fraud which harms the lives of others……..and the State finds the concealment of such acts of fraud simple because they can utter with forged documents and deny access to legal representation and “fucking destroy” anyone who dares speak the truth……….
‘They are the ones who have lost their souls, and what they have forged will leave them in the lurch’
It’s a strange sort of slander though. Because no Scientologist ever slandered me with a mental illness label and then ‘fucking destroyed’ my life with the use of State resources for pointing out the way their offending and misconduct had enabled arbitrary detentions and torture. That and the “after the fact due process” (thanks to a recent MiA article) “editing” of legal narrative to conceal these human rights abuses.
And in my State the current government is “totally obsessed with secrecy” which tends to be a symptom of tyranny and oppression. Their recruitment of thugs as police seems to be more about their own security, rather than defending the rule of law which the Chief Psychiatrist simply writes out of existence to enable human rights abuses.
Once in a position where you can deny the community the protections afforded by the law, your going to need ‘staff’ to do the arbitrary detaining and torture (disguised as ‘medicine’), and the administrators to do the “editing” to maintain your good reputation against Scientologists.
Did you know they are arbitrarily detaining people who throw petrol bombs at protests in China? Isn’t that a human right? You would know this if you read the Australian newspapers, though very little about the way people are being ‘treated’ in facilities they call ‘hospitals’ once their status is changed from ‘citizen’ to “outpatient” by a nurse, before calling police for ‘assistance’ with their now “Outpatient” who needs to be taken into ‘care’.
And I guess I’m just envious of the way you are being silenced. In my country the methods of silencing are a little more vicious (‘spiked’ with date rape drugs and snatched from your bed by thugs with weapons for transportation to a locked ward for ‘treatment’ with a chemical kosh and electricity against your will because ….. made up illness and anasognosia/elutheromania), and tend to result in what are euphemistically called ‘unintended negative outcomes’. Care to examine the ‘raw data’?
I might just take out a subscription to JAD just so I can cancel it.
This was the same tactic used in the 1990’s to discredit those who criticized psychiatry. Psychiatry is highly successful in making patients destabilized and to make their mood disorders worse than ever- changing the trajectory forever for the worse.
Giving stimulants to children and adolescents (as well as adults) furthers the business model where psychiatry is the LONG CON where the ADHD patient quickly becomes the bipolar patient and then the treatment resistant patient and gets on the rollercoaster ride of complex psychopharmacology and the musical chairs game begins but eventually the music stops leaving the patient alone and on the floor with no exit to go to. Only those who pick up on the CON game early on and bail out survive. For the short run the CON works to some extent but as in any CON the end result is always bad for the “mark”.
As soon as they bring out the ad hominem attacks, you know they have no ethical leg to stand on!
However MIA has backed off repeatedly from exposing and confronting this sort of thing head on, and MIA’s refusal to embrace anti-psychiatry is partially based in fear of being accused of supporting Scientology. But if a Scientologist calls water wet does that mean we should deny it?
One cannot allow a fear of being accused of something deter one from doing the right thing. However, Bob Whitaker has of course been accused of being a Scientologist and all sorts of other things despite his determination to maintain a hard, factual stance. I actually don’t know that you or I or anyone else are in a position to criticize his approach, as he has had an enormous impact on exposing the truth about psychiatry, as much as anyone I can think of. So I say, WELL DONE, BOB WHITAKER! We need an antipsychiatry movement, but having a source of reliable information as well as a forum for discussing issues that aren’t discussed anywhere else on the Internet in these kinds of numbers is invaluable.
I was so pleased to discover that such a ‘thing’ as the Journal of Attention Disorders existed. After processing-to the dismal extent possible, it occurred to me that in our neoliberal, technocratic utopian world, such a journal could not not-exist. How fortunate all the attention challenged people around the world are to have a journal dedicated to improving the quality and wellbeing of their cognitive lives. I can’t wait to jump in to (this) journal and learn everything there is to know about “attention disorders”.
But a couple questions do nag. For one, could it be that some the people at the JAS have some “attention” issues of their own? That the respondents at JAS have demonstrated an inability to follow through established protocols and standards, engage and communicate directly, save effectively, and, thus, respond systematically and developmentally-of which posed no small measure of unnecessary conflict and confusion to others, is rather consistent with the DSM’s guidelines surrounding ADD. Could it be that this failure of attention is more the result of an underlying or additional oppositional defiant disorder (or bi-polar power disorder)? Well…it’s really impossible from this distance to posit why the respondents at JAS have had such a difficult go of paying attention, and thus, acting (out) in a manner neither representational nor commensurate with their professional responsibilities. But the good news is that, whatever the causes, the answers can most certainly be found in the black and white of their journals.
Thank you Doctors Ophir and Shir-Raz for your work and bringing this more behind the scenes shenanigans to MIA. I look forward to reading Dr. Ophir’s book.
Thank you for this excellent expose. Once again we see the duplicity of the Biosychiatry establishment, in their unholy alliance with Big Pharma, and how these professional publications who should be welcoming critical peer review end up carrying water for them.
Do you have any suggestions as to what we readers could do to help?
Avoid all psychiatry completely. Let it wither and die choking on its inherent contradictions, and do something productive with your life.