Debunking Denialism

Fighting pseudoscience and quackery with reason and evidence.

Tag Archives: effect size threshold gambit

How Anti-Psychiatry Researchers Attack Antidepressants With Faulty Statistics

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Anti-psychiatry is a pseudoscience that downplays or rejects the existence and severity of psychiatric conditions, denies the efficacy of established treatments and demonizes medical doctors. Not all anti-psychiatry activists are committed to all of these three positions, but they are common beliefs within the movement. It is thus very reminiscent of anti-vaccine activists who wrongly think that vaccine-preventable diseases are natural and not very harmful, reject vaccines and demonize pediatricians. In terms of debating tactics, anti-psychiatry activists make use the same standard denialist toolkit: quoting scientists out of context, cherry-picking data, misunderstanding basic science and so on.

A recent paper by Jakobsen and colleagues (2017) claims to have shown that the antidepressant class SSRI has questionably clinical efficacy. It turns out that they base this claim on a piece of highly deceptive statistical trickery: they erect an arbitrary and evidence-free effect size threshold for clinical significance and then reject all treatments that do not fulfill it.

Because the threshold they picked was so large, they would be forced to reject both psychotherapy and a considerable portion of medications used in general medicine as well. The researchers cite National Institute for Health and Care Excellence (NICE) as support for their criteria, but NICE dumped this criteria as flawed around eight years ago. In the end, SSRIs are effective and a useful treatment for depression (but do not work perfectly for everyone) and clinical significance is a spectrum and not a black-and-white issue.

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