ADHD: Since 2015 much of (if not most) funding for ADHD research have been (mis)used for ideological warfare, at no benefit for, but at all the costs for the persons with ADHD. Is Cochrane at it again!?
ADHD: Since 2015 much of (if not most) funding for ADHD research have been (mis)used for ideological warfare, at no benefit for, but at all the costs for the persons with ADHD. Is Cochrane at it again!?
This qoute from Shakespeare’s Hamlet is, in so many ways, fitting for describing the current situation within the Danish Research Community on ADHD. While authors like Søren Dalsgaard, PhD., have spent the past 8 years on publishing one monumental work upon another, Storebø et al., have been busy furthering their own personal agendas.
In 2018/2019, The Nordic Cochrane Center, led by then CEO Peter C. Gøtzsche, came into a hail storm of criticism due to their research on HPV-virus and Antidepressants, which ultimately let to Gøtzsche being fired, and later excluded from the Cochrane Collaboration. After a governmental enquiry, The Nordic Cochrane Center was “cleared” of wrongdoing, while the report stated that a division of its activities was recommended. This led to the creation of The Nordic Cochrane Center (NCC) located at the Rigshospitalet, Copenhagen, and the new Copenhagen Trial Unit (CTU) which was moved to The University of Southern Denmark (SDU). Christian Gluud remained as CEO of NCC, while Karsten Juhl Jørgensen was appointed as CEO of CTU at SDU.
Meanwhile, Storebø and Erik Simonsen was employed at “The Center for Evidence-Based Psychiatry” at the Region Zealand (regional governmental body, 1 of 5 in Denmark in all), where they ran their research on “Randomized Clinical Trials” from.
Then something … happened in Denmark, when Storebø on 1 September 2020 was appointed as Professor of Psychology at SDU … as he states: “In addition to my affiliation with the Department of Psychology at the University of Southern Denmark a as a professor, I am employed as a senior researcher at the Psychiatric Research Unit and the Department of Child and Adolescent Psychiatry, Region Zealand and as academic director of the Center for Evidence-Based Psychiatry (CEBP).”
This announcement came less than a year after the Cochrane Nordic debacle, where CTU was moved to … SDU … This put Storebø at very center of the power in academic research in Denmark, now towering over all ADHD research in Denmark, along with his tentacles extended wide within all academic, regulatory, and educational institutions, which not only have benefitted him, but to a great extend all of his “Minions” here: Erlend Faltinsen, Pernille Darling Rasmussen, Maria Skoog, Morris Zwi, Camilla Groth, Donna Gillies, Carlos R Moreira-Maia, Mathilde Holmskov, Richard Kirubakaran, Helle B Krogh, Johanne Pereira Ribeiro, Jutta M. Stoffers-Winterling, Erica Ramstad, Henriette Edemann-Callesen, Yael Shmueli-Goetz, Adan Todorovac, Luis Carlos Saiz just to name a “few” of the people he uses as his chess pieces to publish supporting evidence for his 2015 “master-piece”, so that he can ‘reference other authors’ who support his claims. Here is the full list of their combined efforts.
Behind the scenes are the Grand Old Men of his like-minded followers of their modern version of ‘Cochranianism‘: Peter C Gøtzsche, Kim Boesen, Christian Gluud, Karsten Juhl Jørgensen and his main ‘partner-in-crime’ Erik Simonsen.
Just take a close look at Storebø’s Spiderweb of Minions …
As, in my opinion, becomes (un)blindingly obvious, when all his connections becomes visualized, Storebø has since his 2015 triumph, established himself smack in the middle, where most (if not all) of the funding for ADHD research (or ‘Evidenced-Based Psychiatry’) …
As Storebø himself states in his Current Projects List, that:
“Methylphenidate for ADHD: Update of the Cochrane Review on the beneficial and harmful effects of methylphenidate in children and adolescents with ADHD. In 2015, we published a Cochrane systematic review of the beneficial and harmful effects of methylphenidate in children and adolescents with ADHD (Storebø 2015). This review has played an essential role in the decision taken by WHO to not to include methylphenidate on the list of essential drugs for ADHD. The project has helped getting the use of methylphenidate for ADHD on the national as well as international agenda. The review is now 5 years old and will be updated in 2021. The update is important as there is still disagreement about the effects of methylphenidate.”
The 2023 updated review was published on PubMed on 27 March 2023, but was only available as Open Access on PubMed for hours, before it was put on embargo and removed, without further explanation.
Today it can only be accessed in full text at Cochrane’s own website here.
I highly recommend that you read the reactions and commentary on his 2015 publication, first, since the critique from 2015/2016 is just as pertinent for the 2023 version as well. Only change is that “very low quality” have been altered to “high uncertainty” … whatever the difference may be …
[…] A recent review published by a group of researchers led by O. J. Storebo (2015), which illuminates the efficacy and safety of MPH for the treatment of children and adolescents with ADHD, has now reignited this discussion. Indeed, in its edition from 25 November 2015 (p. 16), the German newspaper Süddeutsche Zeitung (SZ) refers to this review in an article entitled “Dissipated Effect – Doubts About the Benefits of Ritalin and Similar Substances” [own translation], concluding that “The substances are taken by millions of children – but their benefits are limited, and side effects can strongly impair everyday life. Doctors therefore call for greater caution in prescribing Ritalin and co. for attention deficits and hyperactivity (ADHD) and for careful consideration of whether children and adolescents benefit from [the substances].” The SZ refers to an interview with one of the co-authors of the study: ‘Our expectations of the treatment are presumably greater than would be justified,’ says the London-based child and adolescent psychiatrist Morris Zwi. ‘Although we can see hints of a benefit, the scientific evidence is of very poor quality.’ […] (Banaschewski et al., 2016)
[…] Negative reports in the media about psychostimulants are nowadays commonplace. However, the SZ news report is particularly noteworthy because Cochrane meta-analyses are generally perceived by experts and the public as representing established knowledge of the highest quality and with the greatest degree of evidence. The Cochrane collaboration is a global network of physicians, clinical researchers, methodologists, members of the healthcare professions, and patients. It advocates better health through improved possibilities for information. A central aim of the Cochrane collaboration is to create an evaluation of therapies oriented toward the principles of evidence-based medicine, to keep it up-to-date and to disseminate it. The systematic reviews published by the Cochrane collaboration claim to work in accordance with strict methodological rules in order to rule out biased results and systemic errors. Moreover, the first premise is to refrain from industrial financial support in order to ensure independence. Cochrane reviews therefore lay claim to a high scientific quality and substantial relevance for evidence-based clinical decisions. […] (Banaschewski et al., 2016)
[…] What Conclusions Can Be Drawn? According to Storebo and colleagues (2015a), the results of their meta-analyses suggest that MPH might improve teacher-rated ADHD symptoms, general behavior, and parent-rated quality of life in children and adolescents with ADHD. They claim, however, that the available evidence is of such poor quality that it is impossible to make any firm statements about the size of the effects. Moreover, they believe that it is generally unclear whether treat-ment with MPH is beneficial (p. 2): “[A]t the moment, the quality of the available evidence means that we cannot say for sure whether taking MPH will improve the lives of children and adolescents with ADHD.”
The conclusions of Storebo and colleagues contradict all previous meta-analyses and reviews, including those by NICE, which provide evidence of a substantial efficacy of MPH in the treatment of ADHD. The Cochrane review of the efficacy and tolerability of MPH treatment in children and adolescents with ADHD is marked by numerous inaccuracies, errors, and inconsistencies. Besides the aforementioned examples, there are also erroneous parameters for calculating the effect sizes of individual studies … […] (Banaschewski et al., 2016)
[…] We have demonstrated that the study selection was flawed and undertaken without sufficient scientific justification. As a consequence, the effect sizes were calculated as too small and, moreover, were inadmissibly clinically interpreted. The methodology of the assessment of bias and quality is not objective and cannot be substantiated by the data. In particular, the aforementioned conclusion of the authors is grossly misleading. Finally, the conclusion that it is methodologically warranted to conduct so-called Nocebo studies, in which a substance which provokes solely undesired effects, claimed to be comparable with those of MPH, is given to the control participants instead of placebo, is extremely dubious from an ethical perspective. […] (Banaschewski et al., 2016)
[…] Overall, it can be concluded that even Cochrane works should be critically read and verified. As recently demonstrated by Guy Goodwin (2015a), they are potentially misleading, for instance, if inadequate inclusion criteria are defined for studies, because dose-finding studies with too low dosages are used to assess effi cacy, if studies that applied too high dosages are included to assess the frequency of ADRs, or if inappropriate criteria are applied to assess the validity of studies and available evidence is thus negated. The consequences of this become apparent in underestimated efficacy, overestimated risks, and uncertainty on the part of clinicians and patients. […] (Banaschewski et al., 2016)
[…] A recently published Cochrane systematic review has now added a new layer of doubt on the use of methylphenidate for children and adolescents with ADHD, by indicating the evidence base of methylphenidate to improve ADHD symptoms to be “of very low quality”. The authors identified a total number of 185 randomized controlled studies of methylphenidate versus placebo or no treatment (38 parallel group trials involving more than 5000 participants; and 147 cross-over trials with over 7000 participants) and assessed all 185 as being at high risk of bias.
We agree it is important to critically consider the role of potential bias due to vested interests in scientific reporting in general and in medication studies in particular. This should, however, be achieved by the empirical testing of whether bias has really distorted the analyses of data, reporting of results and drawing conclusions.
The approach by Storebro etal., is completely different and ends in adeadlock. They appear to introduce a newideology: by definition reports that have been sponsored by industry and/or co-authored by experts from industry or experts with declaration of interests are untrustworthy.
Another main source of bias according to the authors was the fact that it may have been possible for people in the trials to know which treatment the children were taking based on the adverse events that occurred more frequently in children on active treatment compared to placebo.
Thus, the authors stated in their plain language summary: “At the moment, the quality of the available evidence means that we cannot say for sure whether taking methylphenidate will improve the lives of children and adolescents with ADHD.” And: “It was possible for people in the trials to know which treatment the children were taking.”
As a major implication for research the authors recommend comparisons with “nocebo tablets”, designed to have similar adverse events as those associated with methylphenidate. A quick PubMed search revealed the term nocebo in no more than 47 articles involving the clinical trials. However, none of these clinical trials used a nocebo tablet as comparator. Thus, when following the reasoning of Storebro and colleagues virtually the whole evidence base of medicine is of very low quality. But there is more to critically reflect upon.
The main outcome measure in the studies was teacher-reported ADHD symptoms, while the most frequently reported adverse events were sleep problems and decreased appetite. Such non-serious adverse events are not typically discussed with the teachers. Why then was it “possible for people in the trials to know which treatment the children were taking”? Moreover, there was not a tremendous increase in the rates of adverse events in children on active medication, which was about a quarter more than in the placebo group. It is highly unlikely that this has in all cases led to deblinding.
Furthermore, medicine knows many medications with much higher likelihoods of adverse events compared to placebos. For an article with such strong conclusions, we were also disappointed to read a number of inaccuracies. Strangely, the Multimodal Treatment Study of ADHD was included in the meta-analyses, even though that study did not involve comparisons with placebo. Furthermore, in the abstract we read that all 185 studies had high risk of bias, whereas according to the results section, there were still 3 % of studies without such high risk. While this is indeed a very small subgroup, such inaccuracies do not add to a feeling of confidence towards the authors’ analyses.
A final indication of inaccurate reasoning involves the following quote from the article “the fact that the intervention effect of methylphenidate on ADHD symptoms did not differ significantly between the trials at low risk of bias compared with trials at high risk of bias may be taken as an indication that deblinding has occurred among former trials.”
This is an unexpected reasoning for at least two reasons. First, the article has stated that there was not a single study at low risk of bias. Why then can such a statement be made? Apart from that, a much more straightforward conclusion from the fact that the intervention effect of methylphenidate on ADHD symptoms did not differ significantly between the trials at low risk of bias compared with trials at high risk of bias would be to conclude that it is very unlikely that the identified bias has had a major influence on the results.
What to think of the authors’ recommendations? We certainly do not endorse the use of nocebo tablets for future trials. A much more ethical and practical method to avoid the risk of deblinding is to involve independent raters of adverse events and of effectiveness. In our view, there are other priorities. We need well-conducted trials investigating the functional effects of methylphenidate on the long-term, e.g., on cognition and school performance. […] (Hoekstra & Buitelaar, 2016)
[…] The authors’ ideology should strictly speaking lead to a new situation where medication research is conducted by researchers funded independently from industry by public funding bodies like medical research councils. Dreams are the backbone of reality, as the novelist James Salter wrote, but it does not need long thinking to conclude that public funding bodies will never allocate the budgets needed to implement such a new policy. […] (Hoekstra & Buitelaar, 2016)
[…] Recently Storebø et al (2015a) published a Cochrane systematic review on the efficacy and tolerability of methylphenidate (MPH) in children and adolescents for the treatment of attention deficit hyperactivity disorder (ADHD), a summary of which was then published in the BMJ (Storebø et al, 2015b).
In recent years, numerous systematic reviews and meta-analyses have consistently demonstrated the high degree of efficacy of stimulants, such as MPH, for the treatment of ADHD. Consequently, those making treatment recommendations, such as the UK NICE guidelines (NICE, 2008), have identified MPH as a first-line treatment for school-age children with moderate to severe ADHD.
Hence, the new Storebø et al review has generated controversy as it has challenged the quality of this prior evidence-base and suggests that there is significant uncertainty about the effectiveness of methylphenidate for the treatment of ADHD.
Estimates suggest that ADHD affects around 2-5% of school-aged children and young people.
Methods: The authors report a Cochrane systematic review and meta-analysis of randomised controlled trials (RCTs) of methylphenidate for the treatment of children and adolescents (age 18 years or younger) with ADHD.
Major databases were searched and 185 trials were included in the review:
• 38 were parallel-group trials
• 147 were cross-over trials.
The primary outcome reported in the BMJ paper was ADHD symptoms rated by teachers. Other secondary outcomes included general behaviour and quality of life.
Risk of bias: Risk of bias in trials was recorded using the Cochrane ‘risk of bias’ (RoB) tool. The authors added an additional domain of ‘vested interests’ to the RoB tool identifying trials with industry involvement. In effect, every trial that was funded by a manufacturer of the drug, authored by someone with ties to a manufacturer or where this was unclear was considered to have a ‘high risk’ of bias; irrespective of the scientific quality of the trial, i.e. even if it had a low risk of bias in the other methodological RoB domains.
Quality of evidence was summarised using the GRADE approach.
All trials with clear or unclear links to industry were considered to have a high risk of bias, irrespective of their actual scientific quality.
Results: The Storebø et al Cochrane review and meta-analysis reports a large effect size (SMD -0.77) for teacher reported ADHD symptoms, indicating clinically meaningful improvement with methylphenidate. These findings are in line with previous systematic reviews.
Furthermore, the authors report additional benefits of methylphenidate in improving:
o General behaviour (SMD -0.68, 95% CI -0.78 to -0.60)
o Quality of life (SMD 0.61, 95% CI 0.48 to 0.80)
However, Storebø et al cast serious doubt on quality of the evidence and certainty of these effects. They identify 96.8% of included trials as ‘high risk of bias trials’ and assessed all outcomes as ‘very low quality’ using GRADE.
Conclusions: The authors conclude in their BMJ paper that: ‘Given the risk of bias in the included studies and the very low quality of outcomes, the magnitude of effects [of methylphenidate] is uncertain and the strength of evidence is insufficient to guide practice.’
The accompanying BMJ commentary by Mina Fazel (2015) states that the author’s: ‘Findings are potentially important but confusing for clinicians and affected families, thanks to poor overall quality of the evidence.’
Strengths and limitations:Storebø et al have conducted a large and comprehensive systematic review and meta-analysis of the effects of methylphenidate in children and adolescents with ADHD. The main limitation of the study concerns the idiosyncratic methods used to assess study bias and quality of evidence. These methods, although reported under the aegis of a Cochrane review, deviate significantly from standard Cochrane methodology and result in an exaggeration of study bias and excessive downgrading of the quality of evidence.
The most misleading and potentially damaging part of the paper relates to way the quality of studies is assessed. Storebø et al adopt the GRADE approach, which includes the Cochrane risk of bias tool (RoB). However, the authors deviate from standard Cochrane methodologyin two important ways:
Firstly, their idiosyncratic broadening of RoB domains to include ‘vested interests’. The Cochrane Handbook recommends that rather than presuming bias on the basis of industry involvement it is preferable to assess whether there are any reasons to believe that vested interests may have led to bias in each trial individually. If this were the case, then the bias would be coded under the standard RoB tool domains. Adding an additional ‘vested interests’ category runs the risk of ‘double counting’ bias.
Secondly, in summarising risk of bias, the authors combined the ‘uncertain’ and ‘high’ risk of bias categories and reported these all as ‘high’ risk of bias trials. Using this approach, the authors categorised 96.8% of trials as ‘high risk of bias trials’ when the standard Cochrane RoB methodology would categories just over one third (37%; 69/185) of trials as being in the high risk of bias category. For the 19 trials contributing to the primary outcome of teacher rated ADHD symptoms; less than a third of trials (31%; 6/19) had a high risk of bias using the standard Cochrane RoB tool. If the author’s ‘vested interests’ domain is included in the RoB tool, then 63% (12/19) would have a high risk of bias. These figures are significantly lower than the 96.8% of studies having high risk of bias reported as the headline figure in the BMJ paper.
Turning to GRADE, the author’s misapplied the rules for downgrading (and upgrading) evidence as recommended in the Cochrane Handbook.
Firstly, risk of bias is just one of five factors contributing to a GRADE assessment. A high risk of bias would typically lead to downgrading by one or occasionally two points. The authors downgraded all studies assessing ADHD (teacher) outcomes by two points and then by an additional point (total downgrade by 3 points) for study heterogeneity (I²). Thresholds for the interpretation of I² can be misleading, since the importance of inconsistency depends on several factors. The Cochrane Handbook gives a rough guide to interpretation of I² as follows: ‘0% to 40%: might not be important; 30% to 60%: may represent moderate heterogeneity (depending on the magnitude and direction of effects)’. In this review, I² = 37% for the 19 trials contributing to the primary outcome is of questionable significance and would not be expected to result in a downgrading using GRADE.
Finally, GRADE can also be upgraded where there are large effect sizes and narrow confidence intervals: (SMD) -0.77, 95% confidence interval (CI) -0.90 to -0.64, represents a large effect estimated with moderate to high precision. In summary, the authors were excessively stringent in downgrading all GRADE scores by 3 points (all GRADE scores were ‘very low’ quality).
Finally, the substantive question remains whether presumed ‘vested interests’ bias materially affected the results. The key subgroup analyses presented in the full Cochrane review (Storebø et al, 2015a), compares RCTs at high versus low risk of bias. Crucially, this distinction (using the author’s own ratings of study bias) failed to find a significant difference in effect size(χ21=2.43, p=.12).
Summary: The outcomes reported in this review show that methylphenidate is a highly effective, safe and generally well-tolerated treatment for ADHD, with findings similar to those of previous meta-analyses. However, the idiosyncratic approach used by the authors for assessing quality of evidence deviates significantly from the standard Cochrane method and as a result, exaggerates the risk of bias assessment and excessively downgrades the quality of evidence. Crucially, the authors themselves showed in the full Cochrane review (but did not report this in the BMJ paper) that ‘vested interests’ bias did not materially affect the results. Therefore, the author’s interpretation of the results and conclusion that the ‘strength of evidence is insufficient to guide practice’ is misleading and potentially dangerous as it could undermine the confidence of practitioners, children and parents in what is an effective and generally safe treatment. […] (The Mental Elf, 2016).
Finally, let me end with this qoute from my (un)official mentor and friend since 2015, where I asked him for his opinion on Storebø et al. 2015, to which he replied:
[…] … the requirement that studies must use a “nocebo” shows that the authors are not aware that such studies would also not be permitted by IRBs not only for the reasons given above but also because you cannot inflict suffering and harm on people, via inducing side effects, when there is no offsetting benefit to doing so. I am not aware that any such nocebo exists that can specifically create MPH side effects in the equivalent proportion of people and to the equivalent degree as MPH. And even if such a currently fantasy drug existed no IRB here would permit its use. So the authors are asking for the impossible while judging the existing database against a fantasy. That is not a very fair assessment of the prevailing evidence even if they are technically correct about the short term duration of most trials, done mostly of necessity.[…] – Dr. Russell A, Barkley, PhD, (pers. comm., 2015)
Over the past 8 years, Storebø OJ. , Gluud, C., Boesen, K. and Simonsen E. (and their ‘Minions‘) have tried to provide evidence to Methylphenidate being harmful and without efficacy, but they have not only failed miserably in providing unibiased, trustworthy scientific evidence, they have caused unnecessary panic for clinicians, policy-makers and patients, while having been overly biased in their press-releases by always spinning their results in the least beneficial way for the current evidence, while overstating the importance of their own findings.
Unfortunately, the WHO have taking their ‘gospel’ as evidence and therefore removed Methylphenidate from their Essential Medicines List, which Storebø have promoted in now 2 separate publications, with an ‘unblinded self-righteousness gloating’.
in 2023, Storebø released his third publication on Methylphenidate, now counting 212 clinical trials “as very low quality” and with “high or unclear risk of bias” due to “vested interest” … nothing new have been added to the 2015 spectacle, other than “Nocebo” have now been changed to “Active Placebo” – the rest of the ideology remains unchanged.
Next … let’s take a look at the publications from Storebø and his Minions, shall we?
Here’s a short list of the actors playing the “supporting roles”:
Boesen et al., 2017; Darling Rasmussen et al., 2019; E. Faltinsen et al., 2019; E. G. Faltinsen et al., 2017, 2019; E. G. Faltinsen, Gluud, et al., 2018; E. G. Faltinsen, Storebø, et al., 2018; Holmskov et al., 2017; Krogh et al., 2019; Pereira Ribeiro et al., 2021, 2023; Ramstad et al., 2018; Rasmussen et al., 2018; Storebø et al., 2018, 2021, 2023; Storebø, Krogh, et al., 2015; Storebø, Pedersen, et al., 2011; Storebø, Ramstad, et al., 2015; Storebø, Rasmussen, et al., 2016; Storebø, Simonsen, et al., 2016a, 2016b; Storebø, Skoog, et al., 2011, 2015; Storebø, Zwi, et al., 2016; Storebø & Gluud, 2020; Storebø & Simonsen, 2014, 2016; Vibholm et al., 2018
Banaschewski, T., Gerlach, M., Becker, K., Holtmann, M., Döpfner, M., & Romanos, M. (2016). Trust, but verify. The errors and misinterpretations in the Cochrane analysis by O.J. Storebo and colleagues on the efficacy and safety of methylphenidate for the treatment of children and adolescents with ADHD. Zeitschrift Fur Kinder- Und Jugendpsychiatrie Und Psychotherapie, 44(4), 307–314. https://doi.org/10.1024/1422-4917/a000433
Boesen, K., Saiz, L. C., Erviti, J., Storebø, O. J., Gluud, C., Gøtzsche, P. C., & Jørgensen, K. J. (2017). The Cochrane Collaboration withdraws a review on methylphenidate for adults with attention deficit hyperactivity disorder. Evidence-Based Medicine, 22(4), 143–147. https://doi.org/10.1136/ebmed-2017-110716
Darling Rasmussen, P., Storebø, O. J., Løkkeholt, T., Voss, L. G., Shmueli-Goetz, Y., Bojesen, A. B., Simonsen, E., & Bilenberg, N. (2019). Attachment as a Core Feature of Resilience: A Systematic Review and Meta-Analysis. Psychological Reports, 122(4), 1259–1296. https://doi.org/10.1177/0033294118785577
Faltinsen, E. G., Gluud, C., Simonsen, E., Zwi, M., & Storebø, O. J. (2018). Unbalanced risk-benefit analysis of ADHD drugs. The Lancet. Psychiatry, 5(11), 870. https://doi.org/10.1016/S2215-0366(18)30334-1
Faltinsen, E. G., Kongerslev, M., & Storebø, O. J. (2017). Reviews and meta-analyses of psychotherapy efficacy for borderline personality disorder. JAMA Psychiatry, 74(8), 853–854. https://doi.org/10.1001/jamapsychiatry.2017.1397
Faltinsen, E. G., Storebø, O. J., & Gluud, C. (2019). Methodological concerns with network meta-analysis on drugs for attention deficit hyperactivity disorder. European Child & Adolescent Psychiatry, 28(1), 145–146. https://doi.org/10.1007/s00787-018-1164-6
Faltinsen, E. G., Storebø, O. J., Jakobsen, J. C., Boesen, K., Lange, T., & Gluud, C. (2018). Network meta-Analysis: The highest level of medical evidence? Evidence-Based Medicine, 23(2), 56–59. https://doi.org/10.1136/bmjebm-2017-110887
Faltinsen, E., Zwi, M., Castells, X., Gluud, C., Simonsen, E., & Storebø, O. J. (2019). Updated 2018 NICE guideline on pharmacological treatments for people with ADHD: A critical look. BMJ Evidence-Based Medicine, 24(3), 99–102. https://doi.org/10.1136/bmjebm-2018-111110
Hoekstra, P. J., & Buitelaar, J. K. (2016). Is the evidence base of methylphenidate for children and adolescents with attention-deficit/hyperactivity disorder flawed? European Child & Adolescent Psychiatry, 25(4), 339–340. https://doi.org/10.1007/s00787-016-0845-2
Holmskov, M., Storebø, O. J., Moreira-Maia, C. R., Ramstad, E., Magnusson, F. L., Krogh, H. B., Groth, C., Gillies, D., Zwi, M., Skoog, M., Gluud, C., & Simonsen, E. (2017). Gastrointestinal adverse events during methylphenidate treatment of children and adolescents with attention deficit hyperactivity disorder: A systematic review with meta-analysis and Trial Sequential Analysis of randomised clinical trials. PLoS ONE, 12(6). https://doi.org/10.1371/JOURNAL.PONE.0178187
Krogh, H. B., Storebø, O. J., Faltinsen, E., Todorovac, A., Ydedahl-Jensen, E., Magnusson, F. L., Holmskov, M., Gerner, T., Gluud, C., & Simonsen, E. (2019). Methodological advantages and disadvantages of parallel and crossover randomised clinical trials on methylphenidate for attention deficit hyperactivity disorder: a systematic review and meta-analyses. BMJ Open, 9(3). https://doi.org/10.1136/BMJOPEN-2018-026478
Pereira Ribeiro, J., Arthur, E. J., Gluud, C., Simonsen, E., & Storebø, O. J. (2021). Does Methylphenidate Work in Children and Adolescents with Attention Deficit Hyperactivity Disorder? Pediatric Reports, 13(3), 434–443. https://doi.org/10.3390/pediatric13030050
Pereira Ribeiro, J., Lunde, C., Gluud, C., Simonsen, E., & Storebø, O. J. (2023). Methylphenidate denied access to the WHO List of Essential Medicines for the second time. BMJ Evidence-Based Medicine, 28(2). https://doi.org/10.1136/BMJEBM-2021-111862
Ramstad, E., Storebø, O. J., Gerner, T., Krogh, H. B., Holmskov, M., Magnusson, F. L., Moreira-Maia, C. R., Skoog, M., Groth, C., Gillies, D., Zwi, M., Kirubakaran, R., Gluud, C., & Simonsen, E. (2018). Hallucinations and other psychotic symptoms in response to methylphenidate in children and adolescents with attention-deficit/hyperactivity disorder: a Cochrane systematic review with meta-analysis and trial sequential analysis. Scandinavian Journal of Child and Adolescent Psychiatry and Psychology, 6(1), 52–71. https://doi.org/10.21307/SJCAPP-2018-003
Rasmussen, P. D., Storebø, O. J., Shmueli-Goetz, Y., Bojesen, A. B., Simonsen, E., & Bilenberg, N. (2018). Childhood ADHD and treatment outcome: the role of maternal functioning. Child and Adolescent Psychiatry and Mental Health, 12(1). https://doi.org/10.1186/S13034-018-0234-3
Storebø, O. J., Faltinsen, E., Zwi, M., Simonsen, E., & Gluud, C. (2018). The Jury Is Still Out on the Benefits and Harms of Methylphenidate for Children and Adolescents With Attention-Deficit/Hyperactivity Disorder. Clinical Pharmacology and Therapeutics, 104(4), 606–609. https://doi.org/10.1002/CPT.1149
Storebø, O. J., & Gluud, C. (2020). Methylphenidate for ADHD rejected from the WHO Essential Medicines List due to uncertainties in benefit-harm profile. BMJ Evidence-Based Medicine, 26(4), 172–175. https://doi.org/10.1136/BMJEBM-2019-111328
Storebø, O. J., Krogh, H. B., Ramstad, E., Moreira-Maia, C. R., Holmskov, M., Skoog, M., Nilausen, T. D., Magnusson, F. L., Zwi, M., Gillies, D., Rosendal, S., Groth, C., Rasmussen, K. B., Gauci, D., Kirubakaran, R., Forsbøl, B., Simonsen, E., & Gluud, C. (2015). Methylphenidate for attention-deficit/hyperactivity disorder in children and adolescents: Cochrane systematic review with meta-analyses and trial sequential analyses of randomised clinical trials. BMJ (Clinical Research Ed.), 351, h5203. https://doi.org/10.1136/bmj.h5203
Storebø, O. J., Pedersen, J., Skoog, M., Thomsen, P. H., Winkel, P., Gluud, C., & Simonsen, E. (2011). Randomised social-skills training and parental training plus standard treatment versus standard treatment of children with attention deficit hyperactivity disorder – The SOSTRA trial protocol. Trials, 12(1), 18. https://doi.org/10.1186/1745-6215-12-18
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Storebø, O. J., Rasmussen, P. D., & Simonsen, E. (2016). Association Between Insecure Attachment and ADHD: Environmental Mediating Factors. Journal of Attention Disorders, 20(2), 187–196. https://doi.org/10.1177/1087054713501079
Storebø, O. J., Ribeiro, J. P., Kongerslev, M. T., Stoffers-Winterling, J., Sedoc Jørgensen, M., Lieb, K., Bateman, A., Kirubakaran, R., Dérian, N., Karyotaki, E., Cuijpers, P., & Simonsen, E. (2021). Individual participant data systematic reviews with meta-analyses of psychotherapies for borderline personality disorder. BMJ Open, 11(6), e047416. https://doi.org/10.1136/bmjopen-2020-047416
Storebø, O. J., & Simonsen, E. (2014). Is ADHD an early stage in the development of borderline personality disorder? Nordic Journal of Psychiatry, 68(5), 289–295. https://doi.org/10.3109/08039488.2013.841992
Storebø, O. J., & Simonsen, E. (2016). The Association Between ADHD and Antisocial Personality Disorder (ASPD): A Review. Journal of Attention Disorders, 20(10), 815–824. https://doi.org/10.1177/1087054713512150
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Storebø, O. J., Skoog, M., Damm, D., Thomsen, P. H., Simonsen, E., & Gluud, C. (2011). Social skills training for Attention Deficit Hyperactivity Disorder (ADHD) in children aged 5 to 18 years. Cochrane Database of Systematic Reviews, 12, CD008223–CD008223. https://doi.org/10.1002/14651858.cd008223.pub2
Storebø, O. J., Skoog, M., Rasmussen, P. D., Winkel, P., Gluud, C., Pedersen, J., Thomsen, P. H., & Simonsen, E. (2015). Attachment Competences in Children With ADHD During the Social-Skills Training and Attachment (SOSTRA) Randomized Clinical Trial. Journal of Attention Disorders, 19(10), 865–871. https://doi.org/10.1177/1087054713520220
Storebø, O. J., Storm, M. R. O., Pereira Ribeiro, J., Skoog, M., Groth, C., Callesen, H. E., Schaug, J. P., Darling Rasmussen, P., Huus, C.-M. L., Zwi, M., Kirubakaran, R., Simonsen, E., & Gluud, C. (2023). Methylphenidate for children and adolescents with attention deficit hyperactivity disorder (ADHD). The Cochrane Database of Systematic Reviews, 3(3), CD009885. https://doi.org/10.1002/14651858.CD009885.pub3
Storebø, O. J., Zwi, M., Krogh, H. B., Moreira-Maia, C. R., Holmskov, M., Gillies, D., Groth, C., Simonsen, E., & Gluud, C. (2016). Evidence on methylphenidate in children and adolescents with ADHD is in fact of “very low quality.” Evidence-Based Mental Health, 19(4), 100–102. https://doi.org/10.1136/EB-2016-102499
Vibholm, H. A., Pedersen, J., Faltinsen, E., Marcussen, M. H., Gluud, C., & Storebø, O. J. (2018). Training, executive, attention and motor skills (TEAMS) training versus standard treatment for preschool children with attention deficit hyperactivity disorder: a randomised clinical trial. BMC Research Notes, 11(1). https://doi.org/10.1186/S13104-018-3478-3
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