University finds “preponderance of evidence” of misconduct by child psychiatrist

JPN39_2_CoverAn investigation at the University of Illinois at Chicago has found “a preponderance of evidence” that a psychiatrist who has received millions of dollars in federal funding has committed misconduct.

One paper co-authored by Mani Pavuluri, the director of the Pediatric Mood Disorders Program, has been officially retracted so far, from the Journal of Psychiatry & Neuroscience. UIC has requested that two others be retracted as well. None of the child participants in the three papers received medication as part of the research, but the Journal of Psychiatry & Neuroscience paper was pulled after the investigation found that Pavuluri had misrepresented how much medication some children had taken outside of the study.

On Tuesday, after we’d learned of the first retraction, Pavuluri told Retraction Watch that she didn’t “want mountains made out of molehills,” but admitted to “a bit of an [Institutional Review Board] infraction.”

The retraction note from the Journal of Psychiatry & Neuroscience lays the blame squarely on Pavuluri’s shoulders:

The article “Altered affective, executive and sensorimotor resting state networks in patients with pediatric mania” (DOI: 10.1503/jpn.120073; authors: Wu M, Lu LH, Passarotti AM, Wegbreit E, Fitzgerald J, Pavuluri MN) published in the July 2013 issue of the Journal of Psychiatry and Neuroscience has been retracted at the request of the University of Chicago at Illinois, as communicated to our editorial offices by one of the article’s authors, Mani Pavuluri. This request follows a formal institutional investigation by the University of Chicago at Illinois that found that allegations of research misconduct against Dr. Pavuluri were supported by a preponderance of evidence. The investigation panel concluded that Dr. Pavuluri intentionally made false statements in the Results section of the article whereby the medication status of research participants whose data were included in the analyses was misrepresented, thus compromising the results and conclusions of the article. The article’s co-authors were not implicated in the research misconduct.

A spokesperson at the University of Illinois at Chicago — not the University of Chicago at Illinois as listed in the notice, which does not exist — confirmed the investigation, and noted Pavuluri was asked to retract two additional papers:

Following a research integrity investigation by a faculty committee, the University required Dr. Pavuluri to retract three publications.  The publications were: 1)   Wegbreit et al.  “Where, when and how high, and how long? The hemodynamics of emotional response in psychotropic-naíve patients with adolescent bipolar disorder. Journal of Affective Disorders, 147:304 -311, 2013; 2) Shankman et al. “Deficits in emotion recognition in pediatric bipolar disorder: the mediating effects of irritability. Journal of Affective Disorders, 144:134-140, 2013); and 3) Wu et al. “Altered affective, executive and sensorimotor resting state networks in patients with pediatric mania.  Journal of Psychiatry and Neuroscience, 38:232-240, 2013.

The young people with bipolar disorder who participated in the affected papers in the Journal of Affective Disorders were either off medications or avoiding psychotropic meds. Neither has an editor’s note, but that may change soon, Co-Editor in Chief Paolo Brambilla told us:

Yes, we’ve been taking into consideration this retraction request and will operate shortly

We’re not sure what went wrong in those papers. Wegbreit et al. has been cited five times, according to Thomson Scientific’s Web of Knowledge, and Shankman et al. has three citations.

Pavuluri gave us a few details on the retracted Journal of Psychiatry & Neuroscience paper, which has been cited eight times. The paper examined the physiology of children with mania, and included some children who had received medication outside of the study. In theory, that medication could influence the conclusions about the condition. Here’s a statement from the results section of the paper:

Eight of 34 patients received minimal doses of medication around the emergence of the disorder.

But Pavuluri told us something different: Although the paper says the dose of medication was minimal, she said it was actually the time frame during which patients received medication that was minimal — less than two weeks. (The paper does not specify the actual dose the children received.) She also said first author Minje Wu, a research assistant professor, has the data:

The interesting part is that the first author has access to the data. I have not looked at that. I asked her to check it and make sure its accurate. She talked to the editors about [it.]

According to Pavuluri, a Distinguished Fellow of the American Academy of Child and Adolescent Psychiatry, the patients’ medication status came to light when the article was in press, and Wu “contacted the editors [and] explained that the patients were exposed to medications, and it wouldn’t make any difference in the result.”

Wu is not a co-author on any of the other papers the university has requested be retracted.

Pavuluri said the responsibility is being put on her because she is the principal investigator:

 If there is an IRB issue, they want to go after one person. They want to go after one person. They would rather have the person take the responsibility rather than have the institution be responsible.

We asked her for more details on the university’s investigation:

You are seeking information that is inappropriate. I want this to be left alone so I can help people.

We asked her if she thought the first author had made a mistake:

I don’t think so. I feel remorseful. I need to take responsibility in supervising. I should be careful to make sure to be careful. It is a large lab with too many things going on. You know, she corrected it, she tried hard, I don’t want to blame her.

We asked her to clarify what exactly went wrong in communicating the patient’s medication data:

It’s very difficult questions you are asking me. I’ve forgotten about this. I don’t want mountains made out of molehills. In my opinion results wouldn’t even change, I swear.

Pavuluri ended our phone conversation by saying that she needed to see a patient.

Last year, Pavuluri had a corrigendum on a paper in the Journal of the International Neuropsychological Society, “Negative Emotion Interference During a Synonym Matching Task in Pediatric Bipolar Disorder with and without Attention Deficit Hyperactivity Disorder,” which has been cited four times. Here, the problem was a blinding issue:

The following is a correction for an error that occurred in the article ‘Negative emotion interference during a synonym matching task in pediatric bipolar disorder with and without attention deficit hyperactivity disorder,’ originally published online February 11, 2013. In the article it was reported that clinicians were ‘blind to diagnosis,’ however we recently ascertained that they were not. In the sentence ‘‘Clinicians who were blind to diagnosis rated all subjects on the YMRS and CDRS,’’ (p603) the text ‘‘who were blind to diagnosis’’ should be removed. This correction does not affect the data analyses or results interpretation. The authors regret this error.

The first author on that paper is Alessandra Passarotti, a psychiatry professor at UIC. She is also a co-author on the three papers flagged in the UIC investigation.

The retracted paper in the Journal of Psychiatry & Neuroscience was funded by multiple grants from the U.S. National Institutes of Health; Pavuluri has been listed as the project leader on many NIH grants, totaling more than $7 million. The UIC spokesperson told us that the federal Office of Research Integrity “has been informed,” as the research was federally sponsored.

Pavuluri’s professional bio says,

Her goal is to understand brain mechanisms in order to develop molecular and brain biosignatures of pediatric mood disorders and unravel how treatments can reverse brain dysfunction, working towards personalized interventions. She is also working on suicide prevention and understanding the domain dysfunction at neurocognitive level, across child psychiatric illnesses. Dr. Pavuluri’s work is the foremost among the cohort of studies mapping the interfacing affective and cognitive brain circuits. Her book What Works for Bipolar Kids: Help and Hope for Parents draws on her 25+ years of experience treating children and adolescents with bipolar disorder.

We have contacted Wu, the first authors on the other papers flagged by the UIC, Passarotti, as well as the editors of the Journal of Psychiatry & Neuroscience. We’ll update this post if we hear back.

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2 thoughts on “University finds “preponderance of evidence” of misconduct by child psychiatrist”

  1. I believe everyone should pause for a moment of silence, and reflect upon the good deeds of the University of Illinois at Chicago.

    They have reached an adverse decision, concerning a tenured faculty member, who has secured millions of dollars in research funds for the institution.

    And still, they reach a finding of guilt, applying only a preponderance of evidence. Ethics and morals trump finances? Surely, you jest!

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