Advertisement

How close is evidence to truth in evidence-based treatment of mental disorders?

  • Hans-Jürgen Möller
Original Paper

Abstract

Given the importance of the term ‘evidence’ in evidence-based medicine (EBM), the meaning of this term is evaluated, going back to the philosophical tradition and current meaning of the terms ‘evidence’ and ‘truth’. Based on this, current problems in the definition of evidence and in the grading of evidence in EBM are described, taking examples from the field of psychiatry and especially pharmacopsychiatry. These problems underline that the use of the term evidence in EBM is inconsistent and inconclusive. This should be fairly stated in all EBM-related publications, especially in EBM-based guidelines, to avoid severe misunderstandings in and outside the field of psychiatry. Although EBM might have increased empirically driven rational decision-making in psychiatry/medicine, the current limitations should be carefully considered.

Keywords

Truth Evidence Evidence-based medicine (EBM) Mental disorders 

Notes

Conflict of interest

H.-J. Moeller has received grants or is a consultant for and on the speakership bureaus of AstraZeneca, Bristol-Myers Squibb, Eisai, Eli Lilly, GlaxoSmithKline, Janssen Cilag, Lundbeck, Merck, Merz, Novartis, Organon, Pfizer, Sanofi-Aventis, Schering-Plough, Schwabe, Sepracor, Servier and Wyeth.

References

  1. 1.
    American Psychiatric Association APA Guideline Development Process (2006) http://www.psych.org/psych_pract/treatg/pg/prac_guide.cfm.Anonymous
  2. 2.
    Antes G (2004) The evidence base of clinical practice guidelines, health technology assessments and patient information as a basis for clinical decision-making. Z Ärztl Fortbild Qualitätssich 98:180–184PubMedGoogle Scholar
  3. 3.
    Atkins D, Best D, Briss PA, Eccles M, Falck-Ytter Y, Flottorp S, Guyatt GH, Harbour RT, Haugh MC, Henry D et al (2004) Grading quality of evidence and strength of recommendations. BMJ 19:1490Google Scholar
  4. 4.
    Baldwin D, Broich K, Fritze J, Kasper S, Westenberg H, Möller HJ (2003) Placebo-controlled studies in depression: necessary, ethical and feasible. Eur Arch Psychiatry Clin Neurosci 253:22–28PubMedCrossRefGoogle Scholar
  5. 5.
    Bandelow B, Zohar J, Hollander E, Kasper S, Moller HJ, Zohar J, Hollander E, Kasper S, Moller HJ, Bandelow B et al (2008) World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the pharmacological treatment of anxiety, obsessive-compulsive and post-traumatic stress disorders—first revision. World J Biol Psychiatry 9:248–312PubMedCrossRefGoogle Scholar
  6. 6.
    Bandelow B, Zohar J, Kasper S, Möller HJ (2008) How to grade categories of evidence. World J Biol Psychiatry 9:242–247PubMedCrossRefGoogle Scholar
  7. 7.
    Bateman A, Fonagy P (1999) Effectiveness of partial hospitalization in the treatment of borderline personality disorder: a randomized controlled trial. Am J Psychiatry 156:1563–1569PubMedGoogle Scholar
  8. 8.
    Bauer M, Whybrow PC, Angst J (2002) World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of unipolar depressive disorders, Part 2: Maintenance treatment of major depressive disorder and treatment of chronic depressive disorders and subthreshold depressions. World J Biol Psychiatry 3:69–86PubMedCrossRefGoogle Scholar
  9. 9.
    Bauer M, Bschor T, Pfennig A, Whybrow PC, Angst J, Versiani M, Möller HJ, WFSBP Task Force on Unipolar Depressive Disorders (2007) World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of unipolar depressive disorders in primary care. World J Biol Psychiatry 8:67–104PubMedCrossRefGoogle Scholar
  10. 10.
    Bauer M, Tharmanathan P, Volz HP, Möller HJ, Freemantle N (2009) The effect of venlafaxine compared with other antidepressants and placebo in the treatment of major depression: a meta-analysis. Eur Arch Psychiatry Clin Neurosci 259(3):172–185Google Scholar
  11. 11.
    Bauer M, Whybrow PC, Angst J, Versiani M, Möller HJ, WFSBP Task Force on Treatment Guidelines for Unipolar Depressive Disorders (2002) World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of unipolar depressive disorders, Part 1: Acute and continuation treatment of major depressive disorder. World J Biol Psychiatry 3:5–43Google Scholar
  12. 12.
    Beynon S, Soares-Weiser K, Woolacott N, Duffy S, Geddes JR (2008) Pharmacological interventions for the prevention of relapse in bipolar disorder: a systematic review of controlled trials. Br J Psychiatry 192(1):5–11Google Scholar
  13. 13.
    Bottlender R, Rudolf D, Strauss A, Moller HJ (1998) Antidepressant-associated maniform states in acute treatment of patients with bipolar-I depression. Eur Psychiatry 248:296–300Google Scholar
  14. 14.
    Campbell M, Fitzpatrick R, Haines A, Kinmonth AL, Sandercock P, Spiegelhalter D, Tyrer P (2000) Framework for design and evaluation of complex interventions to improve health. BMJ 321:694–696PubMedCrossRefGoogle Scholar
  15. 15.
    Carnap R (1956) The methodological character of theoretical concepts. In: Feigl HSM (ed) Minnesota studies on the philosophy of science. 1. Minneapolis, pp 38–76Google Scholar
  16. 16.
    Carnap R (1966) Philosophical foundations on physics. Gardner M, New YorkGoogle Scholar
  17. 17.
    Carpenter WT (2001) Evidence-based treatment for first-episode Schizophrenia? Am J Psychiatry 158:1771–1773PubMedCrossRefGoogle Scholar
  18. 18.
    Cartabellotta A, Minella C, Bevilacqua L, Caltagirone P (1998) Evidence-based medicine. 3. Systematic reviews: a tool for clinical practice, permanent education and health policy decisions. Italian Group on Evidence-Based Medicine-GIMBE. Recenti Prog Med 89:329–337PubMedGoogle Scholar
  19. 19.
    Cartabellotta A, Montalto G, Notarbartolo A (1998) Evidence-based medicine. How to use biomedical literature to solve clinical problems. Italian Group on Evidence-Based Medicine-GIMBE. Minerva Med 89:105–115PubMedGoogle Scholar
  20. 20.
    Catty J, Burns T, Comas A (2001) Day centres for severe mental illness. Cochrane Database Syst Rev (2):CD001710Google Scholar
  21. 21.
    Chilvers R, Macdonald GM, Hayes AA (2002) Supported housing for people with severe mental disorders. Cochrane Database Syst Rev (2):CD000453Google Scholar
  22. 22.
    Cipriani A, Furukawa TA, Salanti G, Geddes JR, Higgins JPT, Churchill R, Watanabe N, Nakagawa A, Omori IM, McGuire H et al (2009) Comparative efficacy and acceptability of 12 new-generation antidepressants: a multiple-treatments meta-analysis. Lancet 373:746–758PubMedCrossRefGoogle Scholar
  23. 23.
    Clark W, Mucklow J (1998) Gathering and weighing the evidence. In: Panton R, Chapman S (eds) Medicines management. BMJ Books and Pharmaceutical Press, London, pp 59–74Google Scholar
  24. 24.
    Craig JC, Irwig LM, Stockler MR (2001) Evidence-based medicine: useful tools for decision making. MJA 174:248–253PubMedGoogle Scholar
  25. 25.
    Crowther R, Marshall M, Bond G, Huxley P (2003) Vocational rehabilitation for people with severe mental illness (Cochrane Review) [computer program]. The Cochrane Library, Issue 3. Update Software, OxfordGoogle Scholar
  26. 26.
    Czekalla J (2006) Kritische Bewertung von Studien und Metaanalysen. Ein Fortbildungsartikel über die wichtigsten Validitätskriterien der Evidence-based Medicine. Psychopharmakotherapie 13:224–230Google Scholar
  27. 27.
    Davis JM, Chen N, Glick ID (2003) A meta-analysis of the efficacy of second-generation antipsychotics. Arch Gen Psychiatry 60:553–564PubMedCrossRefGoogle Scholar
  28. 28.
    Deutsche Gesellschaft für Psychiatrie PuN DGPPN, BÄK, KBV, AWMF, AkdÄ B, BApK, DAGSHG, DEGAM, DGPM, DGPs et al (eds) (2009) S3-Leitlinien/Nationale VersorgungsLeitlinie Unipolare Depression. Berlin, Düsseldorf. Deutsche Gesellschaft für Psychiatrie, Psychotherapie und NervenheilkundeGoogle Scholar
  29. 29.
    Eccles M, Grimshaw J, Campbell M, Ramsay C (2003) Research designs for studies evaluating the effectiveness of change and improvement strategies. Qual Saf Health Care 12:47–52PubMedCrossRefGoogle Scholar
  30. 30.
    Falkai P, Wobrock T, Lieberman J, Glenthoj B, Gattaz WF, Moller HJ (2006) World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of schizophrenia, part 2: long-term treatment of schizophrenia. World J Biol Psychiatry 7:5–40PubMedCrossRefGoogle Scholar
  31. 31.
    Falkai P, Wobrock T, Lieberman J, Glenthoj B, Gattaz WF, Moller HJ, WFSBP Task Force on Treatment Guidelines for Schizophrenia (2005) World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of schizophrenia, Part 1: acute treatment of schizophrenia. World J Biol Psychiatry 6:132–191Google Scholar
  32. 32.
    Fountoulakis KN, Möller HJ (2011) Efficacy of antidepressants: a re-analysis and re-interpretation of the Kirsch data. Int J Neuropsychopharmacol 14:405–412PubMedCrossRefGoogle Scholar
  33. 33.
    Fritze J, Möller HJ (2001) Design of clinical trials of antidepressants. Should a placebo control arm be included? CNS Drugs 15:755–764PubMedCrossRefGoogle Scholar
  34. 34.
    Geddes JR, Calabrese JR, Goodwin GM (2009) Lamotrigine for treatment of bipolar depression: independent meta-analysis and meta-regression of individual patient data from five randomised trials. Br J Psychiatry 194:4–9PubMedCrossRefGoogle Scholar
  35. 35.
    Geddes JR, Carney SM, Davies C, Furukawa TA, Kupfer DJ, Frank E, Goodwin GM (2003) Relapse prevention with antidepressant drug treatment in depressive disorders: a systematic review. Lancet 361:653–661PubMedCrossRefGoogle Scholar
  36. 36.
    Gerson S, Belin TR, Kaufman A, Mintz J, Jarvik L (1999) Pharmacological and psychological treatments for depressed older patients: a meta-analysis and overview of recent findings. Harv Rev Psychiatry 7:1–28PubMedGoogle Scholar
  37. 37.
    Gonzalez DD (2001) From evidence-based medicine to medicine-based evidence. An Esp Pediatr 55:429–439Google Scholar
  38. 38.
    Grunze H, Kasper S, Goodwin G, Bowden C, Baldwin D, Licht R, Vieta E, Möller HJ (2002) World Federation of Societies of Biological Psychiary (WFSBP) guidelines for biological treatment of bipolar disorders, Part I: Treatment of bipolar depression. World J Biol Psychiatry 3:115–124PubMedCrossRefGoogle Scholar
  39. 39.
    Grunze H, Kasper S, Goodwin G, Bowden C, Baldwin D, Licht RW, Vieta E, Moller HJ (2003) The World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the biological treatment of bipolar disorders, Part II: Treatment of mania. World J Biol Psychiatry 4:5–13PubMedCrossRefGoogle Scholar
  40. 40.
    Grunze H, Kasper S, Goodwin G, Bowden C, Moller HJ (2004) The World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the biological treatment of bipolar disorders, Part III: Maintenance treatment. World J Biol Psychiatry 5:120–135PubMedCrossRefGoogle Scholar
  41. 41.
    Grunze H, Vieta E, Guy M, Goodwin GM, Bowden C, Licht RW, Möller HJ, Kasper S, WFSBP Task Force on Treatment Guidelines for Bipolar Disorders (2009) The World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the biological treatment of bipolar disorders: update 2009 on the Treatment of Acute Mania. World J Biol Psychiatry 10(2):85–116Google Scholar
  42. 42.
    Guyatt G, Gutterman D, Baumann MH, Addrizzo-Harris D, Hylek EM, Phillips B, Raskob G, Lewis SZ, Schunemann H (2006) Grading strength of recommendations and quality of evidence in clinical guidelines: report from an American College of Chest Physicians task force. Chest 129:174–181PubMedCrossRefGoogle Scholar
  43. 43.
    Hegerl U, Hautzinger M, Mergl R, Kohnen R, Schutze M, Scheunemann W, Allgaier AK, Coyne J, Henkel V (2010) Effects of pharmacotherapy and psychotherapy in depressed primary-care patients: a randomized, controlled trial including a patients’ choice arm. Int J Neuropsychopharmacol 13:31–44PubMedCrossRefGoogle Scholar
  44. 44.
    Hegerl U, Plattner A, Moller HJ (2004) Should combined pharmaco- and psychotherapy be offered to depressed patients? A qualitative review of randomized clinical trials from the 1990s. Eur Arch Psychiatry Clin Neurosci 254:99–107PubMedCrossRefGoogle Scholar
  45. 45.
    Horder J, Matthews P, Waldmann R (2010) Placebo, Prozac and PLoS: significant lessons for psychopharmacology. J Psychopharmacol [Epub ahead of print]Google Scholar
  46. 46.
    Huf W, Kalcher K, Pail G, Friedrich ME, Filzmoser P, Kasper S (2011) Meta-analysis: fact or fiction? How to interpret meta-analyses. World J Biol Psychiatry 12:188–200PubMedCrossRefGoogle Scholar
  47. 47.
    Jadad AR, Phil D, Cook DJ (1998) Methodology and reports of systematic reviews and meta-analyses-a comparison of cochrane reviews with articles published in paper-based Journals. JAMA 280:278–280PubMedCrossRefGoogle Scholar
  48. 48.
    Kallert TW (2005) Is mental health services research in need of randomised controlled trials? Psychiatr Prax 32:375–377PubMedCrossRefGoogle Scholar
  49. 49.
    Kawamura T, Tamakoshi A, Wakai K, Ohno Y (1999) Evidence-based medicine and ‘The Cochrane Collaboration’. Nippon Koshu Eisei Zasshi 46:498–506PubMedGoogle Scholar
  50. 50.
    Khan KS, Kunz R, Kleijnen J, Antes G (2004) Systematische Übersichten und Meta-Analysen. Ein Handbuch für Ärzte in Klinik und Praxis sowie Experten im Gesundheitswesen. Springer, BerlinGoogle Scholar
  51. 51.
    Kirsch I, Deacon BJ, Huedo-Medina TB, Scoboria A, Moore TJ, Johnson BT (2008) Initial severity and antidepressant benefits: a meta-analysis of data submitted to the food and drug administration. PLoS Med 5:e45PubMedCrossRefGoogle Scholar
  52. 52.
    Klein DF (2000) Flawed meta-analyses comparing psychotherapy with pharmacotherapy. Am J Psychiatry 157:1204–1211PubMedCrossRefGoogle Scholar
  53. 53.
    Koller M, Lorenz W, Abel U (2006) Methodenvielfalt in der klinischen Forschung. MMW-Fortschritte der Medizin 148:85–91Google Scholar
  54. 54.
    Leichsenring F, Rabung S, Leibing E (2004) The efficacy of short-term psychodynamic psychotherapy in specific psychiatric disorders: a meta-analysis. Arch Gen Psychiatry 61:1208–1216PubMedCrossRefGoogle Scholar
  55. 55.
    Leucht S, Arbter D, Engel RR, Kissling W, Davis JM (2009) How effective are second-generation antipsychotic drugs? A meta-analysis of placebo-controlled trials. Mol Psychiatry 14(4):429–447Google Scholar
  56. 56.
    Lieberman JA, Greenhouse J, Hamer RM, Krishnan KR, Nemeroff CB, Sheehan DV, Thase ME, Keller MB (2005) Comparing the effects of antidepressants: consensus guidelines for evaluating quantitative reviews of antidepressant efficacy. Neuropsychopharmacology 30:445–460PubMedCrossRefGoogle Scholar
  57. 57.
    Lieberman JA, Stroup TS, McEvoy JP, Swartz MS, Rosenheck RA, Perkins DO, Keefe RS, Davis SM, Davis CE, Lebowitz BD et al (2005) Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. N Engl J Med 353:1209–1223PubMedCrossRefGoogle Scholar
  58. 58.
    Linden M (2002) Verhaltenstherapie: theoretische und empirische Grundlagen sowie klinische Anwendungsprinzipien. In: Möller HJ, Laux G, Kapfhammer HP (eds) Psychiatrie and psychotherapie. Springer, Berlin, pp 681–710Google Scholar
  59. 59.
    Linehan MM, Comtois KA, Murray AM, Brown MZ, Gallop RJ, Heard HL, Korslund KE, Tutek DA, Reynolds SK, Lindenboim N (2006) Two-year randomized controlled trial and follow-up of dialectical behavior therapy vs therapy by experts for suicidal behaviors and borderline personality disorder. Arch Gen Psychiatry 63:757–766PubMedCrossRefGoogle Scholar
  60. 60.
    Lohr KN (2004) Rating the strength of scientific evidence: relevance for quality improvement programs. Int J Qual Health Care 16:9–18PubMedCrossRefGoogle Scholar
  61. 61.
    Maier W, Möller HJ (2005) Metaanalyses—highest level of empirical evidence? Eur Arch Psychiatry Clin Neurosci 255:369–370PubMedCrossRefGoogle Scholar
  62. 62.
    Maier W, Möller HJ (2010) Meta-analyses: a method to maximise the evidence from clinical studies? Eur Arch Psychiatry Clin Neurosci 260:17–23PubMedCrossRefGoogle Scholar
  63. 63.
    Manser R, Walters EH (2001) What is evidence-based medicine and the role of the systematic review: the revolution coming your way. Monaldi Arch Chest Dis 56:33–38PubMedGoogle Scholar
  64. 64.
    Marshall M, Crowther R, Almaraz-Serrano A, Creed F, Sledge W, Kluiter H, Roberts C, Hill E, Wiersma D (2003) Day hospital versus admission for acute psychiatric disorders. Cochrane Database Syst Rev (1):CD004026Google Scholar
  65. 65.
    Marshall M, Gray A, Lockwood A, Green R (2003) Case management for people with severe mental disorders (Cochrane Review). The Cochrane Library, Issue 3. Update Software, OxfordGoogle Scholar
  66. 66.
    Marshall M, Lockwood A (2003) Assertive communication treatment for people with severe mental disorder (Cochrane Review). The Cochrane Library, Issue 3. Update Software, OxfordGoogle Scholar
  67. 67.
    Mittelstraß JH (2004) Evidenz. In: Mittelstraß J (ed) Enzyklopädie Philosophie und Wissenschaftstheorie. Sonderausgabe ed. J. B.Metzler, Stuttgart, pp 609–610Google Scholar
  68. 68.
    Mittelstraß JH (2004) Wahrheit. In: Mittelstraß J (ed) Enzyklopädie Philosophie und Wissenschaftstheorie. Sonderausgabe ed. J. B.Metzler, Stuttgart, pp 582–587Google Scholar
  69. 69.
    Mittelstraß JH (2004) Wahrheitsähnlichkeit. In: Mittelstraß J (ed) Enzyklopädie philosophie und wissenschaftstheorie. Sonderausgabe ed. J. B.Metzler, Stuttgart, pp 588–589Google Scholar
  70. 70.
    Moher D, Cook DJ, Eastwood S, Olkin I, Rennie D, Stroup DF (1999) Improving the quality of reports of meta-analyses of randomised controlled trials: the QUOROM statement. Quality of reporting of meta-analyses. Lancet 354:1896–1900PubMedCrossRefGoogle Scholar
  71. 71.
    Möller HJ (1976) Methodische Grundprobleme der Psychiatrie. Kohlhammer, StuttgartGoogle Scholar
  72. 72.
    Möller HJ (1978) Psychoanalyse. Erklärende Wissenschaft oder Deutungskunst? Zur Grundlagendiskussion in der Psychowissenschaft. Fink, MünchenGoogle Scholar
  73. 73.
    Möller HJ (2001) Methodological issues in psychiatry: psychiatry as an empirical science. World J Biol Psychiatry 2:38–47PubMedCrossRefGoogle Scholar
  74. 74.
    Möller HJ (2006) Methodik empirischer Forschung und evidenz-basierter Medizin in der Psychiatrie. In: Möller HJ, Laux G, Kapfhammer HP (eds) Psychiatrie und psychotherapie. 3 Aufl. Springer, BerlinGoogle Scholar
  75. 75.
    Möller HJ (2008) Do effectiveness (“real world”) studies on antipsychotics tell us the real truth? Eur Arch Psychiatry Clin Neurosci 258:257–270PubMedCrossRefGoogle Scholar
  76. 76.
    Möller HJ (2008) Isn’t the efficacy of antidepressants clinically relevant? A critical comment on the results of the metaanalysis by Kirsch et al. 2008. Eur Arch Psychiatry Clin Neurosci 258:451–455PubMedCrossRefGoogle Scholar
  77. 77.
    Möller HJ (2009) Is evidence sufficient for evidence-based medicine? Eur Arch Psychiatry Clin Neurosci 259(Suppl 2):S167–S172Google Scholar
  78. 78.
    Möller HJ, Broich K (2010) Principle standards and problems regarding proof of efficacy in clinical psychopharmacology. Eur Arch Psychiatry Clin Neurosci 260:3–16PubMedCrossRefGoogle Scholar
  79. 79.
    Möller HJ, Fuger J, Kasper S (1993) Statistische metaanalyse der Wirksamkeit neuerer Antidepressiva. Antidepressiva und Phasenprophylaktika. Riederer P, Laux G, and Pöldinger W. Neuro-Psychopharmaka.Wien, Springer, pp 252–256Google Scholar
  80. 80.
    Möller HJ, Maier W (2010) Evidence-based medicine in psychotherapy: possibilities, problems and limitations. Eur Arch Psychiatry Clin Neurosci 260:25–39PubMedCrossRefGoogle Scholar
  81. 81.
    Montgomery SA, Möller HJ (2009) Is the significant superiority of escitalopram compared with other antidepressants cliniclly relevant? Int Clin Psychopharmacol 24:111–118PubMedCrossRefGoogle Scholar
  82. 82.
    Neumann PJ, Tunis SR (2010) Medicare and medical technology–the growing demand for relevant outcomes. N Engl J Med 362:377–379PubMedCrossRefGoogle Scholar
  83. 83.
    Pilling S, Price K (2006) Developing and implementing clinical guidelines: lessons from the NICE schizophrenia guideline. Epidemiol Psichiatr Soc 15:109–116PubMedGoogle Scholar
  84. 84.
    Popper K (1963) Conjectures and refutations. The growth of scientific knowledge. Routledge & Kegan Paul, LondonGoogle Scholar
  85. 85.
    Riedel M, Strassnig N, Müller N, Zwack P, Möller HJ (2005) How representative of everyday clinical populations are schizophrenia patients enrolled in clinical trials? Eur Arch Psychiatry Clin Neurosci 255:143–148PubMedCrossRefGoogle Scholar
  86. 86.
    Sackett DL (2000) Evidence-Based Medicine: How to practice and teach EBM. Churchill Livingstone, New YorkGoogle Scholar
  87. 87.
    Sackett DL, Richardson S, Rosenberg WS, Haynes W, Dt. Ausg: Kunz R, Fritsche L (1999) Evidenzbasierte Medizin. Zuckschwerdt, MünchenGoogle Scholar
  88. 88.
    Sackett DL, Rosenberg WM, Gray JA, Haynes RB, Richardson WS (1996) Evidence based medicine: what it is and what it isn’t. BMJ 312:71–72PubMedCrossRefGoogle Scholar
  89. 89.
    Saha S, Coffman DD, Smits AK (2010) Giving teeth to comparative-effectiveness research—the Oregon experience. N Engl J Med 362:e18PubMedCrossRefGoogle Scholar
  90. 90.
    Schmacke N (2006) Evidenzbasierte Medizin und Psychotherapie: die Frage nach den angemessenen Erkenntnismethoden. Psychother Psychosom Med Psychol 56:202–209PubMedCrossRefGoogle Scholar
  91. 91.
    Schöchlin C, Möller HJ, Engel RR (2002) Meta-Analysen von Antidepressiva-Studien. In: Riederer P, Laux G, Pöldinger W (eds) Neuro-psychopharmaka, Bd. 3, 2. Aufl. Springer, Wien New York, pp 349–363Google Scholar
  92. 92.
    Seemüller F, Möller HJ, Obermeier M, Adli M, Bauer M, Kronmüller K, Holsboer F, Brieger P, Laux G, Bender W et al (2010) Do efficacy and effectiveness samples differ in antidepressant treatment outcome? An analysis of eligibility criteria in randomized controlled trials. J Clin Psychiatry 71:1426–1433CrossRefGoogle Scholar
  93. 93.
    Stegmüller W (1954) Metaphysik, Wissenschaft, Skepsis. Frankfurt, WienGoogle Scholar
  94. 94.
    Tarski A (1935) Der Wahrheitsbegriff in den formalisierten Sprachen. Stud Philos 1:262–405Google Scholar
  95. 95.
    Wampold BE, Minami T, Baskin TW, Callen TS (2002) A meta-(re)analysis of the effects of cognitive therapy versus ‘other therapies’ for depression. J Affect Disord 68:159–165PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  1. 1.Department of PsychiatryLudwig-Maximilian University MunichMunichGermany

Personalised recommendations