Does Evidence-Based Medicine Apply to Psychiatry?
- 348 Downloads
Evidence-based psychiatry (EBP) has arisen through the application of evidence-based medicine (EBM) to psychiatry. However, there may be aspects of psychiatric disorders and treatments that do not conform well to the assumptions of EBM. This paper reviews the ongoing debate about evidence-based psychiatry and investigates the applicability, to psychiatry, of two basic methodological features of EBM: prognostic homogeneity of clinical trial groups and quantification of trial outcomes. This paper argues that EBM may not be the best way to pursue psychiatric knowledge given the particular features of psychiatric disorders and their treatments. As a result, psychiatry may have to develop its own standards for rigour and validity. This paper concludes that EBM has had a powerful influence on how psychiatry investigates and understands mental disorders. Psychiatry could influence EBM in return, reshaping it in ways that are more clinically useful and congruent with patients’ needs.
Keywordsevidence evidence-based medicine evidence-based psychiatry outcome measures prognosis psychiatry quantification randomized controlled trials
Unable to display preview. Download preview PDF.
- Akiskal, H.G. “Mood disorders: Clinical features.” In Kaplan and Sadock’s comprehensive textbook of psychiatry, 8th edition. Edited by B.J. Sadock,V.A. Sadock. 1611–1652. Online edition: Lippincott, Williams & Wilkins, 2004.Google Scholar
- Cochrane Qualitative Methods Research Group. http://www.joannabriggs.edu.au/cqrmg/about.html [Accessed March 2, 2007].Google Scholar
- Evidence -Based Mental Health, 10 (2007): 2.Google Scholar
- Giacomini, M., D. Cook, and G. Guyatt. “Therapy and applying the results: qualitative research.” In Users’ Guide to the Medical Literature. Edited by G. Guyatt and D. Rennie. 433–448 (AMA Press, 2002).Google Scholar
- Goldner, E.M., A. Abbass, J.S. Leverette et␣al. “Evidence-based psychiatric practice: implications for education and continuing professional development.” Canadian Journal of Psychiatry 46 (2001): insert.Google Scholar
- Goldner E.M. and D. Bilsker. “Evidence-based psychiatry.” Canadian Journal of Psychiatry 40 (1995): 97–101.Google Scholar
- Guyatt, G. “Preface.” In Users’ Guide to the Medical Literature. Edited by G. Guyatt and D. Rennie. xiii-xvi (AMA Press, 2002).Google Scholar
- Guyatt, G., B. Haynes, R. Jaeschke et␣al. “Introduction: The philosophy of evidence-based medicine.” In Users’ Guide to the Medical Literature. Edited by G. Guyatt and D. Rennie. 3–12 (AMA Press, 2002).Google Scholar
- Hay, P.J., J. Bacaltchuk, and S. Stefano. “Psychotherapy for bulimia nervosa and binging.” Cochrane Database of Systematic Reviews 3 (2004).Google Scholar
- Kennedy S.H., R.W Lam, et␣al. “Clinical guidelines for the treatment of depressive disorders -IV. Medications and other biological treatments.” Canadian Journal of Psychiatry 46 (2001): 38S–58S.Google Scholar
- McCutcheon, C. “What kind is evidence in evidence-based healthcare?” Unpublished manuscript, Submitted in completion of MA requirements, York University, Canada, 2005.Google Scholar
- Oakley-Browne M.A. “EBM in practice: psychiatry.” Medical Journal of Australia 174 (2001): 403–404.Google Scholar
- Price J.R., J. Couper. “Cognitive-behaviour therapy for chronic fatigue syndrome in adults.” Cochrane Database of Systematic Reviews 4 (1998).Google Scholar
- Raynor, D.K., A. Blenkinsopp, P. Knapp, et␣al. “A systematic review of quantitative and qualitative research on the role and effectiveness of written information available to patients about individual medicines.” Health Technology Assessment, 11 (2007) 5. Accessed March 2, 2007.Google Scholar
- Roland M. and D.J. Torgerson. “What are pragmatic trials?” British Medical Journal 316 (1998): 285–288.Google Scholar
- Roth, A. and P. Fonagy. “Translating Research into Practice: methodological considerations.” In What works for whom? : A Critical Review of Psychotherapy Research. 34 (London: Guilford Press, 1996).Google Scholar
- Seeman M.V. “Clinical trials in psychiatry: do results apply to practice?” Canadian Journal of Psychiatry 46 (2001): 352–355.Google Scholar
- Strauss, S.E., W.S. Richardson, P. Glasziou, and R.B. Haynes. Evidence-Based Medicine: How to Practice and Teach EBM, 3rd edition, Elsevier Churchill Livingstone, 2005.Google Scholar
- Worrall J. “What evidence in evidence-based medicine?” http://www.lse.ac.uk/collections/CPNSS/CPNSS-DPS/causalityDPseries.htm (2002): 1–26.