[The concept of "evidence-based medicine" in psychiatry. A path to a more rational psychiatry?].
Many of the diagnostic and therapeutic procedures in psychiatry and psychotherapy are based on opinion rather than evidence. The concept of evidence-based medicine aims to bridge the gap between clinical research and clinical decision-making by integrating the best available external evidence with personal expertise. In this article, we demonstrate several examples of the non-evidence-based medicine paradigm. Then we show the usefulness and practicability of the new evidence-based medicine paradigm by using a clinical example. Finally, we discuss the consequences, chances, and limitations of this new model. We also examine the role of the individual clinician's viewpoint as well as the need of institutional re-engineering and the possible restructuring of the entire health care system towards evidence-based methods.
Berner
M M
MM
Abteilung Psychiatrie und Psychotherapie, Klinikum der Albert-Ludwigs-Universität, Freiburg. michael_berner@psyallg.ukl.uni-freiburg.de
Rüther
A
A
Stieglitz
R D
RD
Berger
M
M
D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D003695:Delivery of Health Care / Q000639:trends; D003866:Depressive Disorder / Q000188:drug therapy; D019317:Evidence-Based Medicine / Q000639:trends*; D006801:Humans; D020902:Hypericum / Q000627:therapeutic use; D008517:Phytotherapy; D010946:Plants, Medicinal; D011570:Psychiatry / Q000639:trends*; D011613:Psychotherapy / Q000639:trends*; D016032:Randomized Controlled Trials as Topic; D017749:Total Quality Management / Q000639:trends
D000929:Antidepressive Agents, Tricyclic