Randomized controlled trials in schizophrenia: a critical perspective on the literature.
OBJECTIVE
The randomized trial provides an opportunity to minimize the inclusion of biases in the evaluation of interventions in psychiatry. Difficulties arise, however, when applying their results to 'real world' clinical practice and decision-making. We, therefore, examined the real world applicability of schizophrenia trials.


METHODS
A narrative overview of the content and quality of the randomized trials relevant to the care of those with schizophrenia is provided.


RESULTS
Complex, explanatory, under-powered randomized drug trials dominate evaluative research in schizophrenia.


CONCLUSIONS
Explanatory designs are a necessary but insufficient step in establishing the true worth of interventions in schizophrenia. Research from other spheres of mental health and wider health care suggest that pragmatic trials are feasible. This design allows large scale trials to be conducted which include patients which we would recognize from routine practice and which record outcomes which are of genuine interest to decision-makers.
Gilbody
S
S
Cochrane Schizophrenia Group, Academic Unit of Psychiatry and Behavioural Sciences, University of Leeds, Leeds, UK. s.m.gilbody@leeds.ac.uk
Wahlbeck
K
K
Adams
C
C
D006801:Humans; D016032:Randomized Controlled Trials as Topic; D012559:Schizophrenia / Q000188:drug therapy*; D012565:Schizophrenic Psychology