Concept and practice of evidence-based psychiatry and its application in Nigerian psychiatry: a critical review.
BACKGROUND
The practice of Evidence-Based Psychiatry started in the 1990's, however prior to this time the practice of psychiatry did have an evidenced base though not structured and systematically spelt out. This study aimed to review the development of the concept and practice of Evidence-Based Psychiatry and to identify position of Nigerian psychiatry in it.


METHODS
Narrative reviews were made from information obtained from scientific publications i.e. (books and journals) and internet-based electronic articles.


RESULTS
Evidence-Based Psychiatry emerged from Evidence-Based Medicine in the 1990's and aims to base practice on the best available evidence. The evidence is graded into A, B, and C, depending on the study design. Also critical to the practice of Evidence-Based Psychiatry is the availability of high-grade evidence and an efficient means of storing and retrieving it. Evidence-Based Psychiatry uses a systematic approach and involves five steps. Its scope covers aetiology, diagnosis, intervention, and prognosis.


CONCLUSIONS
A comprehensive definition of Evidence-Based Psychiatry is given. There is a suggestion to change the term 'Evidence-Based' to 'Systematic Evidence-Based'. The right way to determine if a therapeutic intervention is evidence-based is to consider if the process that led to it is systematic in terms of the five steps of Evidence-Based Psychiatry. Nigeria is yet to develop structures required for Systematic Evidence-Based Psychiatry.
Onifade
P O
PO
Neuropsychiatric Hospital, Aro, Abeokuta, Nigeria.
Oluwole
L O
LO
D019317:Evidence-Based Medicine; D006801:Humans; D001523:Mental Disorders / Q000453:epidemiology / Q000628:therapy*; D009549:Nigeria; D011570:Psychiatry / Q000379:methods* / Q000592:standards