title: [What is 'evidence' in psychiatry?].
abstract: Evidence-based medicine (EBM) is a concept that has come to dominate the medical literature over the last twenty years. Developed in the early 1990s at McMaster University in Canada, EBM captured a simple and compelling principle--that clinical decision-making should be based on the most up to date, rigorously generated research findings. The same principle has been applied in the development of evidence-based psychiatry. However, numerous scholars have pointed out epistemological problems in EBM's concept of evidence and have highlighted ways in which social factors can influence and distort the generation, interpretation and dissemination of EBM-preferred research data. These issues may be more problematic in psychiatry as compared to other medical specialties. Furthermore, as this paper argues, there are other kinds of data excluded by EBM that are essential to psychiatric practice. The validity of these data have been investigated empirically only rarely. In an era in which evidence- based psychiatric practice is becoming synonymous with "good" practice, developing a comprehensive understanding of what constitutes evidence in psychiatry -rather than the narrower version allowed by EBM- is an urgent priority. This paper represents an initial effort to develop a defensible, broader version of psychiatric evidence.
authors.affiliation: Departament of Psychiatry, University of Toronto. mona.gupta@utoronto.ca
authors.forename: Mona
authors.initials: M
authors.lastname: Gupta
mesh_terms: D019317:Evidence-Based Medicine / Q000592:standards; D006801:Humans; D011570:Psychiatry