Psychiatric Times. Vol. 25 No. 4
Why Evidence-Based Medicine Cannot Be Applied to Psychiatry
By Robert Levine, MD and Max Fink, MD | April 1, 2008
Dr Levine is associate professor of clinical psychiatry at New York University School of Medicine. Dr Fink is professor emeritus of psychiatry and neurology at Stony Brook University, Stony Brook, NY. He is the author of Electroshock: Restoring the Mind (Oxford University Press), founding editor of The Journal of ECT, and co-author of Catatonia: A Clinician's Guide to Diagnosis and Treatment and Melancholia: The Diagnosis, Pathophysiology and Treatment of Depressive Illness (both with Cambridge University Press). The authors report no conflicts of interest to disclose concerning the subject matter of this article.
1. Sackett DL, Rosenberg WM, Gray JA, et al. Evidence-based medicine: what it is and what it isn't. BMJ. 1996;312:71-72.
2. Sackett DL, Strauss SE, Richardson WS, et al. Evidence-Based Medicine: How to Practice and Teach EBM. 2nd ed. New York: Churchill Livingstone; 2000.
3. Gray GE. The philosophy and methods of evidence-based medicine: an introduction for psychiatrists. Dir Psychiatry. 2002;22:165-173.
4. Maier W, Lichtermann D, Minges J, et al. Continuity and discontinuity of affective disorders and schizophrenia. Results of a controlled family study. Arch Gen Psychiatry. 1993;50:871-883.
5. Rende R, Hodgins S, Palmour R, et al. Familial overlap between bipolar disorder and psychotic symptoms in a Canadian cohort.Can J Psychiatry. 2004;50:189-194.
6. Kendall RE. The major functional psyches: are they independent entities or part of a continuum? In: A Kerr, H McClellan, eds. Concepts of Mental Disorder. London: Gaskell; 1991:1-16.
7. Williams DD, Garner J. The case against "the evidence": a different perspective on evidence-based medicine. Br J Psychiatry. 2002;180:8-12.
8. Weinberger DR, Egan MF, Bertolino A, et al. Prefrontal neurons and the genetics of schizophrenia. Biol Psychiatry. 2001;50:825-844.
9. Goldberg TE, Egan MF, Gschidle T, et al. Executive subprocesses in working memory: relationship to catechol-O-methyltransferase Val158Met genotype and schizophrenia. Arch Gen Psychiatry. 2003;60:889-896.
10. Numakawa T, Yagasaki Y, Ishimoto T, et al. Evidence of novel neuronal functions of dysbindin, a susceptibility gene for schizophrenia. Hum Mol Genet (England). 2004;13:2699-2708.
11. Burt SA, Krueger RF, McGue M, Iacono W. Parent-child conflict and the comorbidity among childhood externalizing disorders. Arch Gen Psychiatry.2003; 60:505-513.
12. Maughan B, Rowe R, Messer J, et al. Conduct disorder and oppositional defiant disorder in a national sample: developmental epidemiology. J Child Psychol Psychiatry. 2004;45:609-621.
13. Thapar A, Harrington R, McGuffin P. Examining the comorbidity of ADHD-related behaviours and conduct problems using a twin study design. Br J Psychiatry. 2001;179:224-229.
14. Cassano GB, Pini S, Saettoni M, Dell'Osso L. Multiple anxiety disorder comorbidity in patients with mood spectrum disorders with psychotic features. Am J Psychiatry. 1999;156:474-476.
15. Katerndahl DA, Realini JP. Comorbid psychiatric disorders in subjects with panic attacks. J Nerv Ment Dis. 1997;185:669-674.
16. Richter MA, Summerfeldt LJ, Antony MM, Swinson RP. Obsessive-compulsive spectrum conditions in obsessive-compulsive disorder and other anxiety disorders. Depress Anxiety. 2003;18:118-127.
17. Sanderson WC, DiNardo PA, Rapee RM, et al. Syndrome comorbidity in patients diagnosed with a DSM-III-R anxiety disorder. J Abnorm Psychol. 1990; 99:308-312.
18. Rihmer Z, Barsi J, Belso N, et al. Antidepressant induced hypomania in obsessive-compulsive disorder. Int Clin Psychopharmacol. 1996;11:203-205.
19. Tucker GJ. Limitations of the DSM-IV as a diagnostic tool. Dir Psychiatry. 2000;20:127-135.
20. Shapiro AK, Shapiro E. The Powerful Placebo. Baltimore: Johns Hopkins University Press; 1997:190-201.
21. Vedamtan S. Drugmakers prefer silence on test data. Washington Post. July 6, 2004:A01. Available at: http://www.washingtonpost.com/wpdyn/articles/A29576-2004Jul5.html. Accessed September 21, 2007.
22. Sussman N. Misuse of evidence: an open secret. Prim Psychiatry. 2003;10:14.
23. Lexchin J, Bero LA, Djulbegovic B, Clark O. Pharmaceutical industry sponsorship and research outcome and quality: systematic review. BMJ. 2003; 326:1167-1170.
24. Bauer MS. How solid is the evidence for the efficacy of mood stabilizers in bipolar disorder? Dir Psychiatry. 2005;25:165-181.
25. Weinberger D, Stahl SM. Genes, Circuits, and Pharmacology: Clinical Connections in Schizophrenia. Archived satellite presentation. Carlsbad, Calif. NeuroScience Education Institute; July 2004.
26. Egger M, Smith GD, O'Rourke K. Rationale, potentials, and promise of systematic reviews. In: Egger M, Smith GD, Altman DG, eds. Systematic Reviews in Health Care: Meta-Analysis in Context. London: BMJ Books; 2001:3-19.
27. Baker M, Kleijnen J. The drive towards evidence-based health care. In: Rowland N, Gross S, eds. Evidence-Based Counseling and Psychological Therapies: Research and Applications. Philadelphia: Routledge; 2000:3013-3029.
28. Reynolds S. The anatomy of evidence-based practice: principles and methods. In: Trinder L, Reynolds S, eds. Evidence Based Practice: A Critical Appraisal. Malden, Mass: Blackwell Science; 2000.
FROM PHYSICIANS PRACTICE
Five Steps to Improving Patient Access
Judy Capko, May 21, 2013
Patient access is getting increased attention through reform initiatives. Here are five steps you can take to make sure patients get appropriate access to care in your office.
Growing HIPAA Threat – Ignore Windows XP at Your Own Peril
Marion K. Jenkins, May 21, 2013
Chances are good that you have some major ticking software time bombs lurking in your medical practice's computer environment, namely Windows XP and Server 2003.
Finding Physician Work-Life Balance in the Small Moments
Jennifer Frank, MD, May 21, 2013
At my practice and at home, things are always busy. There's laundry or homework, or a patient with needs.
Three Areas to Reduce Costs at Your Medical Practice
Greg Mertz, May 19, 2013
By taking a hard look at reducing costs for staffing, overhead, and technology at your medical practice, you may see increased physician compensation.
Dos and Don’ts for Starting a Physician Blog
Michael Woo-Ming, MD, May 18, 2013
Starting a physician blog can provide your medical practice with marketing benefits, but it's important to do it right.
SearchMedica SEARCH RESULT
Find peer-reviewed literature and websites for practicing medical professionals