What’s Evidence-Based Psychiatry?

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Evidence-based psychiatry is a method of studying and treating mental health disorders that relies on knowledge and empirical evidence rather than folk remedies and intuition. There are many different practices across all fields, including psychiatry, that are done mostly because “it’s always been done this way” and not because they are necessarily useful practices. Evidence-based psychiatry practitioners seek to eliminate these practices and use only those supported by empirical evidence. This also includes making sure that empirical data is widely available to both psychiatrists and patients. Evidence-based psychiatry and other types, and other fields of medicine as well, are sometimes studied through meta-analyses by sociologists and philosophers of science.

An important aspect of evidence-based psychiatry that allows practitioners to evaluate the effectiveness of various techniques and to link specific findings to particular techniques is the adoption of rigorous and detailed records. This involves detailing all techniques used, providing quantitative data regarding time and all medications used, and monitoring any changes in the patient’s condition with great detail. This method is in opposition to record keeping methods which are merely anecdotal and lack any quantitative rigor. Any speculation or change in practice in evidence-based psychiatry should be firmly based on quantitative observation, not drawn from speculation based on anecdotal or poorly recorded evidence.

Even in evidence-based psychiatry, the judgment of the individual psychiatrist is very important, as similar symptoms can result from very different disorders. Only by understanding the subtleties of the patient’s condition can the physician make effective judgments about the best treatment options. Psychiatric practices that take into consideration all aspects of the individual patient, including gender, age, and background, fall into the category of “personalized medicine.” Altering treatment methods based on the individual, even if it means treating two people differently for the same condition, does not mean abandoning evidence-based psychiatry. The psychiatrist must consider a number of factors before treating a patient: the important part is to actually take these factors into consideration and not act purely on intuition.

Sociologists and philosophers of science often study the best methods of psychiatric practice through meta-analyses of a variety of different treatment styles. In general, a practitioner, whether practicing medicine in a highly traditional way or based on strict adherence to evidence, will have some successes and some failures. As such, one cannot judge from just one practice whether or not evidence-based psychiatry or some other method is the most effective. The meta-analysis seeks to examine many different practices and, from the information gathered, to determine which method is most effective. Analyzing many different practices allows researchers to draw conclusions that would be impossible from analyzing just one.

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