Psychiatry and Evidence-based Medicine

Authors

  • Marcos Rochedo Ferraz Psicólogo e Doutor em Ciências. Professor associado do departamento de Farmacologia e Psicobiologia do Instituto de Biologia Roberto Alcântara Gomes; UERJ https://orcid.org/0009-0002-3407-158X

DOI:

https://doi.org/10.36489/saudecoletiva.2025v16i103p18300-18311

Keywords:

Evidence-based medicine, Pathologization of life, Psychiatry, Human health

Abstract

Evidence-Based Medicine (EBM) emerged in the 1990s to make medical practice more scientific, replacing decisions based on authority with choices based on empirical data and rigorous studies. Defined as the judicious use of the best available evidence, EBM proposes to integrate scientific research, clinical experience and patient values, promoting shared decisions and reducing errors. Despite its positive impact, it faces criticism regarding the influence of economic and ideological interests, especially in psychiatry, where it can contribute to the pathologization of life. The article concludes that a return to EBM’s original critical spirit is needed, with more rigor and reflection when evaluating evidence, particularly in mental health.

 

References

Sackett, D. L., Rosenberg, W. M. C., Gray, J. A. M., Haynes, R. B., & Richardson, W. S. (1996). Evidence based medicine: What it is and what it isn’t. BMJ, 312(7023), 71–72. https://doi.org/10.1136/bmj.312.7023.71 DOI: https://doi.org/10.1136/bmj.312.7023.71

GRADE Working Group. (2011). GRADE guidelines: 1. Introduction—GRADE evidence profiles and summary of findings tables. Journal of Clinical Epidemiology, 64(4), 383–394. https://doi.org/10.1016/j.jclinepi.2010.04.026 DOI: https://doi.org/10.1016/j.jclinepi.2010.04.026

Djulbegovic, B., & Gordon, G. H. (2017). Progress in evidence-based medicine: A quarter century on. The Lancet, 390(10092), 415–423. https://doi.org/10.1016/S0140-6736(16)31592-6 DOI: https://doi.org/10.1016/S0140-6736(16)31592-6

Freddi, G., & Romàn-Pumar, J. L. (2011). Evidence-based medicine: What it can and cannot do. Annali dell'Istituto Superiore di Sanità, 47(1), 22–25. https://doi.org/10.4415/ANN_11_01_05

Burns, P. B., Rohrich, R. J., & Chung, K. C. (2011). The levels of evidence and their role in evidence-based medicine. Plastic and Reconstructive Surgery, 128(1), 305–310. https://doi.org/10.1097/PRS.0b013e318219c171 DOI: https://doi.org/10.1097/PRS.0b013e318219c171

Holmes, D., Murray, S. J., Perron, A., & Rail, G. (2006). Deconstructing the evidence-based discourse in health sciences: Truth, power and fascism. International Journal of Evidence-Based Healthcare, 4(3), 180–186. https://doi.org/10.1111/j.1479-6988.2006.00041.x DOI: https://doi.org/10.1097/01258363-200609000-00003

Turner, E. H., Matthews, A. M., Linardatos, E., Tell, R. A., & Rosenthal, R. (2008). Selective publication of antidepressant trials and its influence on apparent efficacy. New England Journal of Medicine, 358(3), 252–260. https://doi.org/10.1056/NEJMsa065779 DOI: https://doi.org/10.1056/NEJMsa065779

Stip, E. (2002). Happy birthday neuroleptics! 50 years later: La folie du doute. European Psychiatry, 17(3), 115–119. https://doi.org/10.1016/S0924-9338(02)00639-6 DOI: https://doi.org/10.1016/S0924-9338(02)00639-9

Connolly, S. J., Ezekowitz, M. D., Yusuf, S., Eikelboom, J., Oldgren, J., Parekh, A., ... & Wallentin, L. (2009). Dabigatran versus warfarin in patients with atrial fibrillation. New England Journal of Medicine, 361(12), 1139–1151. https://doi.org/10.1056/NEJMoa0905561 DOI: https://doi.org/10.1056/NEJMoa0905561

Kirsch, I., Deacon, B. J., Huedo-Medina, T. B., Scoboria, A., Moore, T. J., & Johnson, B. T. (2008). Initial severity and antidepressant benefits: A meta-analysis of data submitted to the Food and Drug Administration. PLoS Medicine, 5(2), e45. https://doi.org/10.1371/journal.pmed.0050045 DOI: https://doi.org/10.1371/journal.pmed.0050045

Resende, M. S., Pontes, S., & Calazans, R. (2015). O DSM-5 e suas implicações no processo de medicalização da existência. Psicologia em Revista, 21(3), 534–546. https://doi.org/10.5752/P.1678-9563.2015v21n3p534 DOI: https://doi.org/10.5752/P.1678-9523.2015V21N3P534

Stahl, S. M. (2014). Psicofarmacologia: Bases neurocientíficas e aplicações práticas (4ª ed.). Guanabara Koogan.

Oberlander, V. C., Xu, X., Chini, M., & Hanganu-Opatz, I. L. (2019). Developmental dysfunction of prefrontal-hippocampal networks in mouse models of mental illness. European Journal of Neuroscience, 50(6), 3072–3084. https://doi.org/10.1111/ejn.14466 DOI: https://doi.org/10.1111/ejn.14436

Whitaker, R. (2017). Anatomia de uma epidemia. Editora Fiocruz. DOI: https://doi.org/10.7476/9786557082324

Kirsch, I. (2019). The emperor’s new drugs: Exploding the antidepressant myth (2nd ed.). Basic Books.

Furukawa, T. A., Cipriani, A., Atkinson, L. Z., Leucht, S., Ogawa, Y., Takeshima, N., ... & Salanti, G. (2016). Placebo response rates in antidepressant trials: A systematic review of published and unpublished double-blind randomised controlled studies. BMJ Open, 6(1), e009912. https://doi.org/10.1136/bmjopen-2015-009912 DOI: https://doi.org/10.1136/bmjopen-2015-009912

Fournier, J. C., DeRubeis, R. J., Hollon, S. D., Dimidjian, S., Amsterdam, J. D., Shelton, R. C., & Fawcett, J. (2010). Antidepressant drug effects and depression severity: A patient-level meta-analysis. JAMA, 303(1), 47–53. https://doi.org/10.1001/jama.2009.1943 DOI: https://doi.org/10.1001/jama.2009.1943

De Camargo, K. R. (2010). A economia política da produção e difusão do conhecimento biomédico. In S. Caponi, M. Verdi, F. S. Brzozowski, & F. Hellmann (Orgs.), Medicalização da vida: Ética, saúde pública e indústria farmacêutica (pp. 45–62). Editora Unisul.

Greene, E. M. (2019). The mental health industrial complex: A study in three cases. Journal of Humanistic Psychology, 63(1), 84–102. https://doi.org/10.1177/0022167819830516 DOI: https://doi.org/10.1177/0022167819830516

Fond, G., Gavaret, M., Vidal, C., Brunel, L., Riveline, J.-P., Micoulaud-Franchi, J.-A., ... & Boyer, L. (2020). Pharmaceutical industry marketing strategies influencing prescribing trends in psychiatry: A 10-year prospective study in France. Journal of Clinical Medicine, 9(8), 2406. https://doi.org/10.3390/jcm9082406 DOI: https://doi.org/10.3390/jcm9082406

Moncrieff, J. (2006). Disease mongering and drug marketing: Does the pharmaceutical industry manufacture diseases as well as drugs? EMBO Reports, 7(4), 358–361. https://doi.org/10.1038/sj.embor.7400665 DOI: https://doi.org/10.1038/sj.embor.7400665

Read, J., & Moncrieff, J. (2021). Depression: Why drugs and electricity are not the answer. Psychological Medicine, 52(8), 1401–1411. https://doi.org/10.1017/S0033291721005031 DOI: https://doi.org/10.1017/S0033291721005031

Wouters, O. J., McKee, M., & Luyten, J. (2020). Estimated research and development investment needed to bring a new medicine to market, 2009–2018. JAMA, 323(9), 844–853. https://doi.org/10.1001/jama.2020.1166 DOI: https://doi.org/10.1001/jama.2020.1166

Published

2025-12-23

How to Cite

Ferraz, M. R. (2025). Psychiatry and Evidence-based Medicine. Sa´úde Coletiva (Barueri), 16(103), 18300–18311. https://doi.org/10.36489/saudecoletiva.2025v16i103p18300-18311

Issue

Section

Literature Review