EVIDENCE BASED HEALTH-CARE IN OLD-AGE PSYCHIATRY

Objective: The purpose of this article is to present the current statu s and future needs of old age psychiatry in relation to evidence-based health care. Method: The opportunities and difficulties of evidence-b ased medicine as applied to old age psychiatry are described. Depressi on, is used as a specific example. The role of the Cochrane Collaborat ion and of clinical guidelines in dealing with these difficulties are discussed. Results: There has been a tendency for drug studies to focu s on younger age groups and to exclude patients with comorbidity or po lypharmacy. Aspects of clinical management separate from drugs are giv en insufficient attention. The generalizability of current studies is a problem in old age psychiatry. Conclusions: Psychiatry is no less I, art of medicine than any other specialty. Increased attention to studi es of effectiveness, as opposed to efficacy, is indicated. The Cochran e Collaboration is an international network which promotes and conduct s systematic reviews of the effectiveness of health care. Systematic r eviews can increase the generalizability of the current knowledge base and better define the needs for future research.