From clinical approach to evidence based medecine in an emergency psychiatric department

The purpose of this report is to discuss the place of << evidence based medicine >> (EBM), in the clinical practice of a psychiatric emergency department. Facing the need of increasing effectiveness, clinicians have difficulties to keep informed and to integrate new data of the literature in their practice. The application of data emerging from EBM in the reality of an emergency unit will be discussed from a clinical and ethical point of view, integrating some economic issues. Surpassing of what we might call the phases of sophism (to deny the interest of the EBM) and of paralogism (overestimating the EBM approach), will allow practicians to envisage quality improvement of care. The establishment of a good compromise between EBM clinical guidelines and the individualization of care according to the personal history of each person mlight be a challenge for emergency units.