E Guthrie1. 1. School of Psychiatry and Behavioural Sciences, Manchester Royal Infirmary.
Abstract
BACKGROUND: A clear distinction has been made between efficacy and effectiveness in relation to the methods of evaluation of new psychological treatments in psychiatry. Efficacy trials target patients with relatively pure conditions, who may not be representative of the patients who are usually referred for psychological treatment in a clinical setting. Few studies have explored the benefits of psychotherapy in patients with complex disorders and enduring symptoms. AIMS: To explore the rationale for the distinction between efficacy and effectiveness, particularly in relation to outcome studies of patients with complex and enduring disorders. METHOD: A narrative review with examples drawn from the literature, and an illustration of a recent naturalistic outcome study which combines features of both efficacy and effectiveness. RESULTS: Studies of patients with complex and mixed disorders can be designed so that they retain internal validity, but also have external validity and are relevant to clinical practice. CONCLUSION: Studies which evaluate psychological interventions should be carried out in populations of patients clinically representative of those who are likely to receive the intervention, should it be shown to be of benefit.
BACKGROUND: A clear distinction has been made between efficacy and effectiveness in relation to the methods of evaluation of new psychological treatments in psychiatry. Efficacy trials target patients with relatively pure conditions, who may not be representative of the patients who are usually referred for psychological treatment in a clinical setting. Few studies have explored the benefits of psychotherapy in patients with complex disorders and enduring symptoms. AIMS: To explore the rationale for the distinction between efficacy and effectiveness, particularly in relation to outcome studies of patients with complex and enduring disorders. METHOD: A narrative review with examples drawn from the literature, and an illustration of a recent naturalistic outcome study which combines features of both efficacy and effectiveness. RESULTS: Studies of patients with complex and mixed disorders can be designed so that they retain internal validity, but also have external validity and are relevant to clinical practice. CONCLUSION: Studies which evaluate psychological interventions should be carried out in populations of patients clinically representative of those who are likely to receive the intervention, should it be shown to be of benefit.
Authors: Rickard E Malmström; Brian B Godman; Eduard Diogene; Christoph Baumgärtel; Marion Bennie; Iain Bishop; Anna Brzezinska; Anna Bucsics; Stephen Campbell; Alessandra Ferrario; Alexander E Finlayson; Jurij Fürst; Kristina Garuoliene; Miguel Gomes; Iñaki Gutiérrez-Ibarluzea; Alan Haycox; Krystyna Hviding; Harald Herholz; Mikael Hoffmann; Saira Jan; Jan Jones; Roberta Joppi; Marija Kalaba; Christina Kvalheim; Ott Laius; Irene Langner; Julie Lonsdale; Sven-Äke Lööv; Kamila Malinowska; Laura McCullagh; Ken Paterson; Vanda Markovic-Pekovic; Andrew Martin; Jutta Piessnegger; Gisbert Selke; Catherine Sermet; Steven Simoens; Cankat Tulunay; Dominik Tomek; Luka Vončina; Vera Vlahovic-Palcevski; Janet Wale; Michael Wilcock; Magdalena Wladysiuk; Menno van Woerkom; Corrine Zara; Lars L Gustafsson Journal: Front Pharmacol Date: 2013-05-14 Impact factor: 5.810