To treat or not to treat? and How to treat? Two questions whose answers are far removed from evidence informed practice in child psychiatry

摘要

Decision making in medicine is not subject to mathematical or physical rules and goes well beyond the existence of evidence. In this issue, based on previous research on the variables that influence clinicians' decisions about ADHD medication, Marina Danckaerts et al. discuss the reliability of the Influences on Prescribing for ADHD Questionnaire (IPAQ) and explore the relationship between questionnaire scores and clinician background and characteristics (Danckaerts et al., this issue). Sixty-eight clinicians from Belgium and the UK were interviewed. Despite the small sample size the authors identified four groups of prescrib-ers-pro-psychosocial; medication focused; unsystematic; and response optimizers-with important differences between pediatricians and psychiatrists. Regardless of their specialty participants received high overall ratings on the rule-based approach subscale, suggesting that clinicians in this sample believe that their prescribing decisions are currently informed by best practice and published guidelines. Unfortunately, I do not believe this is the rule for many treatment decisions in the mental health field.