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[Evaluation of therapeutics in psychiatry: clinical trials and evaluation of psychotherapies].

Clinical trial methodology is well established in the field of somatic disorders, but what about psychiatric treatments? The situation is relatively clear in the case of psychotropics but opinions diverge when it comes to psychotherapeutic approaches. The author considers four key methodological issues in this setting. What are the treatments to be compared? Which patients should be enrolled? How to evaluate treatment effectiveness? and how to ensure the treatment groups are comparable? The evaluation of treatments used in psychiatry, whether drug-based or psychotherapeutic, should follow a methodology very similar to that used for somatic diseases. Particularly strong similarities exist with the approaches used to evaluate surgical treatments.