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Welcome to HeadtoHead

28 Jul, 08 | by BMJ

Welcome to HeadtoHead, the new blog for readers of Evidence-Based Mental Health. If talk of Mozilla, RSS feeds, or Web 2.0 (whatever was wrong with Web 1.0?) leaves you, like me, in a mild state of delirium, here is a quick definition: in a nutshell a blog (short for web-log) is a website that allows you to “post” comments, and then lists those comments in chronological order (I had a tutorial). Why are we blogging at EBMH? Well, the aim is to make the journal more interactive, immediate and responsive to what you, the reader, want. So feel free to join in and comment on any of the journal’s contents, or draw our attention to what else is going on in the world of mental health.

There is plenty to talk about in this issue. In EBMH notebook Hamish McAllister-Williams reviews a review. Not just any review, but the meta-analysis by Irvine Kirsch and colleagues that made headlines in the popular press and also drew fierce criticism from many. Are antidepressants really no better than placebo? Or is it all a matter of interpretation – do you see a full glass or an empty one? Whatever your thoughts on the study, six months later and after so much publicity, has this paper had any effect on your clinical practice or prescribing of antidepressants?

Meanwhile, speaking of meta-analyses, Peter Tyrer, Editor of the British Journal of Psychiatry, wants to knock them off the top rung of the evidence ladder. To muddle my metaphors even further, he views them as ‘interim stations on the evidence journey but never the final destination’. The role of the meta-analysis is to guide us toward undertaking better trials that will in turn provide definitive answers. I’m not sure the Cochranistas would agree.

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