Canadian psychiatry across 5 decades: from clinical inference to evidence-based practice.

OBJECTIVE: To examine the evolution of the epistemological basis of Canadian psychiatry over the last 50 years.

METHOD: A comparison of the content of The Canadian Journal of Psychiatry in its early years, then known as the Canadian Psychiatric Association Journal, with publications from recent years, shedding light on broader trends in psychiatric theory and practice.

RESULTS: A dramatic change has occurred in Journal content, from clinical inference to an evidence-based approach, reflecting stronger biological orientations, as well as empirical psychosocial research.

CONCLUSIONS: Epistemological changes in psychiatry are a positive development. The future should bring an even stronger neuroscience base as well as an evidence-based approach to psychotherapy.