Literature searching for psychiatry - Mental Health - Subject Guide - LibGuides at South Australian Health Library Service

Effective literature searching with examples from psychiatry

PICO basics

Converting an information need into a clinical question

Check before beginning: is your question a foreground question? Background questions such as broad information on a disorder or a treatment are best answered in textbooks and in online clinical tools such as UpToDate. Foreground questions are very specific - such as the adverse effects of a particular drug, or the comparable effectiveness of different treatments.

A foreground question requires a search for evidence in a citation database.
Formulating a precise and answerable clinical question is critical for translating the question into searchable concepts.

PICO

PICO is a mnemonic framework for the four elements of a clinical foreground question. The patient or population, the intervention or treatment we are considering, the comparison of one intervention to another - if this is applicable - and the outcome we are interested in. PICO is just one tool that is particularly suitable for looking at interventions.

Once a well-structured question is formulated, you will be in a better position to effectively search the literature.

The PICO elements only inform the search - not all the elements of the PICO are used in the search. While it's important to consider the outcome in developing an answerable clinical question, we want to undertake a discovery process and so the Outcome element is not used in the search strategy.

Identify the PICO elements in these clinical questions

In individuals with psychotic disorders (including schizophrenia) who require long term antipsychotic treatment, are anticholinergic medications more effective in preventing or reducing extrapyramidal side-effects and/or improving treatment adherence than placebo/treatment as usual?
In children and adolescents with anxiety disorders, what is the effectiveness and safety, considering system issues in low- and middle-income countries, of using pharmacological interventions in non-specialist settings?
Is removing means for self-harm better than no intervention for persons with thoughts or plans of self-harm in the last month or acts of self-harm in the last year?
Is hospitalization better than no hospitalization for persons with self-harm?
In individuals with a first psychotic episode with full remission, how long should antipsychotic drug treatment be continued after remission in order to allow for the best outcomes?
What are the effective maternal mental health interventions to prevent developmental problems in early infancy?
For people with dementia, which cognitive/psychosocial interventions (such as cognitive stimulation, cognitive rehabilitation, reality orientation, reminiscence therapy) when compared to placebo/comparator produce benefits/harm in the specified outcomes?
In people with depressive symptoms (in absence of depressive episode/disorder) - who are in distress or have some degree of impaired functioning - is a problem-solving approach better (more effective in symptom reduction) than treatment as usual?
In individuals with psychotic disorders (including schizophrenia), is the use of two or more antipsychotic medications concurrently more effective and safer than the use of one antipsychotic only?
In individuals with psychotic disorders (including schizophrenia) and bipolar disorders are psychoeducation, family interventions and cognitive-behavioural therapy feasible and effective?
In children and adolescents with anxiety disorders, what is the effectiveness and safety, considering system issues in low- and middle-income countries, of using pharmacological interventions in non-specialist settings?