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J Neuropsychiatry Clin Neurosci 13:318-325, August 2001
© 2001 American Psychiatric Press, Inc.


Special Article

Applying Bradford Hill's Criteria for Causation to Neuropsychiatry

Challenges and Opportunities

Robert van Reekum, M.D., F.R.C.P.C., David L. Streiner, Ph.D., C.Psych. and David K. Conn, M.B., F.R.C.P.C.

Received March 7, 2000; revised May 8, 2000; accepted May 25, 2000. From the Department of Psychiatry and Kunin-Lunenfeld Applied Research Unit, Baycrest Centre for Geriatric Care, Toronto; Division of Geriatric Psychiatry, University of Toronto; and Department of Psychiatry, University of Toronto, Ontario, Canada. Address correspondence to Dr. van Reekum, Department of Psychiatry, Baycrest Centre for Geriatric Care, 3560 Bathurst Street, Toronto, ON M6A 2E1, Canada.

Establishing an argument of causation is an important research activity with major clinical and scientific implications. Sir Austin Bradford Hill proposed criteria to establish such an argument. These criteria include the strength of the association, consistency, specificity, temporal sequence, biological gradient, biologic rationale, coherence, experimental evidence, and analogous evidence. These criteria are reviewed with the goal of facilitating an increase in rigor for establishing arguments of causation in neuropsychiatry. The challenges and opportunities related to these criteria in neuropsychiatry are reviewed, as are two important arguments for causation: one for poststroke depression and one for brain injury as a cause of psychiatric disorders.

Key Words: Bradford Hill, Austin • Neuropsychiatry Research • Causation




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