Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the management of schizophrenia and related disorders.
OBJECTIVE
This guideline provides recommendations for the clinical management of schizophrenia and related disorders for health professionals working in Australia and New Zealand. It aims to encourage all clinicians to adopt best practice principles. The recommendations represent the consensus of a group of Australian and New Zealand experts in the management of schizophrenia and related disorders. This guideline includes the management of ultra-high risk syndromes, first-episode psychoses and prolonged psychoses, including psychoses associated with substance use. It takes a holistic approach, addressing all aspects of the care of people with schizophrenia and related disorders, not only correct diagnosis and symptom relief but also optimal recovery of social function.


METHODS
The writing group planned the scope and individual members drafted sections according to their area of interest and expertise, with reference to existing systematic reviews and informal literature reviews undertaken for this guideline. In addition, experts in specific areas contributed to the relevant sections. All members of the writing group reviewed the entire document. The writing group also considered relevant international clinical practice guidelines. Evidence-based recommendations were formulated when the writing group judged that there was sufficient evidence on a topic. Where evidence was weak or lacking, consensus-based recommendations were formulated. Consensus-based recommendations are based on the consensus of a group of experts in the field and are informed by their agreement as a group, according to their collective clinical and research knowledge and experience. Key considerations were selected and reviewed by the writing group. To encourage wide community participation, the Royal Australian and New Zealand College of Psychiatrists invited review by its committees and members, an expert advisory committee and key stakeholders including professional bodies and special interest groups.


RESULTS
The clinical practice guideline for the management of schizophrenia and related disorders reflects an increasing emphasis on early intervention, physical health, psychosocial treatments, cultural considerations and improving vocational outcomes. The guideline uses a clinical staging model as a framework for recommendations regarding assessment, treatment and ongoing care. This guideline also refers its readers to selected published guidelines or statements directly relevant to Australian and New Zealand practice.


CONCLUSIONS
This clinical practice guideline for the management of schizophrenia and related disorders aims to improve care for people with these disorders living in Australia and New Zealand. It advocates a respectful, collaborative approach; optimal evidence-based treatment; and consideration of the specific needs of those in adverse circumstances or facing additional challenges.
Discipline of Psychiatry, School of Medicine, The University of Adelaide, SA, Australia Ramsay Health Care (SA) Mental Health, Adelaide, SA, Australia Northern Adelaide Local Health Network, Adelaide, SA, Australia cherrie.galletly@adelaide.edu.au.
Cherrie
C
Galletly
Department of Psychiatry, St Vincent's Health and The University of Melbourne, Melbourne, VIC, Australia.
David
D
Castle
Rehabilitation Services, Metro South Mental Health Service, Brisbane, QLD, Australia.
Frances
F
Dark
Mental Health and Addiction Services, Northland District Health Board, Whangarei, New Zealand.
Verity
V
Humberstone
Centre for Clinical Research in Neuropsychiatry, School of Psychiatry and Clinical Neurosciences, The University of Western Australia (UWA), Crawley, WA, Australia.
Assen
A
Jablensky
Orygen - The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia The University of Melbourne, Melbourne, VIC, Australia.
Eóin
E
Killackey
The Alfred Hospital and Monash University, Clayton, VIC, Australia Monash Alfred Psychiatry Research Centre, Melbourne, VIC, Australia.
Jayashri
J
Kulkarni
Orygen - The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia The University of Melbourne, Melbourne, VIC, Australia Board of the National Youth Mental Health Foundation (headspace), Parkville, VIC, Australia.
Patrick
P
McGorry
Psychiatry, Northern Clinical School, The University of Sydney, Sydney, NSW, Australia.
Olav
O
Nielssen
St Vincent's Mental Health, Melbourne, VIC, Australia Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia.
Nga
N
Tran
D001315:Australia; D019468:Disease Management; D019317:Evidence-Based Medicine / Q000592:standards*; D006801:Humans; D009520:New Zealand; D012559:Schizophrenia / Q000188:drug therapy / Q000628:therapy*; D012955:Societies, Medical
Schizophrenia; first-episode psychosis; management; schizoaffective; treatment