Schizophrenia practice guidelines: international survey and comparison.

BACKGROUND Schizophrenia guidelines differ considerably in methodology and content. AIMS To systematically compare national schizophrenia guidelines from different countries. METHOD An international survey was conducted on guideline development and a methodological comparison was made using a validated guideline appraisal instrument (the Appraisal Guideline Research and Evaluation Europe). RESULTS The methodological quality of many schizophrenia guidelines was at best moderate. Few guidelines had included key stakeholders in their development process. Although pharmacotherapy recommendations were similar, there were strong variations in the type of psychosocial interventions recommended. CONCLUSIONS The methodological quality of guidelines has a strong influence on their applicability. However, the lack of financial means to develop and implement guidelines is a serious problem. Independent international organisations could contribute to defining a core set of unbiased schizophrenia treatment recommendations. In countries with a shortage of resources, this could be a basis for adaptation to different cultural and economic backgrounds in collaboration with stakeholders.