MJA
MJA

The 2016 Royal Australian and New Zealand College of Psychiatrists guidelines for the management of schizophrenia and related disorders

Med J Aust 2017; 206 (11): 501-505. || doi: 10.5694/mja16.01159

Abstract

  • Introduction: The Royal Australian and New Zealand College of Psychiatrists (RANZCP) clinical practice guidelines for the management of schizophrenia and related disorders provide evidence-based recommendations for optimising treatment and prognosis. This update to the 2005 RANZCP guidelines has a greater emphasis on psychosocial treatments, physical health comorbidities and vocational rehabilitation.

  • Main recommendations: The guidelines advise a clinical staging approach and deliver specific recommendations for:•comprehensive treatment using second generation antipsychotic agents continuously for 2–5 years;•early treatment of comorbid substance use;•community treatment after initial contact, during crises and after discharge from hospital;•physical health monitoring and management of comorbidities, particularly metabolic health;•interventions to optimise recovery of social function and return to study or work; and•management of schizophrenia in specific populations and circumstances.

  • Changes in management as a result of the guidelines: The guidelines provide benchmarks against which the performance of services and clinical teams can be assessed. Measuring treatment response and clinical outcome is essential. General practitioners have an important role, particularly in monitoring and reducing the high cardiovascular risk in this population. Clinical services focusing on early detection, treatment and recovery need continuous funding to be proactive in implementing the guidelines and closing the gap between what is possible and what actually occurs.

  • David J Castle1,2
  • Cherrie A Galletly3,4
  • Frances Dark5,6
  • Verity Humberstone7,8
  • Vera A Morgan9
  • Eóin Killackey2,10
  • Jayashri Kulkarni11,12
  • Patrick McGorry13,14
  • Olav Nielssen15
  • Nga T Tran1,2
  • Assen Jablensky9,16,17

  • 1 St Vincent's Hospital, Melbourne, VIC
  • 2 University of Melbourne, Melbourne, VIC
  • 3 University of Adelaide, Adelaide, SA
  • 4 Northern Mental Health, Adelaide, SA
  • 5 Metro South Health, Brisbane, QLD
  • 6 University of Queensland, Brisbane, QLD
  • 7 Northland District Health Board, Whangarei, New Zealand
  • 8 University of Auckland, Auckland, New Zealand
  • 9 University of Western Australia, Perth, WA
  • 10 Orygen Youth Health, Melbourne, VIC
  • 11 Alfred Health, Melbourne, VIC
  • 12 Monash University, Melbourne, VIC
  • 13 National Centre of Excellence in Youth Mental Health, Melbourne, VIC
  • 14 headspace National Youth Mental Health Foundation, Melbourne, VIC
  • 15 Macquarie University, Sydney, NSW
  • 16 Medical Research Foundation, Royal Perth Hospital, Perth, WA
  • 17 Centre for Clinical Research in Neuropsychiatry, University of Western Australia, Perth, WA

Correspondence: david.castle@svha.org.au

Acknowledgements: 

We thank Susie Hincks, Lived Experience Advisor for her contribution to the guidelines.

Competing interests:

No relevant disclosures.

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