International Scholarly Research Notices

Review Article

Clinical Practice Guidelines in Psychiatry: More Confusion Than Clarity? A Critical Review and Recommendation of a Unified Guideline

Table 3

Comparison of guidelines and unified guideline for the management of schizophrenia.


	APA	Canadian	NICE	Maudsley	Unified

Acute treatment of first episode	SGAs/FGAs	Olanz/Risp/Quet	SGAs/FGAs	SGAs/FGAs	SGAs/FGAs

Prophylaxis	To continue same antipsychotic	To continue same antipsychotic	To continue same antipsychotic	To continue same antipsychotic	To continue same antipsychotic

Duration	Acute phase: 4 to 8 weeks Stabilization phase: up to 6 months Stable phase: up to 1 to 1.5 years in first episode, up to 5–10 years in case of 2 or more episodes, and indefinite for multiple prior episodes or more than 2 episodes in 5 years.	Acute phase: 6 to 12 weeks Stabilization phase: 1 year Stable phase: up to 2 years in first episode and up to 5 years in case of multiple episodes.	Acute treatment to last 2 years No duration of long term treatment indicated	Same as NICE	Acute phase: up to 12 weeks Stabilization phase: up to 12 months Stable phase: 2 years for 1st and 5 years to lifetime for subsequent episodes

Psychosocial management	Family psychoeducation (>9 months), assertive community treatment, supported employment, social skills training, and CBT (16–20 sessions)	Supported employment, family psychoeducation, skills training, and CBT	CBT (16 sessions)/FFT (10 sessions)/Arts therapy/supported employment	No recommendations	Family psychoeducation (>9 months), assertive community treatment, supported employment, social skills training, and CBT (16–20 sessions)

SGAs: second generation antipsychotics; FGAs: first generation antipsychotics; OLZ: Olanzapine; Risp: Risperidone; Quet: Quetiapine; CBT: cognitive behavioral therapy; FFT: family focused therapy.