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.