Summary Australian and New Zealand Clinical Practice Guideline for the Treatment of Schizophrenia 2003

2003 ◽  
Vol 11 (2) ◽  
pp. 136-147 ◽  
Author(s):  
Patrick McGorry ◽  
Eoin Killackey ◽  
Kathryn Elkins ◽  
Martin Lambert ◽  
Tim Lambert ◽  
...  

Objective: To provide a summary of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) Clinical Practice Guideline for the Management of Schizophrenia. Conclusions: Schizophrenia is a complex and misunderstood illness with a poor public image, but it is more treatable than ever before. A new generation of medication and psychosocial therapies, combined with a first generation of service reform, have created an evidence-based climate of realistic optimism. However, the potential for better outcomes and quality of life for people with schizophrenia has not been translated into reality. The gap between efficacy and effectiveness is wider for schizophrenia than for any other serious medical disorder. These guidelines distil the current evidence and make recommendations based on the best available knowledge. They are based on systematic meta-analyses and comprehensive reviews of the evidence, and their validity is supported by their congruence with several recent rigorous and independent guideline statements from the UK and North America.

2016 ◽  
Vol 50 (10) ◽  
pp. 939-1000 ◽  
Author(s):  
Gregory Carter ◽  
Andrew Page ◽  
Matthew Large ◽  
Sarah Hetrick ◽  
Allison Joy Milner ◽  
...  

Nutrition ◽  
2008 ◽  
Vol 24 (10) ◽  
pp. 998-1012 ◽  
Author(s):  
Lyn Gillanders ◽  
Katherina Angstmann ◽  
Patrick Ball ◽  
Christine Chapman-Kiddell ◽  
Gil Hardy ◽  
...  

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e031442
Author(s):  
Carole Lunny ◽  
Cynthia Ramasubbu ◽  
Savannah Gerrish ◽  
Tracy Liu ◽  
Douglas M Salzwedel ◽  
...  

IntroductionGuidelines are systematically developed recommendations to assist practitioner and patient decisions about treatments for clinical conditions. High quality and comprehensive systematic reviews and ‘overviews of systematic reviews’ (overviews) represent the best available evidence. Many guideline developers, such as the WHO and the Australian National Health and Medical Research Council, recommend the use of these research syntheses to underpin guideline recommendations. We aim to evaluate the impact and use of systematic reviews with and without pairwise meta-analysis or network meta-analyses (NMAs) and overviews in clinical practice guideline (CPG) recommendations.Methods and analysisCPGs will be retrieved from Turning Research Into Practice and Epistemonikos (2017–2018). The retrieved citations will be sorted randomly and then screened sequentially by two independent reviewers until 50 CPGs have been identified. We will include CPGs that provide at least two explicit recommendations for the management of any clinical condition. We will assess whether reviews or overviews were cited in a recommendation as part of the development process for guidelines. Data extraction will be done independently by two authors and compared. We will assess the risk of bias by examining how each guideline developed clinical recommendations. We will calculate the number and frequency of citations of reviews with or without pairwise meta-analysis, reviews with NMAs and overviews, and whether they were systematically or non-systematically developed. Results will be described, tabulated and categorised based on review type (reviews or overviews). CPGs reporting the use of the Grading of Recommendations, Assessment, Development and Evaluation approach will be compared with those using a different system, and pharmacological versus non-pharmacological CPGs will be compared.Ethics and disseminationNo ethics approval is required. We will present at the Cochrane Colloquium and the Guidelines International Network conference.


2003 ◽  
Vol 11 (2) ◽  
pp. 129-133 ◽  
Author(s):  
Pierre Beumont ◽  
Phillipa Hay ◽  
Rochelle Beumont ◽  

Objective: To provide a summary of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) Clinical Practice Guideline for the Management of Anorexia Nervosa (AN). Conclusions: Anorexia nervosa affects only a small proportion of the Australian and New Zealand population but it is important because it is a serious and potentially life-threatening illness. Sufferers often struggle with AN for many years, if not for life, and the damage done to their minds and bodies may be irreversible. Anorexia nervosa is characterized by a deliberate loss of weight and refusal to eat. Overactivity is common. Approximately 50% of patients also use unhealthy purging and vomiting behaviours to lose weight. There are two main areas of physical interest: the undernutrition and mal-nutrition of the illness and the various detrimental weight-losing behaviours themselves. Basic psychopathology ranges from an over-valued idea of high salience concerning body shape through to total preoccupation and eventually to firmly held ideas that resemble delusions. Comorbid features are frequent, especially depression and obsessionality. It is inadvisable in clinical practice to apply too strict a definition of AN because to do so excludes patients in the early stage of the illness in whom prompt intervention is most likely to be effective. The best treatment appears to be multidimensional/multidisciplinary care, using a range of settings as required. Obviously, the medical manifestations of the illness need to be addressed and any physical harm halted and reversed. It is difficult to draw conclusions about the efficacy of further treatments. There is a paucity of clinical trials, and their quality is poor. Furthermore, the stimuli for developing AN are varied, and the psychotherapy options to address these problems need to be tailored to suit the individual patient. Because there is no known ‘chemical imbalance’ that causes the illness, no one drug offers relief. There is a high rate of relapse, and some patients are unable to recover fully. Because AN is a psychiatric illness, a psychiatrist should always be involved in its treatment. All psychiatrists should be capable of assuming this responsibility. Because cognitive behavioural methods are generally accepted as the best mode of therapy, a clinical psychologist should also be involved in treatment. Because medical manifestations are important, someone competent in general medicine should always be consulted. The optimal approach is multidisciplinary or at least multiskilled, with important contributions from psychologists, general practitioners, psychiatric nurses, paediatricians, dietitians and social workers.


2003 ◽  
Vol 11 (1) ◽  
pp. 29-33 ◽  
Author(s):  
Gavin Andrews ◽  
Mark Oakley-Browne ◽  
David Castle ◽  
Fiona Judd ◽  
Andrew Baillie ◽  
...  

Objective: To provide a summary of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) Clinical Practice Guideline for the treatment of panic disorder and agoraphobia Conclusions: Evidence-based treatments for panic disorder and agoraphobia are now clear. These conditions are chronic and disabling in nature, are complicated by delayed treatment and the presence of other psychiatric conditions, and the presence of severe agoraphobia is a negative prognostic indicator. Choice of therapy will depend on the skill of the therapist in applying psychological treatments as well as the preferences of the patient, but there is a role for both psychological and evidence-based pharmacological approaches. The present article is a summary version of the comprehensive Clinical Practice Guideline (Australian and New Zealand Journal of Psychiatry, 2003) which was developed in accordance with National Health and Medical Research Council (NHMRC) criteria. It provides a two-page desk-top summary for use in clinical practice. Economic evaluation of the available evidence-based treatments showed that at 1 year the cost of cognitive behaviour therapy (CBT) is less than the cost of the average drug therapy (CBT becomes cheaper than paroxetine at 8 months, than clomipramine at 11 months and cheaper than imipramine at 13 months). During the second and subsequent years the superiority of CBT increases whether or not the drugs are continued. Evidence levels for specific treatments are provided in the comprehensive guideline and placed in the context of overall principles of thorough assessment and quality clinical management.


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