The basis of clinical practice is mainly clinical judgement, that is, the array of knowledge and experiences acquired by clinical professionals throughout their professional trajectory and which is expressed in every action and in the decision-making process in the case of each individual patient.

However, the quantitative and qualitative development of scientific research in the general medical field and in the psychiatric field in particular make it difficult for professionals to remain updated on knowledge that keeps exponentially expanding and diversifying.

Therefore, it is necessary to provide all health care professionals who are involved in the management of patients with schizophrenia with updated and reliable information on the advances provided by research that are applicable to the clinical field. Better use of this information will be ensured if it is expressed as a CPG, meaning it is formulated as “a series of recommendations designed to help health care professionals and patients select the best option in the diagnosis and treatment of specific clinical conditions in specific circumstances”.³⁵

The development of a CPG applicable to schizophrenia and incipient psychotic disorder requires the fulfilment of precise elaboration conditions and a methodology that guarantees a systematic review of available scientific evidence.

Furthermore, the development of a recommendations guideline must necessarily consider the conditions of real clinical practice where recommendations must be applied; that is, all those elements that condition clinical judgement and health care practice, such as the specific characteristics of health care professionals in terms of training, experience and specific technical knowledge; the characteristics of the population cared for, in particular the acceptability of therapeutic proposals and informed consent; and, lastly, the conditions that surround the health care act such as accessibility, availability of resources and material conditions of the care.

For all these reasons, we aim to provide a guideline that responds to both, the technical requirements and methodological rigour in terms of the systematic review and development of recommendations, as well as to the consideration of applicability conditions inherent to our health care setting, and particularly those related to the mental health network of public use.

Objective

The objective of this CPG is to provide recommendations for the management of patients with schizophrenia and incipient psychotic disorder that are preferably applicable in public use mental health services. This CPG develops recommendations on diagnostic, therapeutic and rehabilitation interventions, with the aim of aiding professionals in decision-making. Hence, it aims to tailor treatment to each patient’s specific situation, providing several therapeutic and rehabilitation options for each phase of the disorder and the idiosyncratic characteristics of each patient.

The main users of this CPG are psychiatrists, psychologists, nurses, social workers and educators, occupational therapists, psychiatric aides and other mental health professionals. It may also be useful to family physicians, nurses and other primary care professionals who are involved in the management of patients with schizophrenia.

As in the previous CPG, the working group agreed for the CPG update to focus on adult patients diagnosed with schizophrenia and also to include a new section on early intervention in psychosis, which can initiate in childhood or adolescence and also in adulthood. The CPG provides a broad view of schizophrenia and has addressed the diagnosis, treatment and rehabilitation of this health problem.