Saddichha Sahoo, Chaturvedi Santosh K
NWMH, Melbourne Health, 4a Devonshire Road, Sunshine, VIC 3020, Australia.
Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore 560029, India.
ISRN Psychiatry. 2014 Mar 31;2014:828917. doi: 10.1155/2014/828917. eCollection 2014.
The discipline of psychiatry has a plethora of guidelines, designed to serve the needs of the clinician. Yet, even a cursory glance is enough to discern the differences between the various guidelines. This paper reviews the current standard guidelines being followed across the world and proposes a unified guideline on the backbone of current evidence and practice being followed. The algorithm for pharmacological and psychosocial treatment for bipolar disorder, major depressive disorder, and schizophrenia is formulated after cross-comparison across four different guidelines and recent meta-analytical evidence. For every disorder, guidelines have different suggestions. Hence, based on the current status of evidence, algorithms have been combined to form a unified guideline for management. Clinical practice guidelines form the basis of standard clinical practice for all disciplines of medicine, including psychiatry. Yet, they are often not read or followed because of poor quality or because of barriers to implementation due to either lack of agreement or ambiguity. A unified guideline can go a long way in helping clear some of the confusion that has crept in due to the use of different guidelines across the world.
精神病学学科有大量指南，旨在满足临床医生的需求。然而，即便只是粗略一看，也足以辨别出各种指南之间的差异。本文回顾了世界各地目前遵循的标准指南，并在现有证据和实践的基础上提出了一项统一指南。双相情感障碍、重度抑郁症和精神分裂症的药物治疗和心理社会治疗算法是在对四项不同指南及近期荟萃分析证据进行交叉比较后制定的。对于每种疾病，各指南都有不同建议。因此，根据现有证据状况，将各种算法进行整合，形成了一项统一的管理指南。临床实践指南构成了包括精神病学在内的所有医学学科标准临床实践的基础。然而，由于质量欠佳，或者因缺乏共识或表述模糊而存在实施障碍，这些指南常常未被阅读或遵循。一项统一指南对于消除因世界各地使用不同指南而逐渐产生的一些困惑大有帮助。
